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Inpatient Treatment - a Matter of Social Background in Germany

Hospital financing in Germany is based on the principle of "dual financing": the operating costs of the hospitals, i.e. all costs that arise for treating patients, are financed by the health insurance companies. The investment costs, however, are financed by the federal states. The remuneration of the hospitals by the health insurance companies is based on the DRG system, which is a flat-rate billing system in which inpatient hospital treatments are billed as flat-rate fees, largely regardless of the length of the patient's stay. The DRG system is currently the subject of criticism because it makes it more difficult for children's clinics to cover costs, especially in pediatrics. On the basis of hospital billing data, there is a connection between the socio-economic status of a family and the likelihood of hospitalization in the event of a child's illness. The likelihood of inpatient treatment for certain pediatric diseases is significantly higher in economically weaker federal states. A proportionately higher inpatient treatment capacity is available in the affected federal states for this higher need. Should the poor financial situation of the federal states lead to the number of beds being rationed, the quality of care will deteriorate, especially for these children.