12th MVF Conference "Pandemic Impact on Healthcare" on December 7, 2023 (Part 1) and January 18, 2024 (Part 2)
19.09.2023 13:02
12th MVF Conference "Pandemic Impact on Healthcare: Effects and Consequences of the Pandemic on Healthcare (Part 1) - Findings from Healthcare Research (Part 2)". The conference took place online.
Managers and those responsible
- Self-help / patient associations
- Health insurance (GKV / PKV)
- Institutions of self-government
- Patient representatives
- Doctors and pharmacists
- Health Professions
- Supply manager
- Federal and state politics
- Pharmaceutical and medical technology companies
- Service providers and consultants
Greetings from the editor
Ladies and Gentlemen
Dear Colleagues,
The corona pandemic claimed countless victims worldwide and had serious consequences for societies and the economy. But above all, of course, for people and their families - especially old people, children and young people. How did we in Germany deal with the problems during the pandemic? How good or bad are the results?
There were and are many exciting topics in public, such as masks, vaccinations and their consequences. The role of science in political decisions is also a highly controversial topic. What does health services research have to contribute to this discussion and what results does it deliver?
At this conference organized by “Monitor Health Care Research” in cooperation with the IGES Institute, we want to focus on the effects of the pandemic on health care. How did the political discussion go and how were the decisions made? What was right, what was wrong and how do we need to do better in future pandemics?
We also present health care research evidence on the questions of Corona's impact on excess mortality, on inpatient care and on intensive care with forced ventilation. And we look at collateral damage and long-term effects of the decline in hospital cases during the pandemic.
In particular, we would like to discuss your experiences during the coronavirus pandemic with you! Please participate actively in our 12th specialist conference, which, due to numerous requests – which we respect – was not held in person, but will be held online in two parts (on December 7, 2023, and January 18, 2024).
The congress will be chaired with me by Prof. Dr. Bertram Häussler, head of the IGES Group and key source of ideas for the congress.
Your Prof. Dr. Reinhold Roski,
Publisher “Monitor Health Services Research”
Contact
If you have any questions about the workshop congress, please contact Anke Heiser
- per email to [email protected] or
- by phone at 0228 – 76368033
Speakers & Lectures
Here you will find the speakers (in chronological order) of the MVF specialist conference "Pandemic Consequences" (Part 1), which took place online on December 7, 2023. The second part of the online conference will also take place online on January 18, 2024, starting at 2 p.m. The presentations and their audio recordings are available open access to all interested parties. We would, of course, welcome any new subscribers who show that our work is valued. You can read the documentation of the event in the MVF issues (January and February 2024).
Speakers
Prof. Dr. Reinhold Roski,
MVF editor
Speaker
Sabine Dittmar MdB, Parliamentary State Secretary to the Federal Minister of Health
Corona pandemic – effects on health policy
Speaker
Prof. Dr. Bertram Häussler, IGES
Effects of the corona pandemic – an overview
Abstract:
The starting point for the topic of this specialist conference is the unexpected effect that the pandemic had on the healthcare system: the impetus for a sustained decline in the volume of hospital treatment. It is important to examine all branches of this chain of effects in order to learn from the once-in-a-century event Covid-19 for the German care system. This specialist conference is intended to contribute to this.
So that the epoch-making nature of the pandemic is not lost sight of, we should also remember the many other effects that can be attributed to the pandemic or the measures that were intended to combat it.
It is being discussed whether the lack of evidence at the time when measures are implemented or the retrospective view (“it wasn't that bad after all”) can be used as absolute evaluation criteria.
Speaker
Prof. Dr. Matthias Schrappe, University of Cologne
Politics: Fear instead of information?
Abstract:
The control and control (infection control) of an infectious disease that is spreading at an epidemic level is the classic: double complexity of complex facts and complex intervention.
In terms of influencing factors, health services research differentiates between the individual level (behavior), the professional level (professionals in the healthcare system), the organizational level (institutions) and the political level.
The latter has various means at its disposal to fulfill its tasks (establishing cooperation, prioritization, conveying values) (legal order, crucial: setting up measurement concepts, forming treatment and network structures, communication with the population).
During the Corona pandemic, long- and medium-term developments in the understanding of politics have increased, which favor linear top-down concepts under the term TINA (there is no alternative) and other concepts (in particular evidence-based, individual self-determination, dealing with corporatist ones structures). When controlling, instruments such as fear, moralization and conformity are consciously and officially used. A scientistic, purely scientific understanding of science (“the” science, the “war against the virus”) is used for legitimation, other scientific approaches are excluded.
Against this background, the element of “fear” is systematically presented in the lecture and reflected with a concept that focuses on the individual responsibility of the informed citizen.
