Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.
ADVANCED SEARCH
Log in
Top
The European Journal of Health Economics
Published in: The European Journal of Health Economics 4/2014

01-05-2014 | Original Paper

Explaining differences in remuneration rates of nursing homes in Germany

Authors: Roman Mennicken, Boris Augurzky, Heinz Rothgang, Jürgen Wasem

Published in: The European Journal of Health Economics | Issue 4/2014

Login to get access

Abstract

Remuneration rates of German nursing homes are prospectively negotiated between long-term care insurance (LTCI) and social assistance on the one side and nursing homes on the other. They differ considerably across regions while there is no evidence for substantial differences in care provision. This article explains the differences in the remuneration rates by observable characteristics of the nursing home, its residents and its region with a special focus on the largest federal state of North Rhine Westphalia, in which the most expensive nursing homes are located. We use data from the German Federal Statistical Office for 2005 on all nursing homes that offer full-time residential care for the elderly. We find that differences in remuneration rates can partly be explained by exogenous factors. Controls for residents, nursing homes and district characteristics explain roughly 30 % of the price difference; 40 % can be ascribed to a regionally different kind of negotiation between nursing homes and LTCI. Thirty percent of the raw price difference remains unexplained by observable characteristics.
Footnotes
1
The LTC reform in 2008 (Pflegeweiterentwicklungsgesetz 2008) has increased transparency with regards to quality. From 2009 on, every nursing home is assessed yearly by the Medical Review Board of the Statutory Health Insurance Funds. Results are presented as school grades in so-called “transparency reports” and are publicly available.
 
2
In Germany, employees earning less than 400 € per month are referred to as so-called “mini-jobbers”. People working in a “mini-job” do not need to pay income tax or social insurance. On average, persons having a mini-job are working around 10 h per week [14].
 
