Arbeitspapiere Health Services for Children in Denmark , Germany , Austria and Great Britain

This paper compares health services for children in Denmark, Germany, Austria and Great Britain using the following dimensions: (1) coverage, where it is asked under which conditions children are covered by the health care system; (2) access, where the family doctor principle in Denmark and Great Britain is compared with the free choice of doctors in Germany and Austria; (3) organizational structure, which is important for co-ordination and co-operation of service providers and for the possibility of orientating oneself within the health care system; (4) comprehensiveness: level and extent of health services for children; and (5) financing, or how families with children are supported by different principles of financing. The conclusion is that the health insurance systems of Austria and especially Germany take health needs of children into consideration to a lesser extent than the national health systems of Denmark and Great Britain. Due to the closer doctor–patient relationship, the family doctor principle of the national health systems gives children easier access to the health care system, and does a better job of ensuring that parents make use of preventive health measures for their children. On the other hand, the free choice of doctors in the health insurance systems is not considered helpful for building up a close and trusting doctor– patient relationship. Children are especially dependent on good co-operation between different service providers such as general practitioners, paediatricians, child health visitors and school nurses. Co-ordination and co-operation is easier and more targeted at the health of children when services are organized at the local level as in the Danish municipalities and the British districts, while the systems of Germany and Austria are characterized by a more fragmented organizational structure. But even when different health systems regard children differently, the financing principles in all four countries give a clear signal: families shall have no additional costs for securing health care for their children. There is a high financial redistribution from single households to family households in all four health care systems.