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How can real-world data be made available and used in such a way that it benefits all stakeholders involved and, above all, benefits patients? The BMG symposium at the DKVF addressed this question under the title “Real-world data for health services research”. After an introductory lecture by Jana Holland (BMG), Dr. med. Ursula Marschall (Barmer), Prof. Dr. Monika Klinkhammer-Schalke (Tumor Center Regensburg, Institute for Quality Assurance and Health Services Research at the University of Regensburg), Dr. Frank Wissing (Medical Faculty Day), Dr. Jürgen Malzahn (AOK Federal Association), Dr. Christian Dierks (Dierks + Company) position from the perspective of the stakeholders. Dr. Johannes Bruns (German Cancer Society) also took part in the panel discussion.
04.10.2019
For many decades, the treatment of lung cancer has been based on the classic treatment concept, which includes surgery, chemotherapy and radiation therapy. The division into the two diagnoses of small cell and non-small cell lung cancer still exists today, but molecular biological methods ensure increasing genetic differentiation. And so for around one in 10 patients with certain target structures on or in the tumor cells in non-small cell lung cancer, novel targeted therapies are possible. These provide an impressive example of the development in modern oncology.
04.10.2019
Die AOK Nordost gehört nicht nur mit zu den größen gesetzlichen Krankenkassen Deutschlands, sondern seit vielen Jahren auch zu den agilsten und innovationsfreudigsten. Das liegt zum einen in ihrer Historie begründet, die geprägt war von Fusionen und vor allem durch die Herausforderung, aus drei Einzelkassen nicht eine, sondern die gestaltende Versorgerkasse in gleich drei Bundesländern (Berlin, Brandenburg, Mecklenburg-Vorpommern) zu schaffen. Die Person und Konstante hinter diesem Prozess ist seit 2006 Frank Michalak, zuerst Vorstandsvorsitzender der damaligen AOK Brandenburg, ab 2011 dann der AOK Nordost. Nach 13 Jahren im Amt an der Spitze der größten Krankenkasse der Region gibt er nun die Führung in jüngere Hände: ein Grund für einen Blick zurück und nach vorne.
04.10.2019
According to numerous health politicians and officials, the German healthcare system is one of the better ones in the world. However, if you compare the high level of competence of service providers and health scientists with the resources used to provide health care in our country, you can see countless potential for improvement. The star headline from September 5th, 2019 “Doctors demand, people before profit” [Albrecht, 2019] and the debate about hospital care, triggered by the study by the Bertelsmann Foundation [Loos et al., 2019] with the closure of half of the existing hospitals, clearly show that our healthcare system urgently needs a realignment. The design principles presented below for the realignment of the healthcare system are called salu.TOP*. These principles create health and care goals, assign responsibility and provide comprehensive transparency. The system constructed in this way forms a reference for the analysis of the current system, for the identification of the most important optimization options and for the prioritization for concrete redesign.
04.10.2019
Wer Neuruppin in Brandenburg hört, denkt vielleicht zuallererst an den wohl größten Sohn der brandenburgischen Kreisstadt, den gelernten Apotheker und späteren Essayisten und Schriftsteller Theodor Fontane (1819–1898), bekannt durch Romane wie „Effi Briest“ oder Balladen wie „John Maynard“ und „Herr von Ribbeck auf Ribbeck im Havelland“. Doch ohne entsprechendes Hintergrundwissen denkt man eher nicht an ein Thema wie Versorgungsforschung, was sich aber ändern wird. Denn in der überaus großzügig angelegten Residenzstadt im Norden des Landes Brandenburg, deren „raumverschwendende Anlage“ Fontane höchstselbst für eine kleine Provinzialstadt als „bedenklich“ bezeichnete, wird Versorgungsforschung neu gedacht. Dabei geht es weniger um den methodischen Ansatz an sich, sondern vielmehr um die Rolle, die diese Wissenschaftsrichtung in Neuruppin für das Flächenland Brandenburg einnehmen soll. Oder wie es der Präsident der Medizinischen Hochschule Brandenburg Theodor Fontane, Univ.-Prof. Dr. Prof. h.c. Dr. h.c. Edmund A. M. Neugebauer, formuliert: „Der Unterschied zu anderen Herangehensweisen ist, Versorgungsforschung nicht als Add-on, sondern als wesentlichen Bestandteil einer Lösungsstrategie zu sehen.“ Und die ist in der Leitlinie der MHB klar gefasst, die eine Universität sein und werden will, „die sich etwas zutraut, die in Lehre und Forschung mutig neue Wege geht, beherzt Neuland betritt und als Bildungspionier zur Lösung drängender gesellschaftlicher Fragen beiträgt“.
