Public Services with Special Consideration of Nationwide Close-to-Home Inpatient Hospital Care

Abstract

We consider the implications of Germany's demographic development on the regional structure of rural hospital care. According to different predictions regional disparities will arise. This will lead to a legal conflict with the German constitution which demands nationwide close-to-home hospital care. This development is a consequence of demographic change, population aging and internal migration.

Because rural hospitals are very important for regional development, sustainable reforms of political and care structures are needed. An "interdisciplinary medical center for in- and outpatient hospital care" (IVZ) as well as an improvement of infrastructure could provide solutions. Furthermore the organizational form of Functional, Overlapping Competing Jurisdictions (FOCJ) could assure an adequate transformation of nationwide close-to-home hospital care.

Keywords: demographic development, FOCJ, inpatient hospital care, interdisciplinary medical center for in- and outpatient hospital care (IVZ), nationwide close-to-home care, public services, regional disparities

JEL Classification: I18, R23