Archive:
Commentary by Dr. h. c. Helmut Hildebrandt, healthcare system architect and CEO of OptiMedis AG
03.06.2024
What connects Templin, Prignitz, and Ostprignitz-Ruppin? They share an infrastructure with plenty of room for improvement, a vast landscape, and a small population, many of whom have reached old age. Prignitz stands out in particular: with only 36 inhabitants per square kilometer (as of 2021), the district has the lowest population density of all German districts. Ostprignitz-Ruppin and Templin follow with 40 and 41 inhabitants per square kilometer, respectively. Prignitz and Ostprignitz-Ruppin are also among the structurally weakest areas in Brandenburg and among those with high future risks. Recently, something else has connected the three districts and their municipalities: the Innovation Fund project "ProReVers" (1), which builds on the experiences of the very first Innovation Fund project, IgiB-StimMT (2), but at the same time goes significantly beyond it.
03.06.2024
"In the long run, we will not be able to simultaneously assess and plan for regional needs on a sector-by-sector basis." "Local regional partners are given too little scope for their actions." "We will have to establish entirely new working methods and workflows together." These three quotes from the cover interview with Dr. Sabine Richard, Managing Director of Healthcare at the AOK Federal Association, demonstrate what is important to her: to exert as much influence as possible on the ongoing parliamentary process of the Health Care Strengthening Act (GSVG) in order to "gain more options for shaping healthcare in the regions, not fewer."
03.06.2024
„Es wird zwangsläufig zu einer Neuverteilung der Tätigkeiten zwischen den Gesundheitsprofessionen zur Sicherstellung der Gesundheitsversorgung kommen müssen.” Im Titelinterview mit „Monitor Versorgungsforschung“ spricht sich Prof. Dr. Gabriele Meyer, Professorin für Gesundheits- und Pflegewissenschaften an der Martin-Luther-Universität Halle-Wittenberg sowie ehemaliges Mitglied im Sachverständigenrat zur Begutachtung der Entwicklung im Gesundheitswesen, für eine auskömmliche Förderung der Pflegewissenschaft, vor allem aber für einen besseren Skill- und Grade-Mix, eine bessere Verständigung zwischen den Professionen sowie „im relevanten Umfang” klinisch-akademische Pflegerollen aus.
03.06.2024
The empirically based simulation model proposed here, which equally considers accessibility, patient preference, and capacity, offers, against the backdrop of the state's duty of care and the obligation to use resources economically, a scientific way of relating the importance of care to the need for hospital locations per service group. The simulation model is intended to support hospital planning (here: the allocation of service groups) by the federal states and to create guidelines for rational planning. It is also suitable for the management of financial resources within the framework of hospital reform. It enables impact analysis and does not intend to automate or otherwise impose rigid specifications. The calculations are to be viewed as examples. The weightings of all parameters are variable. However, the accessibility limits and the parameterization of the simulation model should be determined jointly by the federal and state governments in the spirit of a common target vision.
03.06.2024
The COVID-19 pandemic posed major challenges to science and society worldwide. Given the significant scientific uncertainty, decisions had to be made urgently, justified, and risks clearly communicated. It is almost inevitable that assessments can change over the course of such a situation—and retrospectively—and that mistakes happen. In order to avoid repeating past mistakes and instead learn from them for the future, we believe it is particularly important to closely examine, systematically analyze, and controversially discuss the communication and decision-making processes during the pandemic. With this article, we aim to initiate this discussion and, in our view, once again highlight problematic aspects of pandemic and crisis communication by authorities, politicians, and the media in Germany. We are aware that our view of these processes is naturally subjective. We therefore view the presentation and harmonization of complementary perspectives on crisis communication and management as an iterative process that should be continued with further texts.
03.06.2024
The aim of this study was to investigate the prevalence and factors associated with in-hospital mortality in patients with heart failure (HF). This multicenter cross-sectional study was based on data from HF patients from fourteen hospitals across Germany. A total of 19,288 inpatients (15,431 patients) were included (mean age: 79.4 years, 49.9% female). Mortality was 9.7%, increasing from 4.2% in the age group ≤65 years to 15.1% in the age group >90 years. Left heart failure with symptoms at rest, acute renal failure, respiratory failure, pneumonia, and pleural effusion were associated with an increased risk of death. Paradoxically, several chronic cardiovascular and metabolic diseases—including hypertensive heart disease, essential hypertension, pulmonary heart disease, obesity, dyslipidemia, and diabetes—were associated with a lower risk of death as secondary diagnoses. While our study provides a comprehensive snapshot of in-hospital mortality in HF patients, it also highlights the need for further studies to better understand the complex interplay of various risk factors.
03.06.2024
The second part of the review on the diagnosis and care of patients with metabolically associated steatohepatitis (MASH) addresses the challenges and recommendations, taking into account the current S2k guidelines. The diagnostic algorithm focuses on a screening procedure for the early detection of MASH, with primary care physicians playing a key role. Elevated liver function tests or an abnormal fatty liver index (FLI) indicate further testing and, if necessary, referral to a specialist. Early identification is essential, especially in high-risk groups such as individuals with type 2 diabetes, obesity, or metabolic syndrome, to enable preventive action. Comprehensive metabolic diagnostics are a prerequisite for preventing disease progression. However, the care situation in the diagnosis of MASH is characterized by a number of limitations, including the limited application of the screening algorithm and the challenges of making a definitive diagnosis using liver biopsy. The discrepancy between the diagnosed number of MASH cases and the presumed prevalence indicates a significant number of undiagnosed cases, which ultimately leads to therapeutic deficits.
03.06.2024
The aim of the study is to precisely examine the population-normalized treatment costs of orphan drugs. For this purpose, a study examining the treatment costs of orphan drugs for the years 2005 to 2021 was already conducted in 2022. The calculations have now been validated as part of a study update using the identical population. The update enabled inflation adjustment based on the 2022 price index as well as seamless treatment costs after AMNOG assessment and price negotiations for all orphan drugs. The analysis shows that AMNOG fulfills its function as a price regulation instrument for orphan drugs as well. Since the introduction of AMNOG, the inflation-adjusted normalized treatment costs for orphan drugs have decreased both in terms of the introductory price (minus 25% of the total) and the reimbursement amount (minus 6% of the total).
03.06.2024
The potential of organizational ambidexterity for managing digital transformation remains largely untapped in healthcare organizations. In particular, ambidextrous leadership, the ability of leaders to adapt flexibly to change and continually reconfigure employees' competencies across multiple dimensions to create new knowledge and integrate new knowledge into routines, is underutilized in healthcare organizations.