Health kiosks: How the German healthcare system is now to become fairer
1,000 health kiosks are to be set up in the next few years and improve access to comprehensive and low-threshold healthcare, especially for disadvantaged population groups – according to the
Federal Ministry of Health
. But what services should health kiosks offer, who runs them, and how does funding work? You can read an overview of all the information on the legislative initiative known so far here!
What is a health kiosk?
Everyone with statutory health insurance has the same entitlement to medical care, regardless of individual requirements such as contributions to the statutory health insurance scheme or place of residence. In reality, however, socioeconomic factors such as income, education and migration background worsen the chances of receiving this basic care show that people with lower incomes and education levels tend to rate their health status worse.
Patients with a migration background, for example, often face high language and bureaucratic barriers in the health care system. People from low-education backgrounds also tend to have lower health literacy and have difficulty understanding specialized medical information. Even though much important information is now translated into both foreign languages and plain language, it still often does not reach those affected.
The government’s legislative initiative to set up 1,000 health kiosks aims to improve access to healthcare in the most structurally weak urban districts and communities in Germany. This will result in one health kiosk per 80,000 inhabitants, serving as a first point of contact for local people’s medical and psychosocial concerns and reintegrating certain socioeconomic groups into the social system.
What services does a health kiosk offer?
Health kiosks should be open to all citizens in principle, but are aimed primarily at people who have more difficult access to medical care. Accordingly, a health kiosk in the future should also provide medical services for which many others go to their family doctor:
- Low-threshold counseling on health issues such as vaccination, infection prevention, preventive care
- Basic diagnostics (blood tests, sexually transmitted diseases, etc.)
- Health promotion groups and courses (e.g. nutrition and exercise)
- Referral to further services and specialists
At the same time, the health kiosk is intended to strengthen the competencies of those affected in the long term and, according to the
Statement
of the Bundesverband für Prävention und Gesundheitsvorsorge e.V. (Federal Association for Prevention and Health Care). as an “interface
interface between medical care and the social environment.
” (Bundesverband Prävention und Gesundheitsvorsorge e.V. in his). Therefore, these offers are also planned in addition:
- Individual promotion of health literacy by the health insurance funds
- Provision of information materials
- Coordination of the institutions in the application for health care services.
- Assistance with booking appointments and other formal matters
Health kiosk in Hamburg a success since 2017
The German-wide initiative is based on a successful model project in Hamburg. Since 2017, a health kiosk in Billstedt/Horn has acted as a contact point for all people in the district. Consultation is offered in German as well as in six other languages.
But also with regard to the
digitization of the health care system
the health kiosk has already proven to be a pioneer. For example, clients can book an appointment for an online video consultation via the website at any time and thus access the services of the district center from home, regardless of location.
A
Study by the University of Hamburg
has proven the success of the concept in Billstedt/Horn in 2021. More than every second insured person has taken advantage of the offer at least once. The effective treatment even led to a 19% reduction in preventable deaths compared to other neighborhoods in Hamburg.
Based on the positive experience with low-threshold health care in the district, the Bundesverband Prävention und Gesundheitsförderung e. V. (Federal Association for Prevention and Health Promotion) has issued a
recommendation
for the adoption of the concept in the state’s standard care.
Health kiosk: Retail clinics from the USA are role models
The concept of health kiosks is not a completely new idea. In the USA, there are already
over 2.000
so-called “
Retail
Clinics
“, which are located in shopping malls and other public places. However, the U.S. counterparts to the health kiosk are privately operated and, like almost all health services in the U.S., are not free to the public.
Nevertheless, the offer is so well received that the market has been growing for years. In Germany, even this additional barrier would be eliminated.
When will health kiosks be implemented nationwide?
At the beginning of September, the Federal Ministry of Health published an initial letter of intent with key data on the project. The financing described, however, is subject to criticism. Thus already expressed
some municipalities
their concerns about the project’s financial viability.
Representatives of private health insurers also do not want to cover the planned 5.5 percent of the costs. Their insureds are not the target audience for the health kiosk, a representative told the South German Newspaper. The umbrella organization of the AOK, however, demanded a financing share of the municipalities of 50 percent.
The medical profession, on the other hand, warns against expensive duplicate structures. He also said the number of health kiosks is too high at 1000 facilities.
It is still unclear when the initiative will be rolled out across the board. The list of benefits also remains unresolved and will depend to a large extent on agreement on the financing issue. The recently published response to a small Union question on health kiosks reveals that there have been no further votes on the bill to date.
However, according to the response, a trial phase and connection to the telematics infrastructure are not yet planned. It is clear that, according to the Federal Ministry of Health, the health kiosk is intended to have a supporting and coordinating effect and to guide those seeking advice into the existing preventive and curative care structures.
In addition, close cooperation with the ÖGD or with physicians in private practice should be ensured.
Who should operate health kiosks?
Municipalities are to be given the right of initiative in the choice of location. If a municipality makes use of this, the respective state association of the statutory health insurance must take the lead in setting up the health kiosk. Otherwise, the SHI funds are to provide the best possible support for the establishment of low-threshold services through the initiative “GKV – Bündnis für Gesundheit” – Gesundheitsförderung und Prävention in allen Lebenswelten (Health Promotion and Prevention in All Environments).
The concept of the health kiosk is informed by the idea of Community Health Nursing. The management of a health kiosk should not be carried out by physicians, but initially by registered nurses. In the medium term, nurses with competences in the field of medicine should also be allowed to take over the management. This is intended to reduce possible fear of contact with doctors.
Bottom line: health kiosks should create equity
Health kiosks are designed to bring basic medical counseling, care, and prevention services to disadvantaged neighborhoods and, with low-threshold, multilingual services, directly target people who otherwise fall through the health care system.
It is not yet clear what health kiosks might look like in the future. However, the pilot project in Hamburg shows that the services are being used and have the potential to improve healthcare for thousands of people and prolong lives.
