High level of quality in the German health care system

An international comparison found that Germany has the shortest waiting times; laboratory findings are more reliable and more rapidly available; patients have more choices in selecting a doctor; they more rarely experience infections when in hospital; chronically ill patients are more often and more regularly given preventive treatment. Germans are nevertheless much less satisfied with their health service than patients in other countries. This was the result of a recent questionnaire sent to severely ill adults in Canada, Australia, New Zealand, Great Britain, the USA and Germany. According to the study, the weak points in the German care system lie in patient information and in the coordination between different service levels.

These data on care quality were first collected by the Commonwealth Fund (CWF) in 1999. Germany took part for the first time in 2005. The study was managed in Germany by the Institute for Quality and Efficiency in Health Care (IQWiG) (homepage CWF). The study this year concentrated on patients who are particularly dependent on medical care. A representative random sample of patients who had poor health, suffered from a chronic disease or had to have a serious operation in the preceding year were surveyed. In Germany, 1,474 men and women answered an average of 55 questions put by phone. Unusually, everyone asked freely provided information.

As the IQWiG Director Peter Sawicki explained, "The study design permitted a real benchmark comparison between the different participating countries. This made it possible for us to identify specific and correctable deficiencies in care. The overall result for Germany was very good - both nationally and internationally. There was nevertheless room for improvement in some aspects in Germany too".

It was paradoxical that German patients considered that the quality of their health service was high in most individual aspects, but nevertheless considered that basic reforms were desirable. As Sawicki commented, "We are driving a Mercedes, but imagine that we have a broken down Golf." The results of this questionnaire were presented at the health minister conference in Washington on 3-4 November and here too the international participants were puzzled by this discrepancy - which was restricted to Germany. The discussion concluded that German patients regard their health service much more critically than patients in other countries and, in particular, notice the weak points.