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Cost-benefit-based determination of the appropriate reimbursement price for medicines in the statutory health insurance system

It is currently becoming apparent that the discount agreements are reinforcing a development that leads to market results that do not do justice to the relative or absolute value of the medicines and thus lead to allocative inefficiencies. Against this background, a proposal for a central approach to controlling the generic drug market, based on a cost-benefit assessment, was developed. The core of the model is that the reimbursement prices in the statutory health insurance are set in such a way that they reflect the benefit ratio of the drugs to each other. In this way, the approach induces a needs-oriented and efficient distribution of scarce resources in drug supply. The approach also offers a pragmatic multi-step scenario with budget neutrality in the introduction phase of the model.

19.10.2008
Importance of cost-benefit assessment in health services research

When it comes to health care research, health economics emphasizes distributing scarce resources in such a way that overall maximum coverage of needs, measured in terms of patient benefit, is achieved. This means providing care as efficiently as possible, while from a medical perspective the most effective measure - regardless of costs - would be preferred. Using ex ante cost-benefit analysis, it is possible to model various alternative courses of action or care concepts. After an appropriate observation period, a re-evaluation of the everyday care data obtained makes sense. The aim is the targeted and continuous optimization of the quality of care, not cost containment. The actual cost-benefit ratio of a implemented care concept can help here. Health care research that focuses only on the costs or only on the benefits cannot result in optimal care from an economic perspective. For this reason, it is important to pay more attention to efficiency through cost-benefit assessment in health care research.

19.10.2008
Quality of care for psoriasis vulgaris in Germany - results of the national care study PsoHealth 2007

There are a variety of treatment options available to treat psoriasis vulgaris. The S3 guideline of the AWMF defines the current standard of treatment. As early as 2005, a Germany-wide study pointed to an undersupply of psoriasis vulgaris. A variety of treatment options are available to treat psoriasis vulgaris. The S3 guideline of the AWMF defines the current standard of treatment. As early as 2005, a Germany-wide study pointed to an undersupply. In the present Germany-wide cross-sectional study, the care situation of patients with psoriasis in Germany was examined in 2007. The following characteristics, among others, were recorded in 142 dermatological practices and clinics: a) Doctor questionnaire: previous therapies and illnesses, clinical characteristics, severity level (PASI), b) Patient questionnaire: quality of life, patient-relevant therapy benefits, satisfaction with care. Eight indicators of the quality of care were developed in an expert consensus. 11.6 % of the 2,009 patients had severe (PASI>20) and 27.4 % had moderate psoriasis (PASI 10-20). The mean PASI was 10.1. 32.2 % of the patients indicated a severely impaired quality of life (DLQI>10), the mean DLQI was 7.5. Almost half (47.3 %) of the patients had already received systemic therapy, among those with severe psoriasis 62.1 %. 20.1 % of the patients had been treated as inpatients in the previous year. On average, the patients were unable to work for 3.4 days per year due to their psoriasis. An improvement in the quality of care compared to 2005 could be seen in all eight indicators. In the present Germany-wide cross-sectional study, the care situation of patients with psoriasis in Germany was examined in 2007. The following characteristics, among others, were recorded in 142 dermatological practices and clinics: a) Doctor questionnaire: previous therapies and illnesses, clinical characteristics, severity level (PASI), b) Patient questionnaire: quality of life, patient-relevant therapy benefits, satisfaction with care. Eight indicators of the quality of care were developed in an expert consensus. 11.6 % of the 2,009 patients had severe (PASI>20) and 27.4 % had moderate psoriasis (PASI 10-20). The mean PASI was 10.1. 32.2 % of the patients reported a severely impaired quality of life (DLQI>10), the mean DLQI was 7.5. Almost half (47.3 %) of the patients had already received systemic therapy, among those with severe psoriasis 62.1 %. 20.1 % of the patients had been treated as inpatients in the previous year. On average, the patients were unable to work for 3.4 days per year due to their psoriasis. An improvement in the quality of care compared to 2005 could be seen in all eight indicators.

19.08.2008
Simulation of processes in the operating room: How standard operating procedures and their simulation improve patient safety

The topic of patient safety has become very important to the population in recent months due to numerous press releases. The risk of errors increases, especially in highly technical work environments, such as the operating room, and with new team structures, such as when moving into a new building. The aim of the study was therefore to develop and evaluate a training program for moving into new buildings that reduces the risk of errors. For this purpose, standardized processes (SOP) were defined, visualized and first discussed with all employees and then simulated in the new building. Before and after the training, the employees were surveyed using questionnaires. As a result of the training, knowledge is improved and team collaboration is improved. Finally, the rate of errors is also significantly reduced. Aviation training programs, such as SOP and simulation, help improve patient safety and team collaboration. They should be part of everyday life in improving patient safety. The topic of patient safety has become very important to the population in recent months due to numerous press releases. The risk of errors increases, especially in highly technical work environments, such as the operating room, and with new team structures, such as when moving into a new building. The aim of the study was therefore to develop and evaluate a training program for moving into new buildings that reduces the risk of errors. For this purpose, standardized processes (SOP) were defined, visualized and first discussed with all employees and then simulated in the new building. Before and after the training, the employees were surveyed using questionnaires. As a result of the training, knowledge is improved and team collaboration is improved. Finally, the rate of errors is also significantly reduced. Aviation training programs, such as SOP and simulation, help improve patient safety and team collaboration. They should be part of everyday life when improving patient safety.

19.08.2008
The perspective for healthcare?

Any change in the German healthcare system that doesn't involve an increase in power or money is met with fierce resistance from those affected. The opportunities and perspectives of the interlocking legislative measures are rarely recognized and appreciated. The following article analyzes the development trends since Blüm's healthcare reform in 1988, highlights possible courses of action at the current time, and […]

19.08.2008
From research to patients

VII Congress for Health Services Research in Cologne

19.08.2008
Health services research in practice

The example of the scientific institute winDiab, which is financed solely by doctors

19.08.2008
The benefit of the discount agreements remains questionable

Discount agreements – current status and impact on healthcare after one and a half years of the GKV-WSG

19.08.2008
“We don’t make decisions based on the highest class of evidence available, but rather the highest class of evidence available.”

Dr. Rainer Hess, the impartial chairman of the Federal Joint Committee, or G-BA for short, in the MVF cover interview

19.08.2008
“The system needs to become more transparent”

The Federal Government Commissioner for Patient Affairs, Helga Kühn-Mengel, in the MVF cover interview

01.06.2008

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