Patient representation

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Patient representation refers to the organized representation of patients' interests in the healthcare system. In Germany, patient participation in the Federal Joint Committee is usually meant. But it also takes place at the state level and in nursing.

Historical background

Since the 1980s there have been initial efforts by the paternalistic health system with “demigods in white” to get responsible patients to participate. With the Statutory Health Insurance Modernization Act , this idea was expanded to include self-administration in the health sector. Previously, the patient associations were allowed to submit comments, now they were actively involved in the negotiations. The new Paragraph 140f provides for this participation in the Federal Joint Committee and in the relevant bodies at state level (Sections 90, 96, 97, 101).

When making decisions, the patient representatives should ensure more transparency and patient orientation, including consideration of aspects of quality of life as well as age, gender and life situation-specific issues of the patients. With the GKV Competition Strengthening Act , patient representatives were granted methodical and legal support. The patient involvement unit in the G-BA started its work in April 2008. When the joint state committee (Section 90a) was introduced in 2012, patient participation was expanded to include it. In 2012, participation in care was also introduced. The first meeting with patient representatives in this area took place in April 2013.

Patient associations

When selecting the associations involved, two criteria are central: first, independence from other interests in the healthcare system (e.g. health insurance companies or pharmaceutical companies) and second, the diversity of patients.

Patient participation in the healthcare system was specified in the Patient Participation Ordinance. There four associations are named, the "relevant organizations". These are:

The German Disability Council is represented in the G-BA by the following organizations:

Participation in long-term care was implemented analogously through the Ordinance on Participation in Need of Long-Term Care. Six associations were named here:

Patient participation in the Federal Joint Committee

Since 2004, patient representatives have also been taking part in the negotiations on self-administration within the framework of the Federal Joint Committee (Section 140f SGB V). Patient representatives are on the one hand those affected from the respective self-help groups and on the other hand patient advisors. With the members represented by these organizations, they reflect the complexity of patient and self-help organizations. Patient representatives in the G-BA have the right to give advice and make proposals, but not to vote.

Patient representation at national level

At the state level, patient representatives are involved in several committees. In the state committee (§ 90 SGB V), admissions committee (§ 96 SGB V) and in the appointment committee (§ 97 SGB V). If a federal state sets up a joint state committee according to § 90a SGB V to control cross-sector care, patient representatives must also be involved.

Patient representation in nursing

Since 2013, representatives of those in need of care have also been able to advise on self-administration of care (Section 118 of the German Social Code Book XI, Ordinance on Participation in Need of Care - PfleBeteiligungsV). The relevant negotiations take place between the federal association of long-term care insurance funds , the federal working group of supra-local social welfare organizations, the federal association of central municipal associations and the associations of long-term care institutions at federal level. There is no permanent body like the G-BA in Health.

See also

Web links

Individual evidence

  1. ↑ Paragraph 140f (PDF; 1.3 MB)