Comparison of two Data-Sources for the Assessment of Hospital Admissions of Ambulatory Physicians

Abstract

To health politicians in the Federal Republic of Germany, the number of patients who are referred to hospitals by practice-based physicians should be a figure of high interest. According to recent estimates approximately 75% of all hospital admissions in this country are brought about by referrals of today’s 64,000 practice-based physicians. For 1981, the total number of hospital cases that were induced that way, was about 8.6 millions and the expenditure for their treatment amounted to 31 billion deutschmark. For the purpose of cost containment, health politicians, and particularly sick-fund officials, in Germany find it very attractive to set incentives for doctors in private practices to substitute ambulatory for inpatient care. This implies that these physicians have a degree of freedom in deciding whether a patient has to be referred to hospital or whether he/she can be treated in the ambulatory sector, which is clearly separated from the hospital sector (Leidl 1983). To test assumptions about the possibilities for such substitutions, the collection or availability of reliable data bases on hospital referrals by individual physicians is a prerequisite.