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In his lecture “Regional budgets instead of DRG and individual performance remuneration” Prof. Dr. Andreas Beivers, Professor of Economics and Dean of Studies for Health Economics at the Fresenius University of Applied Sciences in Munich, explains the background and possible future of our current compensation system. He compared a compensation and incentive system to a good navigation system that “somehow gets us where we want to go, preferably efficiently.”
29.11.2021
In June 2021, Schüttig and Sundmacher published the results of a Delphi survey and a retrospective data analysis in the “Monitor Healthcare Research” on how incorrect utilization in emergency rooms can potentially be avoided. They identified emergencies described by the authors as “outpatient-sensitive” and classified them in such a way that treatment could potentially be carried out by contracted doctors on an outpatient basis as part of standard care. As a result of a regression analysis, the authors showed a positive relationship between the proportion of people with a migrant background and the rate of outpatient-sensitive emergencies as defined by them. The authors suspect that this can be explained by cultural differences in the use of hospital emergency rooms, but also by language barriers (Schüttig and Sundmacher 2021). The following article is dedicated to the topic of how often and to what extent such a “language barrier” is to be expected among people with a migrant background and what measures are needed to reduce or perhaps completely eliminate it in the German healthcare system. For this purpose, we use our own research results from the last 25 years in the field of migration research/public health as well as generally accessible data from the Federal Statistical Office.
29.11.2021
At the end of December 2020, Germany began vaccinating the population against Covid-19. By February 2021, several vaccines had already been approved in many countries including Germany [1]. However, until June 2021, the Covid-19 vaccination could only be offered to certain groups of people due to limited vaccine availability. The prioritization was based on the level of risk of severe or fatal courses of Covid-19 disease as well as on the basis of occupational exposure or close contact with vulnerable groups of people. The highest priority was, among others, people over 80 and employees of medical facilities or retirement homes. High priority included people over 70 and people with defined serious chronic illnesses (e.g. dementia or mental disability). Increased priority was given to people over 60 and people with other illnesses (e.g. diabetes mellitus or stroke) [2]. In addition, close contacts of those in need of care and pregnant women had to be prioritized. The vaccination prioritization was lifted nationwide for all vaccines on June 7, 2021. Studies conducted in Germany in 2021 showed a high acceptance rate among healthcare workers [3] and among older people [4].
29.11.2021
Although more and more people are being vaccinated against Covid-19, the weekly number of new cases remains relatively high worldwide. In addition, several SARS-CoV-2 variants have been described (Gómez et al., 2021), and there is a significant risk of repeated waves of Covid-19 in the coming years. In this context, further research is needed to better understand the epidemiology of Covid-19. In recent months, several studies have examined the prevalence of Covid-19 and the characteristics of people diagnosed with the disease. The proportion of people diagnosed with Covid-19 has been found to vary greatly by setting and country (Elimian et al., 2020; Fan et al., 2020; Guerriero et al., 2021; Haimovich et al., 2020; Lusignan et al., 2020; Mani et al., 2020; Pouwels et al., 2021; Santos-Hövener et al., 2020; Shen et al., 2020; Shepard et al., 2021; Sundaram et al., 2021 ). Although these studies have advanced the field, most of them included participants regardless of their potential symptomatology, so little is known about the specific prevalence of Covid-19 in people with common Covid-19 symptoms (e.g. cough, fatigue, or fever) is known. Regarding the sociodemographic and clinical characteristics of people diagnosed with Covid-19, the literature has also provided some contradictory results. For example, one study found that people with diabetes have an increased risk of Covid-19 compared to people without diabetes (Fan et al., 2020), while another study found that this was not the case ( Lusignan et al., 2020). Given these discrepancies, more data are needed on the frequency of Covid-19 diagnosis among individuals with common Covid-19 symptoms, as well as on the sociodemographic and clinical characteristics of this population.
