Original article
In the course of the Europeanization of the healthcare system, interest in healthcare system comparisons has also increased noticeably. Looking beyond one's own health policy inevitably enables the strategic further development of best-practice approaches in the health sector. The instruments of the open method of coordination (OMK) adopted by the EU are proving to be a creative driving force in the development of a Europe-wide comparison of health systems. Health policy reform processes triggered by this should also undergo a regular controlling process at the health care level, which requires the targeted methodical use of health care research. As a result, a European model of health services research could be on the health policy agenda in the foreseeable future.
01.03.2009
The “Aut-idem” regulation and the discount agreements according to Section 130a Paragraph 8 SGB V are among the most important regulatory measures regarding pharmaceutical expenditure by statutory health insurance. Both measures aim to replace patent-free original preparations with cheaper preparations with the same active ingredients, so-called generics. However, preparations with the same active ingredients are not necessarily identical to the original due to the use of other excipients and carriers as well as the permitted tolerances for the active ingredients. Exchanging the preparation can have a negative impact on the course of diseases with a narrow therapeutic range, such as epilepsy, due to these tolerances. In this case, recurrent epileptic seizures can mean that the replacement does not save any costs, but rather generates additional expenses. Epilepsy is therefore an indication in which value-added contracts should be concluded instead of discount tenders. These focus not only on cost savings, but also on optimizing patient care.
17.12.2008
The study presented here examines the preferences of members of the German statutory health insurance (GKV) with regard to modern insulin therapy for diabetics. The central question was: Should the long-acting insulin analogue continue to be paid for by the statutory health insurance? The health economics answer is simple. If the willingness to pay of even those people who do not rely on insulin exceeds the additional costs of the new preparation, there is no reason why the GKV should not reimburse it. If their willingness to pay is lower than the additional costs, the patients themselves in the form of an additional payment could still be sufficient to cover the additional costs. With a so-called market experiment, the preferences were determined in 2007 by surveying 1,100 GKV insured people (500 of whom were diabetics). The results show: Not only diabetics treated with insulin, but also those who only need an oral medication, as well as non-diabetics, derive additional benefit from “Insulindetemir” compared to human insulin. Although non-diabetics in particular prefer financing through co-payment, their willingness to pay through an increased statutory health insurance contribution is so high that it exceeds the additional costs compared to treatment with human insulin. Therefore, based on this cost-benefit analysis, nothing stands in the way of financing the drug “Insulindetemir” by the GKV.
19.10.2008
It is currently becoming apparent that the discount agreements are reinforcing a development that leads to market results that do not do justice to the relative or absolute value of the medicines and thus lead to allocative inefficiencies. Against this background, a proposal for a central approach to controlling the generic drug market, based on a cost-benefit assessment, was developed. The core of the model is that the reimbursement prices in the statutory health insurance are set in such a way that they reflect the benefit ratio of the drugs to each other. In this way, the approach induces a needs-oriented and efficient distribution of scarce resources in drug supply. The approach also offers a pragmatic multi-step scenario with budget neutrality in the introduction phase of the model.
19.10.2008
When it comes to health care research, health economics emphasizes distributing scarce resources in such a way that overall maximum coverage of needs, measured in terms of patient benefit, is achieved. This means providing care as efficiently as possible, while from a medical perspective the most effective measure - regardless of costs - would be preferred. Using ex ante cost-benefit analysis, it is possible to model various alternative courses of action or care concepts. After an appropriate observation period, a re-evaluation of the everyday care data obtained makes sense. The aim is the targeted and continuous optimization of the quality of care, not cost containment. The actual cost-benefit ratio of a implemented care concept can help here. Health care research that focuses only on the costs or only on the benefits cannot result in optimal care from an economic perspective. For this reason, it is important to pay more attention to efficiency through cost-benefit assessment in health care research.
