also means that hospitals had an interest ill producing high numbers of inpatient days. I remember that in 1971 I was hospitalized because I had an ingrowing too nail, Nowadays they exercise this surgery in an outpatient department. At the time I had to stay in hospital for 17 days! The first week I had to stay in bed and the second week I could go around in a wheelchair. They really knew how to blow it up. Finally I could go home, but only because I asked! In those days the hospital administration and the medical specialists had the same interest namely high numbers of inpatient days.
Screen 30 (hospital organization: after the budget system)
The next phase was entered after the establishment of the budget system. Then the relalive power of medical and administrative staff was in fact turned upside down, Instead of the doctors determining how many patients were being treated and admitted, the administration had to keep the budget in which numbers of admittance and investigations are negotiated upon with the local sickness funds and the private health insurances. For hospital managers, doctors now produced only costs. At the same time specialists had their own negotiations with the health insurance organizations about the numbers of production, that is the numbers of patients they would treat. This complicated the matter a lot. At that time for a doctor more treatment still meant more money because of the fee-for-service system that determined his income. And, of course, there is the question of professional standard. Medical specialists do not base their decision whether a patient should be treated or not on administrative reasons, but on medical ones. They claim that an investigation is necessary, whether the budget allows it or not.
Screen 31 (hospital organization: controlling the cost)
