Archive:
15 Jahre sind in unserer heutigen schnelllebigen Zeit ein Zeitraum, den man schon fast als „historisch“ bezeichnen darf und der es auf jeden Fall wert ist, gewürdigt zu werden. Es kann zweifelsfrei festgehalten werden, dass sich die DMP als fester Bestandteil der deutschen Versorgungslandschaft durchgesetzt haben. Derzeit werden von allen Krankenkassen rund 10.000 vom BVA zugelassene DMP angeboten. Praktisch alle Krankenkassen bieten DMP an. Mehr als 76.000 Ärzte sind Teil des DMP-Versorgungsnetzes. Eine nahezu flächendeckende Versorgung mit DMP in ganz Deutschland ist somit sichergestellt.
06.12.2017
Demenz und Diabetes mellitus gehören in Anbetracht der Demographie einer immer älter werdenden Gesellschaft in Deutschland daher zu den großen medizinischen und pflegerischen Herausforderungen. Beide Erkrankungen nehmen nicht nur überdurchschnittlich zu, sie beeinflussen sich zum Nachteil des Patienten auch gegenseitig negativ. Aus diesem Grund ist in der Therapie des Diabetes mellitus beim Patienten mit Demenz die Vermeidung von Stoffwechselentgleisungen (insbesondere von Hypoglykämien) ein primäres Therapieziel. Das „Perlen“-Projekt („Persönliche Lebensdokumentation für Menschen mit Demenz und Pflegepersonen“) entwickelt eine dv-basierte Anwendung (App) zur Erfassung medizinisch- und verhaltensbezogen wichtiger Alltagssituationen von Menschen mit Demenz bzw. Demenz und Diabetes.
06.12.2017
Unsere wichtigsten Ziele sind es, die Qualität der Versorgung zu verbessern, den Menschen Zugang zur medizinischen Versorgung und zum medizinischen Fortschritt zu gewährleisten. Dies wird uns nur gelingen, wenn wir den demographischen Wandel und die Digitalisierung nicht als Bedrohung betrachten, sondern diese Trends als elementare für Zukunftsszenarien nutzen. Wir verspielen unsere Zukunft, wenn wir versuchen, gegen diese Trends anzumanagen: „Don‘t fight the current“ – nicht gegen die Strömung ankämpfen, die Weisheit der Rettungsschwimmer gilt auch für uns, die wir die Zukunft unseres Gesundheitswesens gestalten wollen. Dabei ist gerade die Digitalisierung das Schlüsselelement, um die flächendeckende Gesundheitsversorgung in Zukunft, vor dem Hintergrund des demografischen Drucks, gewährleisten zu können.
06.12.2017
Health services research institutes can come from or be connected to all kinds of scientific disciplines – whether economics, sociology, epidemiology or public health; and a few are affiliated with medical schools. However, it is quite rare for a health services research institute – born in a clinical environment – to develop into a health services laboratory and development platform in the clinical setting, as is the case with the Institute for Health Services Research in Dermatology and Nursing Professions (IVDP) at the University Hospital Hamburg-Eppendorf (UKE) is the case. Its head is Prof. Dr. Matthias Augustin, who also teaches as a university professor for health economics and quality of life research at the University Hospital Hamburg-Eppendorf (UKE), since 2005 founder and head of the Competence Centers for Dermatological Research (CeDeF) and co-director of the Hamburg Center for Health Economics (HCHE) of the UKE and the University of Hamburg as well as a board member of the Center for Health Care Research (CHCR) at UKE.
06.12.2017
“How would you decide?” The pharmaceutical company Takeda asked this at a post-ASH press conference and asked scientists from medicine and medical economics to provide real-life data and results of a multicenter cross-sectional study on the treatment preference of patients with relapsed and/or refractory multiplex Present and analyze myeloma.
06.12.2017
Beim Fachsymposium „Patientenrelevante Endpunkte und Big Data-Ansätze im deutschen Versorgungskontext“ – veranstaltet vom Springer-Verlag unter Vorsitz von Dr. Georg Ralle, dem Generalsekretär des Netzwerks gegen Darmkrebs e. V. – wurde einmal mehr deutlich, wie weit doch die Auffassung von Klinikern, Wissenschaftlern und HTA-Behörden auseinanderliegen. Doch wurde auch ein probater Lösungsweg aufgezeigt, wie künftig besser mit einem patientenrelevanten Endpunkt wie PFS (Progressionsfreies Survival/Überleben) umgegangen werden kann.
