[Innovative health care models in Germany - success factors, barriers and transferability]

Abstract

Introduction: Safeguarding country-wide health care in Germany requires innovative ideas: a shortage of skilled staff among medical professionals and in long-term care on the one hand contrasts with an increasing number of multi-morbid elderly patients on the other hand. In the "Innovative Health Care Models" project sponsored by the Robert Bosch Foundation a nationwide status review and systematization of innovative approaches to health care was conducted, along with an analysis of the factors that promote or hinder the implementation of a health care model, and a study of the conditions that must be satisfied if successful concepts are to be transferred to other regions.

Methods: After identifying innovative and successfully implemented health care models, data on success factors and barriers for implementation as well as data on conditions of their transferability to other regions were collected during structured telephone interviews and entered into a specifically developed database. Content analysis was used to qualitatively evaluate the interviews.

Results: Interviews with 65 representatives of successfully implemented models with differing organizational structures and priorities were conducted and evaluated. Success factors and barriers were most obvious in the fields of leadership, readiness to participate, relational aspects, personality traits, cooperation and communication, resources and organizational and structural factors.

Discussion: Various regionally linked health care concepts already exist throughout Germany. The barriers, success factors and conditions influencing the transferability of a model to other regions are largely independent of the type of organization. The success of a model is determined by adequate personal and financial resources, sound organizational structures and external support from political and funding bodies.

Keywords: Deutschland; Germany; Gesundheitsversorgung; Organisationsmodell; Versorgungsforschung; health care delivery; health services research; organizational model; qualitative Evaluation; qualitative evaluation.