Planung, Durchführung und Finanzierung einer öffentlichen Aufgabe - dargestellt am Beispiel des Rettungsdienstes

  • Am Beispiel des Rettungsdienstes wird die Frage untersucht, wie eine öffentliche beziehungsweise staatliche Aufgabe sichergestellt werden kann und welche Schwierigkeiten sich für die Bereiche Planung, Durchführung, Finanzierung und Beurteilung der Aufgabenerfüllung im Hinblick auf den Konsens der Beteiligten ergeben. Ganz auf der Grundlage einer Analyse des ökonomischen Systems "Rettungsdienst" werden die Bedarfs- und Angebotsstrukturen dargestellt. Die zugänglichen Datenbestände in bezug auf das Leistungs- und Kostenvolumen des Rettungsdienstes wurden ausgewertet und der Umfang der Leistungs- und Kostendimension abgeschätzt. Zur Verdeutlichung der Mehrstufigkeit des Leistungsprozesses und der institutionellen Aspekte bei der Beurteilung wird ein Phasenmodell vorgestellt. Anregungen für die Ergänzung der praktizierten Verfahren zur Analyse des Rettungsdienstes werden aufgezeigt.
  • It is the purpose of this investigation to look into the following questions: - how to safeguard a collective or public task; and - why is it so difficult to achieve consensus between the parties involved in planning, executing, financing, and evaluating a task. Using the example of the emergency medical services system (EMSS), the consequences are pointed out which result from its qualification as a collective or public task because of its social welfare characteristics. It then emerges that only indirect consequences for the organization of the task can be derived from this qualification since the respective terms employed are of a problem illustrating nature rather the of a problem solving one. EMSS as part of the system of social goods turns out to be a mixed good case associating option demand which generates both (collective) benefits by providing option service and assuring supply and (individual) benefits for the actual use. Regarding its utilization, EMSS additionally represents a good of merit wants: nobody may be excluded from using the service. However, due to the multidimensional functions of the system considerable difficulties result with respect to the methodology of collecting, classifying and evaluating its various benefit components. From the industrial management point of view, EMSS produces personal interactive services. However, the problem is that there are not yet any adequate instruments available for analysing this type of services. Because of the special nature of service industries (standby function, marketing of services prior to their supply, presence of the service consumers, process orientation) a mere application of the evaluation methods and criteria used in the sector of manufacturing industries will lead to wrong conclusions. Based on an analysis of the "market" system of EMSS, the offer and demand structures are explained. Since market processes to control the economic behavior are largely lacking nonexistent, external control mechanisms have to be set up. However, this requires precise information about the organization and operation of the system. The existing systems of documentation, cost accounting and financing do not satisfy these requirements at all. As a consequence, the information available about the service and cost volumes remains incomplete. Accessible data stocks have been evaluated and the service and cost dimensions of EMSS calculated. In 1986, the cost of the EMS-helicopter system were estimated at DM 58 million, the basic EMS caused costs estimated at DM 1,284 billion. 70 % of the costs are fincanced on a charge basis by the social insurances. 24,4% of the costs are covered by public budgets and 5,6% of the overall EMSS costs by the EMSS organizations. A comparison with a similar calculation for 1978 revealed that the costs increased by more than 50% as a result of developing, refining and extending EMSS. At the same time, the comparison made evident a structural change in the financing system, shifting the burden onto the social insurances. For a more detailed analysis of the services supplied by EMSS, a step-by-step model is presented enabling a more adequate consideration of the multistage process of service performance and of the institutional aspects associated with the evaluation of EMSS. In conclusion, a variety of suggestions are offered for supplementing the analysis methods practiced.

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Metadaten
Author:Robert F. Kühner
URN:urn:nbn:de:hbz:opus-bast-12487
Series (Serial Number):Forschungsberichte der Bundesanstalt für Straßenwesen, Bereich Unfallforschung (209)
Document Type:Book
Language:German
Date of Publication (online):2015/05/28
Release Date:2015/05/28
Tag:Analyse (math); Erste Hilfe; Finanzierung; Kosten; Leistungsfähigkeit (allg); Organisation; Planung; Wirtschaftlichkeitsrechnung
Analysis (math); Cost; Cost benefit analysis; Efficiency; Financing; First aid; Organization (association); Planning
Institutes:Abteilung Verhalten und Sicherheit im Verkehr / Abteilung Verhalten und Sicherheit im Verkehr
Dewey Decimal Classification:6 Technik, Medizin, angewandte Wissenschaften / 61 Medizin und Gesundheit / 610 Medizin und Gesundheit
collections:BASt-Beiträge / ITRD Sachgebiete / 10 Wirtschaft und Verwaltung
BASt-Beiträge / ITRD Sachgebiete / 84 Personenschäden
Licence (German):License LogoBASt

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