04.10.2019
The Brandenburg Theodor Fontane Medical School (MHB) was founded with the stated aim of training doctors working in the state. This goal has been achieved: the first psychologists and the first doctors will be ready this year, and the number of students will be doubled. In addition, innovative approaches to improving care for the aging population should also be scientifically examined and successful projects for the benefit of patients should be translated into reality. That is exactly the goal of the Center for Health Services Research Brandenburg (ZVF-BB), which was officially launched during the 1st Brandenburg Congress on Health Services Research. Two high-ranking state politicians were there - this shows the great importance of health services research for the state: Dr. Martina Münch, Minister for Science, Research and Culture, and Susanna Karawanskij, Minister for Labor, Social Affairs, Health, Women and Family of the State of Brandenburg.
04.10.2019
„Rund 15.000 junge Menschen zwischen 18 und 39 Jahren erkranken jedes Jahr an Krebs. Obwohl die Heilungsaussichten mit über 80% gut sind, haben Erkrankung und die oft notwendige eingreifende Therapie erhebliche soziale und finanzielle Folgen.“ Dies erklärte Prof. Dr. med. Mathias Freund, der Vorsitzende des Stiftungskuratoriums der Deutschen Stiftung für junge Erwachsene mit Krebs, bei der Vorstellung des gemeinsam mit der DGHO herausgegebenen 16. Bands der Gesundheitspolitischen Schriftenreihe, der einen Schwerpunkt auf die finanziellen und sozialen Folgen der Krebserkrankung bei jungen Menschen legt.
04.10.2019
The aging of society with a significant increase in the number of elderly and very old patients is known to be a socio-political and therefore also a medical challenge (World Population Aging 2017). Older patients usually suffer from several chronic illnesses and therefore have to take numerous medications at the same time: multimorbidity and multimedication, also known as polypharmacy, have therefore long been the focus of medical interest in this context (van den Akker et al. 1998, Kaufman et al. 2002). Therefore, it can be difficult for treating physicians to find the right balance between over- and under-care; It is important to avoid harmful drugs and not to forget cheaper drugs, i.e. to minimize risks (e.g. side effects) but also not to miss opportunities (e.g. fewer strokes) (Maher et al. 2014, Barnett et al. 2012). Older patients continue to be underrepresented in clinical research, so there is little evidence on the appropriateness and safety of many medications in old age (Wehling 2011). To support doctors, the FORTA classification (Fit for The Aged) and from it the FORTA list were developed in a Delphi consensus process (Wehling 2008, Kuhn-Thiel et al. 2014), in which active ingredients are combined with age-relevant indications are rated hierarchically from A (positive) to D (negative) by over 20 medical and pharmacological experts (A-bsolutely, B-eneficial, C-areful, D-on't). The use of the FORTA list was clinically successful in a randomized endpoint study (VALFORTA) and was relatively easy and efficient to teach as a learning tool (Wehling et al. 2016). This evaluation approach is now to be tested and used IT-based as an automated algorithm for medication optimization.
04.10.2019
In the area of incapacity for work (AU), according to Meyer and colleagues, various health insurance companies have noticed a significant increase in the importance of depression in recent years [7]. According to data from the current health report from the Techniker Krankenkasse (TK), there was a significant increase in absences due to psychiatric disorders by more than four fifths between 2006 and 2014. This absenteeism only stagnated at a high level in the years 2014 to 2017. An increase in 90% is reported between 2000 and 2017 [8]. Similar information can be found in the current health report of the German Employee Health Insurance Fund (DAK). DAK data shows that the duration of AU in mental disorders has continuously increased threefold over the last 20 years. In 2017, the number of days absent due to mental disorders increased, albeit only slightly, by 1.5% more than in the previous year [9]. With 16.7% of lost days, mental disorders rank second in terms of the volume of sick days. In the results of the report by the umbrella organization of company health insurance companies (BKK), mental disorders also rank second among the causes of AU with 16.6% of all AU days [10]. By far the most absent days were caused by depression [9, 10].
04.10.2019
As part of the Bertelsmann Foundation's “Reorganization of Hospital Care” project, a target image was developed for the German hospital landscape in 2030, which is primarily based on higher quality requirements without resulting in poorer accessibility. The starting point of the Bertelsmann Foundation's “Reorganization of the Hospital Landscape” project is the assessment, shared by numerous healthcare experts, that the hospital sector in Germany is still characterized by overcapacity, a particularly large number of small hospitals, as well as insufficient concentration and specialization, which lead to deficits in the quality of treatment , an above-average frequency of acquisition of patients via the emergency room as well as the treatment of patients without the need for inpatient treatment (so-called “outpatient-sensitive conditions”), loss of efficiency and sometimes ruinous competition.