Development of multidisciplinary community-based health care centres in Germany

Context: Medizinische Versorgungszentren (MVZ) are community interdisciplinary health care centres run by physicians, that were first developed in the German ambulatory medical market in 2004. Objectives: The article describes the emergence of MVZ and their roles in the care services ecosystem and compares them to the French "CS" and "MSP" multidisciplinary medical care centres. Methods: This study is based on a review of the literature and 14 visits and interviews. Results: MVZ were developed from the polyclinics of former east Germany. MVZ are mostly created by physicians or hospitals and are characterised by mandatory multidisciplinary teams of physicians. The number of MVZ is increasing and they now have a very wide range of activities, size and locations. Discussion: MVZ provide community-based health care services improving integrated primary care and specialist care and allow hospital to outsource outpatient activities. They also provide patient-centered care and promote internal and external multidisciplinary coordination. MVZ can provide an example for possible changes to private specialist organisation and structuring of hospital services in France, while MSP mainly focus on primary care and only a few specialist CS have been created.