Original article
The German healthcare system performs well in international comparisons in terms of quality and efficiency, but comparative studies point to existing potential for optimization (Lauerer et al. 2013: 483–491; Manouguian et al. 2010). Trends such as demographic change, which poses new challenges for regional supply security, require a continuous improvement in the supply structure and quality (Stüve 2009: 51–60; Amelung/Wolf 2011: 1566–1572). In order to do justice to this, politicians are calling for stronger networking and cooperation between service providers in the form of integrated care models (Amelung et al. 2009; Mühlbacher 2002). Various studies view interconnected structural, product and process innovations as necessary in order to significantly increase efficiency and effectiveness (Omachonu/Objection 2010: 1-20; Varkey et al. 2008: 382-388; Ilinca et al. 2012: 193 –202). Innovations, which are defined as the successful implementation of a new idea in a way that increases value for some or all participants, are no longer initiated only by individual actors, but are increasingly developed and disseminated in cooperative networks (Akrich et al. 2002: 187-206 ; Varkey et al. 2008: 382–388). With the aim of improving medical care, EU, federal and state policies promote health innovations at all levels, but 40% of these only exist until the start-up funding runs out (Savaya et al. 2008: 478–493). This volatility of improvement initiatives negatively impacts society's support and trust in future projects (Shediac-Rizkallah/Bone 1998: 87-108). The high use of resources during the new introduction creates a legitimate demand for goal achievement and long-term success and increases the interest of stakeholders in the sustainability factor (Edwards et al. 2007: 37–47).
31.03.2016
Dementia is a psychiatric disease caused by neurodegeneration, characterized by a progressive loss of cognitive functions, leading to changes in patients' daily lives (WHO, 2015). 47.5 million people worldwide suffer from dementia, and this number is expected to rise to 75.6 million by 2030 and exceed 140 million by 2050 (WHO, 2015). In Germany, dementia affects around 1.2 million people, mainly women and seniors. Approximately 200,000 new cases are diagnosed every year (Tunstall, 2015). The average cost associated with these mental illnesses is more than 43,000 euros per patient per year, with almost 68% of this amount borne by carers and families (Tunstall, 2015). Dementia therefore has a significant impact on patients and their relatives, which underlines the need for specially adapted treatments and appropriate management of the disease in Germany.
31.03.2016
From a patient's perspective, beneficial innovations—product innovations, but especially process innovations—should benefit all those affected as quickly as possible, meaning they should be covered by the collective agreement. The fact that the Federal Joint Committee (G-BA) largely fails in this regard in the age of out-of-pocket expenses and selective contracts is inherent in the prevailing incentives. The legislator intended the Innovation Fund to at least mitigate this problem. The question is: Can it actually fulfill this function? There is growing evidence that it will not, or hardly, do so.
31.03.2016
Interview mit Dr.med. H.-J. Helming, Vorsitzender des Vorstandes KVBB und Lutz O. Freiberg, KVBB-Unternehmensbereichsleiter und Geschäftsführer der IGiB.
31.03.2016
The KV RegioMed program for structural migration in the Templin region is more than just a pilot project. It is not merely an attempt to use the given prevalence rates in a region – in the Uckermark region, specifically in the Templin area – to make predictions about diseases in the coming years and decades, but rather to draw conclusions about how healthcare restructuring should look in the foreseeable future in order to create a more targeted and thus better-suited regional healthcare system through inpatient and outpatient structural migration.
31.03.2016
Cataracts, also commonly known as cataracts, are one of the most common reasons for surgical intervention in Germany. Consequently, the surgical methods and materials used are also of great importance. Based on a retrospective routine data analysis, the WIG2 Institute examined the health economic consequences of different lens materials in the surgical treatment of cataracts. The comparison of hydrophobic and hydrophilic acrylate lenses shows which implants have a lower risk of complications.
