Unterversorgung im deutschen Gesundheitswesen – das unterschätzte Problem

In Germany, we used to talk only about overuse and misuse, but today the German healthcare system is threatened by a new phenomenon: underuse. Missing specialist appointments, hospital closures, supply bottlenecks for medicines - and the costs are rising rapidly. The aim of the 'Autorengruppe Gesundheit' statement is therefore to place this new issue at the centre of public debate. It seems all the more important to draw attention to undersupply given the considerable reticence that can be observed in professional and scientific circles when it comes to this topic. Whereas a few years ago the focus was still on patient orientation and patient-reported outcomes, today, in the style of paternalistic concepts, there is talk of patient control and optimisation. The paper is divided into 7 sections: Clarification of terms, concept of underuse based on the Expert Council's concept of need, systematic approach to the forms of underuse with particular emphasis on access, and then specific presentation in five selected subject areas: general practitioner care, specialist care, hospitals, nursing care and pharmaceutical care. The penultimate chapter deals with the systemic causes of underuse. Finally, some possible solutions are discussed, which will be presented in more detail in subsequent papers.