Das MDK-Reformgesetz aus dem Jahr 2020 akzentuierte die Rolle des Medizinischen
Dienstes (MD) als unabhängige Institution der Qualitätssicherung im
Gesundheitssystem. Der vorliegende Beitrag vermittelt wesentliche Kenntnisse
allgemeiner Grundsätze der Kompetenzen des MD, seiner Organisation sowie seines
gewachsenen Aufgabenspektrums im Auftrag der gesetzlichen Kranken- und sozialen
Pflegeversicherung einschließlich weiterer Mandanten.
Abstract
As a corporation under public law, the federally established Medical Service (MD)
is an organizationally and substantively independent socio-medical expert
organization. It uses its expertise to support the health and nursing care
insurance companies as well as their associations and other clients from the
healthcare system nationwide in ensuring medical and nursing care within the
social law solidarity community consisting of statutory health and social care
insurance. In relation to the 12.000 employees, the specialist tasks are carried
out by doctors (20.1 %), nursing staff (40.4 %) and members of other suitable
professions in the healthcare sector (5.5 %). With a total of over 2.955.000 GKV
assessments, 13.200 structural audits in hospitals, significantly more than
1.600 on-site quality controls in hospitals, almost 3.000.000 nursing
assessments, almost 21.900 quality inspections in nursing facilities as well as
committee work at state and federal level, the MD assumes a comprehensive
constitutive-constitutional and quality-assuring expert care mandate. The
social-medical service provided, which is committed to the general social law
principles of quality, humanity and cost-effectiveness and is regulated by
guidelines issued by the MD Bund and approved by the Federal Ministry of Health,
is subject to standardized, nationwide quality assurance.
Schlüsselwörter
Medizinischer Dienst - Krankenversicherung - Pflegeversicherung - Qualitätssicherung - Qualitätsmanagement
Keywords
medical service - health insurance - long-term care insurance - quality audit - quality management
