Prof. Dr. Englisch - Logo Prof. Dr. Harald Englisch
 

Leipzig's HBO Ambulancy: Financial Aspects

www.gesundheitsoekonomie.org, www.hbo-leipzig.de
Harald Englisch, Diethelm Kühnert, Leipzig, Germany

In the last year 7 HBO ambulancies were working in East Germany and additional chambers were affiliated at stationary institutions. The health insurances used to reimburse the treatment in Germany for many indications generally, the compulsory insurances paid e.g. 1,7 mill. DM in 1999 [1].
According to the decision of the German board of the insurances and physicians (NUB) the HBO therapy will not longer be paid by the majority of insurances [1].
Only private insurances and the labour co-operatives reimburse the HBO therapy any longer. Patients in Germany are emotionally and financially not prepared for paying important medical therapies from their own budget [2].
The German organisation of HBO chambers went to law against the NUB decision but a final result can be expected in several years only. In the meanwhile all but the Leipzig HBO ambulancy had been forced to close down in East Germany.

In the following we describe the Leipzig approach to continue its work in a difficult surrounding.

The team of the Leipzig ambulancy started working on a bundle of measures, some of them only 1 or 2month ago:
  1. A full-time director is responsible for the commercial aspects, the chief physician has a high reputation.
  2. The income of the employees is connected with the success of the ambulancy.
  3. A communication trainer investigates the processes in the team.
  4. An optimised information structure is mapped into the IT system.
  5. The ambulancy is presented in the internet and at professional flyers.
  6. It is payed for advertisment in regional newspaper and at cars.
  7. A regional football club is sponsored.
  8. Physicians, representatives of patients organisations and the press are invited to trial diving tour.
  9. Remuneration of private doctors according to the table GOÄ for private patients.
  10. We are engaged to convince the insurances that from a health economic point of view the HBO therapy is for some indications very effective in comparison to the standard therapy.

Results:
  1. The regional TV mdr (responsible for a region with about 10 mill. inhibitants) has reported about the ambulancy.
  2. The newspaper for the region of Leipzig LVZ (responsible for a region of about 1 million inhibitants) has reported in a longer article.
  3. The number of patients paying from their own pocket increased remarkably.
  4. A cooperation contract with the municipal hospital of Leipzig is signed.
  5. A chamber associated with this hospital will be opened in the next year.
  6. A Scientific Board for the ambulancy was established.
  7. During the summer 2 diving tours each day took place.

Conclusions:
  1. The health market as a market with very unstable boundary conditions needs a very flexible reaction.
  2. The private HBO chambers can only survive if the economic experiences are shared as well.
  3. The establishment of a non-profit organisation to support the chambers is discussed.
At the beginning of September 2001 the HBO ambulancy in Dresden will be reopened. You are invited to the corresponding Scientific Symposium at December, 14th.

References
[1]Rieser, Sabine: Neue Therapieansätze: Unzulässige Zahlungen, Deutsches Ärzteblatt 98:19, p. A-1224 [POLITIK]
[2]MedWell-Liste Individuelle Gesundheitsleistungen, 2.2 Spitzenmedizin, M400

(To appear in EUBS 2001)