Patient Hochschulmedizin

Patient university medicine. Changes of the legal framework of university hospitals in the context of the German health reform The situation of university of medicine can be compared to that of ?a servant of two masters“. Issues of performance and financing as well as legal regulations and administrative procedure have their roots in both the academic and the health system. While medical training is unthinkable without hospital practice, the ?supra-maximalist care“ produced by university hospitals is absolutely essential in the interest of public health. Out of the complexity of teaching, research and medical care grow valuable additional results but also above average costs which could reduce the competitiveness of university hospitals, once the change of financing to DRGs as a consequence of health reform is generally applied. The problem is made worse by outdated academic decision structures, by unsuitable buildings and by the lack of public funds for their structural maintenance and modernization. With this situation in mind the Federal States of Germany in the mid nineties began to search for alternative sources of investment and for a more efficient legal framework. The article explores the question which proposed solutions were subjects of discussion and why the concept of a public law institution became the favourite in the end.