06.12.2017
Medical progress and changes in medical care structures result in a changed division of labor between practicing physicians and acute inpatient hospitals. Increasingly, outpatient doctors are also providing medical services that previously required an inpatient stay - such as dialysis or lens operations on the eye. This results in a shift of services from the inpatient to the outpatient care sector, which generates “new” services in the outpatient sector. In the context of this work, these services will be referred to as “station-replacing” services and will be specifically analyzed. In addition, other services can be relocated; namely those that can in principle be provided in both sectors, but are increasingly being provided on an outpatient basis as inpatient care structures are dismantled and due to lower costs. This type of service shift is not examined in this work. The reason for this presentation is the intention to make service shifts from the inpatient to the outpatient sector of the healthcare system the subject of contract medical requirements planning (von Stillfried/Czihal 2015). Shifts in services can be seen in the fact that increases in statutory medical services are particularly visible where a corresponding decrease in inpatient billing and occupancy days is calculated, which was shown for certain diagnoses when outpatient services increased (Czihal et al 2013). A further development of this approach would be conceivable, for example with a presentation of billed services for cases with the relevant diagnoses. In this way, the scope of relocated services could be specified and calculated. Due to comorbidities in outpatient cases and a lack of distinction between main and secondary diagnoses in statutory health insurance billing, services for different diagnoses could be counted multiple times. Increasing outpatient service requirements are calculated for 17 of 20 ICD-10 chapters (Czihal et al 2013.). Since the increasing trend in statutory health insurance services can be found in the majority of diagnostic chapters, it would be helpful for the question to be able to narrow this down to certain “station-replacing” services.
06.12.2017
Bundeswehr missions abroad have become a piece of normality (Frank Bötel 2016). But these missions are accompanied by stressful experiences for the soldiers and consequences for their mental health. For example, 2.9 % of the soldiers deployed in 2009 as part of the ISAF mission in Afghanistan met the DSM-IV-TR criteria for post-traumatic stress disorder 12 months after the deployment (Wittchen et al. 2012). This 12-month prevalence is not only significantly higher compared to the control soldiers who are not deployed, but also compared to the rates of the age- and gender-adjusted German general population (Jacobi et al. 2014). In addition, it must be feared that the prevalence rates of mental illness after foreign assignments in general (Kang and Hyams 2005), and that of post-traumatic stress disorder (PTSD) in particular (Brewin et al. 2012) will even increase over the years. A key task that not only the Bundeswehr but all those involved in the care of mentally ill people have to face is how to deal with soldiers of the Bundeswehr who have become mentally ill as a result of the deployment (Holtherm 2014). From the point of view of care, the situation is made more difficult by the fact that soldiers, after leaving the Bundeswehr, switch to the civilian German care system, in which the vast majority of service providers no longer have any personal experience with the military system. So far, however, there are no meaningful scientific findings for Germany either on the subjective need for care or on the objective need for care of former soldiers who are now in the civilian health system.
06.12.2017
With the Cost Containment Act of 1977 and the reform laws that followed in the years that followed, the legislature attempted to ensure high-quality, needs-based and economically efficient provision of medical services to the population. In order to achieve this goal, various instruments have been developed and used; Above all, it was about making the principle of economic efficiency more valid. However, the aforementioned goal was only partially achieved. The approximately 19 million patients who are admitted to inpatient treatment each year are largely well cared for. On the other hand, it is questionable whether the goal of meeting needs is realized in care practice. The increase in the number of inpatients, the number of procedures and the case mix (CM) in hospitals in Germany that has been observed for years was the reason for the development of several studies with the aim of examining the performance development and its causes to evaluate whether the number of medical services provided corresponds to their actual needs1. The studies were published between 2011 and 2014; They explain the volume developments with, among other things, the demographic development of the population, medical and medical-technical progress as well as the resulting new examination and treatment methods (NUB), the insufficient investment financing by the federal states, and various (false) incentives flat-rate G-DRG fee system and the economic interests of hospitals.
06.12.2017
First of all, it helps to repeat something that goes without saying: the healthcare system is there for the citizens, especially if they are patients, and not the other way around. Patient-centeredness is therefore the consistent alignment of all actors and their services/contributions as well as processes to the needs of patients1. It cannot be ignored that the term patient-centeredness has been devalued through inflationary use. The authors of this article therefore prefer the term patient orientation. This is the path to a healthcare system that actually aligns its services, including drug supply, with the needs of patients and enables targeted and easy access to these services for patients. The term is also interpreted heterogeneously in the literature.