31.03.2016
The affiliated doctor system is a long-established form of integrative and cross-sectoral care (Hahn et al., 2015a, 2015b; Wienke and Mündnich, 2011). Both care approaches are also currently in the focus of German politics: (More) integrated care has been repeatedly demanded for almost 20 years now (Mühlbacher et al., 2006). The innovation fund, which became German law in the Supply Strengthening Act of June 10, 2015, provides 225 million euros per year to "new forms of care that aim to improve cross-sector care and have sufficient potential to be permanently included in care". (German Bundestag, 2015). In the classic understanding of affiliated doctors, a doctor who primarily works as a panel doctor/outpatient treats his patients using inpatient resources in a hospital in an affiliated department. For this purpose, the attending doctor has a contract with the hospital to be able to use the infrastructure (including staff) in the hospital. The attending doctor and the hospital are paid independently of each other. While the affiliated doctor accounts for his work using the uniform assessment scale (EBM), the hospital receives a so-called affiliated doctor DRG.
31.03.2016
On January 1st, 2012, with the GKV-VStG, the legislator laid the foundation for the development of a new care structure, the "outpatient specialist medical care" (ASV). With the new version of § 116b SGB V (§ 116b SGB V "new"), since the beginning of 2012, not only hospitals but also contract doctors have been included in the regulations. The ASV essentially pursues two goals: Firstly, it is intended to contribute to overcoming the sectoral boundaries in the German health care system and, secondly, to achieve improved interdisciplinary coordination of diagnostics and therapy among the service providers. For the first time in the German healthcare system, the ASV is intended to open up the possibility for registered panel doctors and hospitals to work and work together across sectors under the same conditions (cf. e.g. G-BA 2015a; Klakow-Franck 2014b: 154 and 2015: 6). The introduction of the ASV was not least in the interest of panel doctors (cf. e.g. Klakow-Franck 2014b: 153), because under the existing regulations (§116b SGB V "old") they had to fear that the comparatively financially strong hospitals there is increasing competition with a correspondingly tougher competitive situation in the healthcare market. Contract doctors had also repeatedly filed lawsuits against hospital approvals under Section 116b SGB V "old" (cf. SVR 2012: 259).
31.03.2016
The affiliated doctor system is a long-established form of integrative and cross-sectoral care (Hahn et al., 2015a, 2015b; Wienke and Mündnich, 2011). Both care approaches are also currently in the focus of German politics: (More) integrated care has been repeatedly demanded for almost 20 years now (Mühlbacher et al., 2006). The innovation fund, which became German law in the Supply Strengthening Act of June 10, 2015, provides 225 million euros per year to "new forms of care that aim to improve cross-sector care and have sufficient potential to be permanently included in care". (German Bundestag, 2015). In the classic understanding of affiliated doctors, a doctor who primarily works as a panel doctor/outpatient treats his patients using inpatient resources in a hospital in an affiliated department. For this purpose, the attending doctor has a contract with the hospital to be able to use the infrastructure (including staff) in the hospital. The attending doctor and the hospital are paid independently of each other. While the affiliated doctor accounts for his work using the uniform assessment scale (EBM), the hospital receives a so-called affiliated doctor DRG.
31.03.2016
When evaluating new drugs for the treatment of cancer, the endpoint survival is the main focus. Many of these new drugs can be shown to have a survival advantage compared to the previously available treatment options. However, it is often emphasized that this is usually only “two to three months” (e.g. Lauterbach 2015, Fojo et al. 2014). This additional survival time is often perceived as insufficient and complaints are also made that the time gained in this way often does not provide an adequate quality of life. Furthermore, the new active ingredients have not been sufficiently tested. The use of the usually high-priced drugs is therefore often not worth the money. Due to the high health policy importance of the assumption that new therapies only offer "two to three months" additional survival time, this study should examine whether this common assumption is in line with the facts. The basis for this is the resolutions for the evaluation of new drugs according to the Drug Market Reorganization Act (AMNOG), which all new active ingredients have had to undergo since 2011 in order to demonstrate their additional benefit compared to the so-called appropriate comparative therapy.