Theme
Panel discussion 1: Consequences for politics (Moderator: Prof. Dr. Reinhold Roski, MVF)
Speakers
Prof. Dr. Maria Blettner/PD Dr. Daniel Wollschläger, University Medical Center Mainz
Was there actually excess mortality due to Covid-19? –
Methods and data
Abstract:
The extent to which COVID-19 illnesses have causally led to additional mortality has been controversially discussed. The estimate of excess mortality was associated with the expectation of obtaining an indicator for mortality attributable to COVID-19 that can be calculated quickly on the basis of reliably collectible data.
As a result, estimates of excess mortality in international comparisons were used to assess the effectiveness of measures to contain the pandemic. However, a number of published evaluations of excess mortality sometimes showed significant differences from one another, suggesting different conclusions.
Based on our own modeling for Germany and especially for Rhineland-Palatinate, we show how different methods and data sources taken into account affect the results.
We come to the conclusion that there was significant COVID-19-related excess mortality in Germany during the pandemic, regionally and for certain periods of time.
On the other hand, a global, regional and highly aggregated statement on excess mortality over a long period of time does not seem to make sense.
The methods for estimating excess mortality remain relevant to public health even after the pandemic for analyzing the effects of heat waves.
Speaker
Prof. Dr. Ralf Kuhlen, Helios Health and IQM, Berlin
Effects of the SARS-CoV-2 pandemic on inpatient care
Abstract:
The Quality Medicine Initiative (IQM), founded in 2008, includes more than 500 member hospitals in Germany and Switzerland, which measure and transparently present quality indicators using a clearly defined analysis of routine data. In this way, they make potential for improvement in medical treatment visible and promote the quality of treatment with active error management - peer review.
IQM used its many years of expertise in dealing with inpatient care data during the pandemic to carry out a timely analysis of the care situation in the member hospitals and to make this available to the public.
The numbers of Covid cases treated as inpatients, intensive care and ventilation cases, as well as the hospital mortality rate for these cases were published at various points in the pandemic. The influence of the pandemic on other non-Covid-related hospital cases was also described.
Such analyzes from routine data provide an excellent and very timely basis for monitoring the entire supply situation during the pandemic, which, in combination with the data on the infection situation, offers an excellent basis for holistic control during the pandemic. The IQM data will be presented and discussed in the lecture.
Speaker
Prof. Dr. Dieter Köhler, former medical director of Kloster Grafschaft Hospital
Intensive care: What did forced ventilation bring?
Abstract:
At the beginning of the pandemic, the WHO recommended intubation and mechanical ventilation at high respiratory rates and oxygen saturation (SO2) below approximately 92 %. Non-invasive ventilation (NIV) was discouraged. As a result of the so-called strategic early intubation, over 80 % patients died in the intensive care units, including younger patients. This was due to the requirements to achieve an SO2 of approx. 92 % again through ventilation and oxygen administration.
Although practiced in many intensive care units for years, there is no pathophysiological justification for intubation and ventilation in isolated hypoxemia (usually pneumonia as in COVID-19). The number of oxygen molecules, which is only reflected in the oxygen content (SO2 and Hb value), is crucial for the supply of the organism.
Both are equivalent for oxygen supply. This corresponds to e.g. B. a decrease in the Hb value from 16 to 12 g/dl a decrease in sO2 from 95 to 73 %. According to the guidelines, no blood transfusion would be given for pneumonia with anemia, while invasive ventilation would be given immediately for low saturation.
The clinics that followed pathophysiology during the pandemic and only provided invasive ventilation for additional illnesses had a mortality rate that was approximately four times lower than the clinics that followed the guidelines. There are two cohort studies from Germany that clearly demonstrate this.
Speaker
Prof. Dr. Martin Möckel, Charité Berlin
Collateral damage and long-term effects of the decline in hospital cases during the pandemic
Speaker
Prof. Dr. Holger Pfaff, University of Cologne
EbM+Theory: How you can still make serious decisions based on uncertain data
Abstract:
Health policy makers rely on expert opinion rather than evidence-based knowledge to reduce uncertainty in times of urgency. This lecture aims to make it clear that an approach that combines evidence-based knowledge with theory can help. The lecture presents a new approach, the “EbM+Theory approach”. This approach integrates both worlds – empirical and theoretical – to reduce uncertainty when making decisions on a scientific basis.
The EbM+Theory approach includes a three-stage process:
1. Application of theory
2. Conducting mechanistic studies (EbM+)
3. Test the hypothesis established by steps 1 and 2 through one or more experiments.
The approach will be critically discussed in the lecture. Independently, the scientific community is encouraged to critically discuss the usefulness of theory.
In order to be able to cope with the future tasks that lie ahead of us, scientists and health politicians need intensive training in theoretical knowledge. In addition, regulatory authorities such as NICE or IQWiG should consider integrating elements of the EbM+theory approach into their decision-making processes.
Theme
Panel discussion 2: How has Corona affected supply? (Moderation: Prof. Dr. Reinhold Roski, MVF)
Congress Chair
Prof. Dr. Reinhold Roski
Publisher “Monitor Health Services Research”