3
These interviews were conducted by a consulting agency and co-author Heinz Rothgang in 2007.
 
4
Full results of these interviews are presented elsewhere [15].
 
5
See e.g. Weibler-Villabos and Röhrig (2010) for a comprehensive discussion of the “transparency reports” [20].
 
Literature
1.
Statistisches Bundesamt: Pflegestatistik 2005: Pflege im Rahmen der Pflegeversicherung Deutschlandergebnisse. Wiesbaden (2007)
2.
Statistisches Bundesamt: Kurzbericht: Pflegestatistik 1999 Pflege im Rahmen der Pflegeversicherung—Deutschlandergebnisse. Bonn (2001)
3.
Roth, G., Rothgang, H.: Die Auswirkungen des Pflege-Versicherungsgesetzes auf die Entwicklung der Heimentgelte. Zeitschrift für Gesundheitswissenschaften 7(4), 306–335 (1999)
4.
Rothgang, H., Wasem, J., Greß, S.: Vergütungsfindung auf dem stationären Pflegemarkt in Nordrhein-Westfalen Bestandaufnahme und Alternativen. Universität Duisburg-Essen, Essen (2005)
5.
Häcker, J., König, B., Raffelhüschen, B., Wernicke, M., Wettke, J.: Effizienzreserven in der stationären Pflege in Deutschland: Versuch einer Quantifizierung und Implikationen für die Reform der Gesetzlichen Pflegeversicherung. Zeitschrift für Wirtschaftspolitik 57(1), 92–116 (2008)
6.
Maike, H.: Zur Preisbildung in der stationären Pflege. In: Dräther, H., Jacobs, K., Rothgang, H. (eds.) Fokus Pflegeversicherung: Nach der Reform ist vor der Reform, pp. 201–236. KomPart, Berlin (2009)
7.
Augurzky, B., Krolop, S., Schmidt, H., Terkatz, S.: Pflegeversicherung, Rating und Demografie. RWI Materialien 27, Essen (2006)
8.
Nyman, J.: The effects of market concentration and excess demand on the price of nursing home care. J Ind Econ 42(2), 193–204 (1994)CrossRef
9.
Norton, E.C., Anthony, J.C., Newhouse, J.P.: Chapter 17 long-term care. In: Anthony, J.C., Newhouse, J.P. (eds.) Handbook of Health Economics, Vol. 1, Part 2, pp. 955–994. Elsevier, Amsterdam (2000)
10.
Mukamel, D.B., Spector, W.D.: The competitive nature of the nursing home industry: price mark ups and demand elasticities. Appl. Econ. 34(4), 413–420 (2002)CrossRef
11.
Mukamel, D.B., Spector, W.D., Bajorska, A.: Nursing home spending patterns in the 1990s: the role of nursing home competition and excess demand. Health Serv. Res. 40(4), 1040–1055 (2005)PubMedCentralPubMedCrossRef
12.
Knox, K.J., Blankmeyer, E.C., Stutzman, J.R.: Relative economic efficiency in Texas nursing facilities: a profit function analysis. J Econ Financ 23(3), 199–213 (1999)CrossRef
13.
Forschungsdatenzentren der Statistischen Ämter des Bundes und der Länder. Pflegestatistik; 2007. Antragsnummer 564–2007
14.
Eichhorst, W., Hinz, T., Marx, P., Peichl, A., Pestel, N., Siegloch, S., Thode, E., Tobsch, V.: Geringfügige Beschäftigung: situation und Gestaltungsoptionen. Bertelsmann Stiftung, Gütersloh (2012)
15.
16.
Mukamel, D.B., Spector, W.D.: Nursing home costs and risk adjusted outcome measure of quality. Med. Care 38(1), 78–89 (2000)PubMedCrossRef
17.
Augurzky, B., Mennicken, R., Röhrig, B., Weibler-Villalobos, U.: Bietet ein teureres Pflegeheim auch eine bessere Qualität?—Evidenz aus Rheinland-Pfalz. Gesundheitsökonomie & Qualitätsmanagement 15(6), 292–298 (2010)
18.
Mennicken, R.: Preise und Qualität in Pflegeheimen—Erste empirische Ergebnisse für Deutschland, Das Gesundheitswesen 75(2), 99–101 (2013)
19.
Augurzky, B., Krolop, S., Mennicken, R., Schmidt, H., Schmitz, H., Terkatz, S.: Pflegeheim rating report 2011—Boom ohne Arbeitskräfte? RWI Materialien 68, Essen (2011)
20.
Weibler-Villalobos, U., Röhrig, B.: Methodische Anforderungen an einrichtungsbezogene Qualitätsberichte in der Pflege. Das Gesundheitswesen 72, 780–789 (2010)PubMedCrossRef
Metadata
Title
Explaining differences in remuneration rates of nursing homes in Germany
Authors
Roman Mennicken
Boris Augurzky
Heinz Rothgang
Jürgen Wasem
Publication date
01-05-2014
Publisher
Springer Berlin Heidelberg
Published in
The European Journal of Health Economics / Issue 4/2014
Print ISSN: 1618-7598
Electronic ISSN: 1618-7601
DOI
https://doi.org/10.1007/s10198-013-0483-2

Other articles of this Issue 4/2014

The European Journal of Health Economics 4/2014 Go to the issue

Original Paper

Impact and cost-effectiveness of a universal strategy to promote physical activity in primary care: population-based Cohort study and Markov model

Original Paper

Cost-effectiveness of injectable disease-modifying therapies for the treatment of relapsing forms of multiple sclerosis in Spain

Editorial

Orphan drugs policies: a suitable case for treatment

Original Paper

Effects of health care decentralization in Spain from a citizens’ perspective

Erratum

Erratum to: Distribution of health-related social surplus in pharmaceuticals: an estimation of consumer and producer surplus in the management of high blood lipids and COPD

Original Paper

Comparative cost-effectiveness analysis of oral triptan therapy for migraine in four European countries