Ko-Produktion im Krankenhaus: Entwicklung eines Verfahrens zur Analyse der Handlungsbedingungen von Patientinnen und Patienten

摘要

Im Zusammenhang mit den aktuellen Veränderungen des Gesundheitssystems gewinnt die aktive Mitwirkung von Patientinnen und Patienten am Prozess der Leistungserbringung erheblich an Bedeutung. Es wird daher vorgeschlagen, diese aktive Mitwirkung in der Ermittlung von Dienstleistungsqualität im Krankenhaus stärker zu berücksichtigen. Hierzu werden Kriterien zur Bewertung der Handlungsbedingungen von Patienten bei der Ko-Produktion im Krankenhaus vorgeschlagen. Es wird von der Entwicklung eines Verfahrens berichtet, das diese Kriterien erfassen soll.%Health services undergo sweeping changes. The financing of the public health system has become a major problem. Chances for savings are seen in the strengthening of the personal responsibility of patients which is realized in the course of the actual reform of the public health system in Germany. This reform comprises the transfer of financial risks to patients as well as the demand for a greater participation of patients at health care. The strengthening of the active participation of patients, however, is not only realized for economic reasons. It is also the result of value change. Paternalistic models of the relationship between physicians and their patients are increasingly complemented by models that grant patients more freedom of choice. Service recipients at interactive service work are as a matter of principle called for as co-producers (that is to say as active participants at the provision of services). With the actual changes of the public health system the role of patients as co-producers is considerably extended. If the active participation of patients in health care is considered, quality of health services goes beyond the quality of services rendered. It is argued that from the perspective of work sciences the quality of health services also comprises the availability of humane conditions for patients in their role as co-producers. However, instruments for the assessment of service quality at the hospital that are available at present do not systematically take the active participation of patients into account. The aim of the article is to present criteria to assess conditions for co-production and to report from the development of an instrument that enables the analysis of these criteria at the hospital.