title: [Legal Analysis of the Implementation Rules of Delegation of Home Visits by Family Doctors to Non-Physician Health Professionals: Is the Implementation in Accordance with the Intention of the Law?]
abstract: Objective:Triggered by the AGnES model project of the University Medicine Greifswald, the Code of Social Law V was changed by the German Lower and Upper House of Parliament (Bundestag and Bundesrat) in 2008 so that the delegation of GP's activities to non-physician colleagues was allowed under highly restricted preconditions. Delegated home visits should become an integral part of the standard care in Germany. In this study, the implementation of § 87 para 2b clause 5 SGB V, established in Annex 8 of the Federal Collective Agreement, was checked for its legality in terms of qualification.Methods:The problem was checked with the legal methods of interpretation in pursuance of the norm and the methods of systematic, historic and teleologic interpretation.Results:Even though the Parliament clearly required orientation to the AGnES model project (in order to assure safety and effective care of delegated home visits), self-management in the implementation of the law remained far behind these guidelines. The main outcome of the legal analysis was that the implementation arrangements of the Code of Social Law V are predominantly illegal.Conclusions:The parties of the Federal Collective Agreement have to change the arrangements to meet the requirements of the Parliament and to avoid risks of liability for delegating GPs.
authors.affiliation: Institut für Community Medicine, Universitätsmedizin Greifswald, Greifswald.
authors.forename: T
authors.initials: T
authors.lastname: Ruppel
authors.affiliation: Institut für Community Medicine, Universitätsmedizin Greifswald, Greifswald.
authors.forename: N
authors.initials: N
authors.lastname: van den Berg
authors.affiliation: Institut für Community Medicine, Universitätsmedizin Greifswald, Greifswald.
authors.forename: W
authors.initials: W
authors.lastname: Hoffmann
mesh_terms: D000488:Allied Health Personnel / Q000331:legislation & jurisprudence*; D032022:Delegation, Professional / Q000331:legislation & jurisprudence*; D005194:Family Practice / Q000331:legislation & jurisprudence*; D005858:Germany; D033161:Government Regulation; D019983:Guideline Adherence / Q000331:legislation & jurisprudence; D006699:Home Care Services / Q000331:legislation & jurisprudence*; D006792:House Calls; D010821:Physicians, Family / Q000331:legislation & jurisprudence*