Background

The economisation of medicine and the associated far-reaching structural changes in the German healthcare system are increasingly influencing medical treatment and decision-making processes. Doctors' actions are increasingly subject to economic evaluation criteria. Economic goals and criteria currently play a central and potentially conflictual role, particularly in paediatrics. Due to structural and specialist characteristics, paediatric clinics and departments for paediatric and adolescent medicine in Germany are in a particularly tense financial situation in the current remuneration system. The primarily economically driven health policy reform processes of recent years are increasingly being criticised for no longer guaranteeing the maintenance of high-quality patient care geared towards the well-being of children in the long term. The endeavour to provide children with professional medical care that meets their special needs and requirements at all times is at odds with financial restrictions, which are making this care increasingly difficult or even impossible in some cases.

Objectives

The aim of this study is to use qualitative methods to identify, typify and provide empirical evidence of existing economically motivated decision-making conflicts between the groups of actors involved in the medical care of children. The identified conflict categories serve as a scientific basis for the development of strategies to avoid and overcome economically motivated conflicts in the field of paediatrics and as a basis for a quantitative follow-up study.