Title : Reasons for the applicability of institutional theory approaches to the specific situation of medical care centers in the context of public health
Abstract:
Introduction: Since their authorization in 2004, Medical Care Centers (Medizinische Versorgungszentren, MVZs) have become an integral component of both the outpatient and inpatient healthcare sectors in Germany. They were introduced to improve interdisciplinary collaboration, strengthen continuity of care, and enhance the efficiency of healthcare delivery. Over the past two decades, MVZs have evolved into a significant organizational form within the German healthcare system, increasingly influencing the provision and coordination of medical services.
Subject of Study: While the legislature’s original objectives have largely been achieved, the rapid expansion and structural transformation of MVZs have generated new economic, organizational, and regulatory challenges. These developments require further scientific analysis and appropriate regulatory responses to ensure sustainable healthcare delivery.
Objectives: This study aims to contribute to the theoretical and practical understanding of MVZs by applying established concepts from institutional economics. The research seeks to demonstrate the relevance of economic theories for analyzing organizational structures, governance mechanisms, and decision-making processes within MVZs.
Methodology: The study employs a conceptual and theoretical approach, examining the transaction cost approach and principal-agent theory as key analytical frameworks. These theories are applied to the institutional and organizational characteristics of MVZs in Germany to assess their explanatory potential regarding contractual relationships, coordination mechanisms, and incentive structures.
Results: The findings indicate that both the transaction cost approach and principal-agent theory are well suited to analyzing MVZs as economically oriented healthcare organizations. These theoretical perspectives provide valuable insights into governance, efficiency, information asymmetries, and the management of complex stakeholder relationships within integrated healthcare settings.
Conclusions and Recommendations for Public Health: By integrating concepts from business administration and institutional economics with healthcare research, this study expands the theoretical foundation for analyzing MVZs. The results contribute to a better understanding of their organizational dynamics and provide a basis for future research and evidence-based health policy decisions aimed at improving efficiency, quality of care, and long-term sustainability within the German healthcare system.
Keywords: Medical Care Centers (MVZs), institutional economics, transaction cost economics, principal-agent theory, healthcare management, healthcare economics, public health.
