title: The healthcare system and the provision of oral healthcare in European Union member states. Part 1: Germany.
abstract: Germany is the largest member state of the EU, both in terms of population and number of dentists and dental team members, with 80.5 million inhabitants and 69,236 active dentists, 182,000 dental nurses and 54,000 dental technicians in 2012. General dental practitioners in private practice provide almost all oral healthcare under a health insurance scheme. The tradition of compulsory health insurance goes back to the nineteenth century when it was introduced by Bismarck. Today, the majority of the German population (86%) are members of a statutory sick fund which reimburses a legally prescribed standard oral healthcare package provided by dentists in contract with the health insurance system. A smaller number are privately insured. Access to oral healthcare is excellent and 80% of adults visited a dentist in 2013. Healthcare expenditure in Germany has long been considered high. This has led to several reforms in recent years. This paper outlines the system for the provision of oral healthcare in Germany and explains and discusses the latest changes.
authors.affiliation: Head of Department of Prevention and Health Promotion (German Dental Association, BZAEK), Chausseestrasse 13, D-10115 Berlin, Germany.
authors.forename: S
authors.initials: S
authors.lastname: Ziller
authors.affiliation: Visiting Professor University College London Eastman and King's College London Dental Institutes, Visiting Professor, University of Leeds, Honorary Professor, University of Kent.
authors.forename: K E
authors.initials: KE
authors.lastname: Eaton
authors.affiliation: CDO National Institute for Health and Welfare (THL), Helsinki, Finland, Professor in Dental Public Health, Institute of Clinical Dentistry, Arctic University of Norway.
authors.forename: E
authors.initials: E
authors.lastname: Widström
mesh_terms: D000328:Adult; D000368:Aged; D002648:Child; D004245:DMF Index; D003695:Delivery of Health Care / Q000458:organization & administration*; D003729:Dental Care / Q000458:organization & administration*; D004497:Education, Dental; D005062:European Union; D005250:Fees, Dental; D005858:Germany / Q000453:epidemiology; D017048:Health Care Costs; D006801:Humans; D007347:Insurance, Dental; D007348:Insurance, Health / Q000458:organization & administration; D011313:Preventive Dentistry / Q000458:organization & administration; D012051:Reimbursement Mechanisms / Q000458:organization & administration; D014076:Tooth Diseases / Q000453:epidemiology; D000078329:Workforce; D055815:Young Adult