29.11.2021
Nationally and internationally, mathematical models of the infection process in the corona pandemic have had an enormous political impact. However, the model-heavy nature of the political decision-making processes has also been widely criticized. From both a technical and a sociological perspective, criticism of maneuvers appears to be necessary due to numerous indications. The extent to which the performance of government-related epidemic modeling in particular has met the challenges should be critically questioned and evaluated in wider circles. Model uncertainties and the complexity of the problem of the spread of infectious diseases should be given greater attention. There needs to be a deeper awareness that mathematical models cannot replace practical medical experience and classical concepts for controlling complex systems.
29.11.2021
Experiences with the COVID-19 pandemic over the past 1.5 years suggest an improvement in inpatient care for patients with COVID-19. Key goals of inpatient treatment are the restoration and maintenance of adequate oxygenation [1]. Severe complications such as sepsis and acute respiratory distress syndrome (ARDS) must be managed. Mechanical ventilation is an essential measure for critically ill patients. In a few situations, dexamethasone and treatment with monoclonal antibodies may be beneficial. Adjustments to public infection control measures that impact the social life of the population, in line with hospital resources, should be based on improved outcomes. Otherwise, the disease burden would remain unchanged if the same number of hospitalizations represented a smaller proportion of an increasing number of infected individuals.
29.11.2021
The thesis paper author group presents its 4th ad hoc statement with twelve concrete demands that should be initiated on the new health minister's first working day. The group of authors is speaking out at a time when the new appointment at the top of the Federal Ministry of Health makes a new beginning seem possible. As of November 28, 2021, 6:00 p.m
29.11.2021
Health Minister Karl-Josef Laumann, together with the North Rhine-Westphalia Hospital Association, the North Rhine-Westphalian Medical Associations, and representatives of the statutory health insurance funds, presented the key elements of the draft of the new hospital plan for North Rhine-Westphalia. The goal of the new hospital plan is to ensure innovative, quality-oriented, needs-based, and comprehensive inpatient care for all citizens in North Rhine-Westphalia – from metropolitan regions to rural areas – through particularly efficient structures.
22.09.2021
Im Juni dieses Jahres legte die Enquete-Kommission „Zukunft der medizinischen Versorgung in Mecklenburg-Vorpommern“ dem Landtag von Mecklenburg-Vorpommern ihren Abschlussbericht (1) vor. Auf über 180 Seiten wird ein Empfehlungs-Katalog entworfen, wobei einer der Hauptpunkte ist, die medizinische Versorgung für eine Cluster-Region modellhaft zu entwickeln und zu erproben.
22.09.2021
In den Bundestags-Wahlprogrammen der wichtigsten Parteien manifestiert sich im Bereich der Gesundheit mehr und mehr ein Gedanke: Versorgung ist regional. So wollen beispielsweise Bündnis90/Die Grünen ambulante und stationäre Angebote in Stadt und Land besser vernetzen und kommunale Gesundheitszentren aufbauen, während die Linke regionale Gesundheitszentren als Anlaufstelle für eine wohnortnahe Versorgung sieht, die eine ambulante und stationäre Versorgung gewährleisten sollen, die auch die FDP besser vernetzen möchte. Während die CDU/CSU lediglich eine stärkere vernetzte Zusammenarbeit der einzelnen Akteure fördern will, spricht sich die SPD dafür aus, dass es in Kommunen mehr medizinische Versorgungszentren geben soll und Krankenhäuser mehr ambulante Behandlungen anbieten sollen. Dieses für Parteien recht neue Gedankengut hat sich über Jahre entwickelt und ist wohl zu Teilen auch zwei Innovationsfonds-Projekten und deren Protagonisten zu verdanken: zum einen Billstedt/Horn der OptiMedis AG, zum anderen dem allerersten Innovationsfonds-Projekt mit der laufenden Nummer 001 von IGiB-StimMT (1), das sich die große Aufgabe einer „Strukturmigration im Mittelbereich Templin“ vorgenommen hat. In diesem sehr umfassenden und hyperkomplexen Projekt wurden so ziemlich alle genannten Schlagwörter der Wahlprogramme erprobt und evaluiert. Die Frage ist nun, wie und was zuerst der G-BA beschließt und was dann vor allen Dingen die Politik daraus macht.