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297700
Market failure in the German healthcare system: Analysis of the relationship between quality and price in nursing homes
Tuesday, November 18, 2014
Tom Schaal, MPH
,
Department of Public Health, Dresden Medical School, University of Dresden, Dresden, Germany
Tonio Schoenfelder, PhD
,
Department of Public Health, Dresden Medical School, University of Dresden, Dresden, Germany
Joerg Klewer, MD PhD
,
Faculty of Public Health and Nursing Sciences, University of Applied Sciences Zwickau, Zwickau, Germany
Joachim Kugler, MD PhD
,
Department of Health Sciences / Public Health, Dresden Medical School, TU Dresden, Dresden, Germany
In Germany quality assessments are carried out in nursing homes since 2009. The results are published in the shape of grades. The legislator demanded this to enhance competition. The charges are at the same time for each nursing home available online. Economically, services with high quality usually have a higher price than services with low quality. There is scientific disagreement about the dependence of both variables. The aim of the study was to investigate the relationship between both variables with respect to a potential market failure (Pearson’s correlation coefficient; p<0.05). The study included 582 assesment results on nursing homes in Saxony (Germany). The price range was 1.482 USD (xmin=2.033 USD; xmax=3.515 USD) and scores of 1.0 to 2.2 have been assigned. The price and quality variables were not significantly correlated (r=0.019, p=0.646). The results showed that nursing homes are able to offer the same quality services at different prices. Free and fair competition did not occur. Nursing homes with low prices can not fully assert themselves due to the limited number of available nursing places. The lack of a market oriented price function constitutes market failure. The lack of elasticity of demand is a possible cause. The need for a nursing place exists even, if no places in the low price segment are longer available. Consequently, one free and therefore more expensive nursing place is accepted. Changes in the assessment system in 2014 will show, whether in future a competitive market is emerging.
Learning Areas:
Administer health education strategies, interventions and programs
Administration, management, leadership
Advocacy for health and health education
Provision of health care to the public
Systems thinking models (conceptual and theoretical models), applications related to public health
Learning Objectives:
Identify market relationships
Demonstrate unclear pricing of the same services
Evaluate new features of the system in terms of a better competition
Keyword(s): Health Disparities/Inequities, Health Care Access
Presenting author's disclosure statement:Qualified on the content I am responsible for because: In addition to the scientific investigation of the quality development of German nursing homes, I am working in the management of a nursing home operator. Competitive conditions are as familiar to me as the basics of pricing. In addition to appropriate expertise a connection between science and practice is created directly.
Any relevant financial relationships? No
I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines,
and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed
in my presentation.
