Information about the hospital system and about getting medical treatment in Germany.

Saturday, 30 December 2006

What are the prices for hospital treatment in Germany?

Since about 5 years, most hospitals in Germany are obliged to follow special government rules for the pricing of their services. A system called DRG (Diagnosis Related Groups) has been installed by law, and must be followed for all patients for whom the costs are covered by social security schemes.

DRGs work as follows: The relevant diagnosis, the medical procedures and any complicating factors that were encountered during the hospital treatment are entered into a special computer programm (called grouper). The system computes a certain relative weight from these factors. (This kind of system is most well known in Australia, from where Germany has adopted it.) So for example the replacement of an old hip endoprothesis without any complications might have a relative weight of 3.027. This factor is multiplied with the so-called base rate for the individual hospital, which is also fixed according to legally defined process and will be in a range between 2600.- and 3000.- Euro. So the DRG-treatment cost in this example would be between 7870.-Euro and 9081.- Euro.

For international patients, some hospitals adopt this system, others use a higher base rate. Some hospitals even abandon the DRG system and calculate their bills on a per day basis: The day can then cost 500.-Euro or more. This is not really within the legal framework, as there is a general rule that treatment prices must be equal for all patients, regardless of their status.

It is important to know, that the DRG price reflects only the hospital costs. If the patient opts to contract for personal treatment by the department chairman, a seperate bill for doctor's services will be added to the hospital bill. These doctor's costs can be between 50% and 100% of the hospital costs.

Further, international patients are usually offered to stay in single-bed rooms. For this add-on, another 40.- to 60.- Euro (or more) per day will be added to the bill. Normal accomodation will be the two-bed room in some hospitals, some hospitals still have 3 or more patients per room. Because international patients often have a different cultural background, accomodation in a single room is advisable. For example, patients from warmer climates (like Arabian countries or Nigeria) will allways find a room cold that is only heated to the normal German standard of 21 °C, and a compromise with a German co-patient will be difficcult.

In some cases, when certain doctors or hospital departments specialize in specific procedures (like artificial spinal disc implantation), they offer all-inclusive rates for these treatments. Of course, they can only do that if the diagnostic information that is made available by the patient prior to the appointment is reasonably complete and up-to-date.

All this makes the pricing situation for international patients rather confusing. It is thus advisable, to employ a patient referral organisation like German Hospital Service Ltd.. They will assist international patients to make the right options regarding treatment and accomodation standards, and they can countercheck the hospital's invoice to make sure it is according to the rules.

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