Abstracts by key term: framework
The German healthcare system performs well in international comparisons in terms of quality and efficiency, but comparative studies point to existing potential for optimization (Lauerer et al. 2013: 483–491; Manouguian et al. 2010). Trends such as demographic change, which poses new challenges for regional supply security, require a continuous improvement in the supply structure and quality (Stüve 2009: 51–60; Amelung/Wolf 2011: 1566–1572). In order to do justice to this, politicians are calling for stronger networking and cooperation between service providers in the form of integrated care models (Amelung et al. 2009; Mühlbacher 2002). Various studies view interconnected structural, product and process innovations as necessary in order to significantly increase efficiency and effectiveness (Omachonu/Objection 2010: 1-20; Varkey et al. 2008: 382-388; Ilinca et al. 2012: 193 –202). Innovations, which are defined as the successful implementation of a new idea in a way that increases value for some or all participants, are no longer initiated only by individual actors, but are increasingly developed and disseminated in cooperative networks (Akrich et al. 2002: 187-206 ; Varkey et al. 2008: 382–388). With the aim of improving medical care, EU, federal and state policies promote health innovations at all levels, but 40% of these only exist until the start-up funding runs out (Savaya et al. 2008: 478–493). This volatility of improvement initiatives negatively impacts society's support and trust in future projects (Shediac-Rizkallah/Bone 1998: 87-108). The high use of resources during the new introduction creates a legitimate demand for goal achievement and long-term success and increases the interest of stakeholders in the sustainability factor (Edwards et al. 2007: 37–47).