19.10.2008
There are a variety of treatment options available to treat psoriasis vulgaris. The S3 guideline of the AWMF defines the current standard of treatment. As early as 2005, a Germany-wide study pointed to an undersupply of psoriasis vulgaris. A variety of treatment options are available to treat psoriasis vulgaris. The S3 guideline of the AWMF defines the current standard of treatment. As early as 2005, a Germany-wide study pointed to an undersupply. In the present Germany-wide cross-sectional study, the care situation of patients with psoriasis in Germany was examined in 2007. The following characteristics, among others, were recorded in 142 dermatological practices and clinics: a) Doctor questionnaire: previous therapies and illnesses, clinical characteristics, severity level (PASI), b) Patient questionnaire: quality of life, patient-relevant therapy benefits, satisfaction with care. Eight indicators of the quality of care were developed in an expert consensus. 11.6 % of the 2,009 patients had severe (PASI>20) and 27.4 % had moderate psoriasis (PASI 10-20). The mean PASI was 10.1. 32.2 % of the patients indicated a severely impaired quality of life (DLQI>10), the mean DLQI was 7.5. Almost half (47.3 %) of the patients had already received systemic therapy, among those with severe psoriasis 62.1 %. 20.1 % of the patients had been treated as inpatients in the previous year. On average, the patients were unable to work for 3.4 days per year due to their psoriasis. An improvement in the quality of care compared to 2005 could be seen in all eight indicators. In the present Germany-wide cross-sectional study, the care situation of patients with psoriasis in Germany was examined in 2007. The following characteristics, among others, were recorded in 142 dermatological practices and clinics: a) Doctor questionnaire: previous therapies and illnesses, clinical characteristics, severity level (PASI), b) Patient questionnaire: quality of life, patient-relevant therapy benefits, satisfaction with care. Eight indicators of the quality of care were developed in an expert consensus. 11.6 % of the 2,009 patients had severe (PASI>20) and 27.4 % had moderate psoriasis (PASI 10-20). The mean PASI was 10.1. 32.2 % of the patients reported a severely impaired quality of life (DLQI>10), the mean DLQI was 7.5. Almost half (47.3 %) of the patients had already received systemic therapy, among those with severe psoriasis 62.1 %. 20.1 % of the patients had been treated as inpatients in the previous year. On average, the patients were unable to work for 3.4 days per year due to their psoriasis. An improvement in the quality of care compared to 2005 could be seen in all eight indicators.
19.08.2008
The topic of patient safety has become very important to the population in recent months due to numerous press releases. The risk of errors increases, especially in highly technical work environments, such as the operating room, and with new team structures, such as when moving into a new building. The aim of the study was therefore to develop and evaluate a training program for moving into new buildings that reduces the risk of errors. For this purpose, standardized processes (SOP) were defined, visualized and first discussed with all employees and then simulated in the new building. Before and after the training, the employees were surveyed using questionnaires. As a result of the training, knowledge is improved and team collaboration is improved. Finally, the rate of errors is also significantly reduced. Aviation training programs, such as SOP and simulation, help improve patient safety and team collaboration. They should be part of everyday life in improving patient safety. The topic of patient safety has become very important to the population in recent months due to numerous press releases. The risk of errors increases, especially in highly technical work environments, such as the operating room, and with new team structures, such as when moving into a new building. The aim of the study was therefore to develop and evaluate a training program for moving into new buildings that reduces the risk of errors. For this purpose, standardized processes (SOP) were defined, visualized and first discussed with all employees and then simulated in the new building. Before and after the training, the employees were surveyed using questionnaires. As a result of the training, knowledge is improved and team collaboration is improved. Finally, the rate of errors is also significantly reduced. Aviation training programs, such as SOP and simulation, help improve patient safety and team collaboration. They should be part of everyday life when improving patient safety.
19.08.2008
Any change in the German healthcare system that doesn't involve an increase in power or money is met with fierce resistance from those affected. The opportunities and perspectives of the interlocking legislative measures are rarely recognized and appreciated. The following article analyzes the development trends since Blüm's healthcare reform in 1988, highlights possible courses of action at the current time, and […]
19.08.2008
The example of the scientific institute winDiab, which is financed solely by doctors