Original article
"Every study has limitations," Prof. Dr. med. Jochen Schmitt of the Center for Evidence-Based Health Care (ZEGV) and one of the main leaders of the WiZen study group (1) told "Monitor Gesundheitsforschung" (Monitor Health Services Research). Anyone who claims that health care studies exist without limitations has failed to understand the fundamentals of scientific work. Therefore, an important part of every scientific study is the discussion of the results, which includes a discussion of the methodological strengths, but also of any potential limitations, as was done extensively in the original publication of the WiZen study in the "Deutsches Ärzteblatt" (2). It is all the more surprising that Prof. Josef Hecken, impartial chairman of the Federal Joint Committee (G-BA) and chairman of the G-BA's Innovation Committee, addressed – Hecken's quote – "one or two methodological weaknesses" of the WiZen project on "Effectiveness of Care in Oncology Centers" (3), funded by the Innovation Fund, in his opening speech at the conference "The Innovation Fund: Between Sustainability and Further Development" (see p. 16 ff.). MVF conducts the fact check.
03.06.2024
643 projects were funded, including 230 projects in new forms of care and 413 projects in health services research, including guideline development projects. €1.25 billion was invested in new forms of care projects and €450 million in health services research projects. Looking at the hard figures for the Innovation Fund, which were presented at the conference "The Innovation Fund: Between Stabilization and Further Development," the fund is certainly a success story, having been transferred from "temporary" to "permanent" status with the Digitalization Act passed by the Bundestag at the end of 2023. The transition worked in this case, but less so for many of the Innovation Fund's projects themselves. There is a need for action here, as the stakeholders involved, especially the Chairman of the Federal Joint Committee (G-BA) and the Innovation Committee, Prof. Josef Hecken, are aware.
03.06.2024
The Spreestadt Forum is an interdisciplinary lecture series with changing topics. Organized and academically led by TU professors Busse and Kersting, the event takes place every semester. This year's guest was Prof. Josef Hecken, the impartial chairman of the Federal Joint Committee, who spoke on "On the Necessity of Structural Reforms in the Health Care System" and offered a more than emphatic take on the current hospital reform. His wish: "I would prefer no law at the moment to any law." Busse added: "I do too, to be honest."
03.06.2024
Commentary by Dr. h. c. Helmut Hildebrandt, healthcare system architect and CEO of OptiMedis AG
03.06.2024
What connects Templin, Prignitz, and Ostprignitz-Ruppin? They share an infrastructure with plenty of room for improvement, a vast landscape, and a small population, many of whom have reached old age. Prignitz stands out in particular: with only 36 inhabitants per square kilometer (as of 2021), the district has the lowest population density of all German districts. Ostprignitz-Ruppin and Templin follow with 40 and 41 inhabitants per square kilometer, respectively. Prignitz and Ostprignitz-Ruppin are also among the structurally weakest areas in Brandenburg and among those with high future risks. Recently, something else has connected the three districts and their municipalities: the Innovation Fund project "ProReVers" (1), which builds on the experiences of the very first Innovation Fund project, IgiB-StimMT (2), but at the same time goes significantly beyond it.
03.06.2024
"In the long run, we will not be able to simultaneously assess and plan for regional needs on a sector-by-sector basis." "Local regional partners are given too little scope for their actions." "We will have to establish entirely new working methods and workflows together." These three quotes from the cover interview with Dr. Sabine Richard, Managing Director of Healthcare at the AOK Federal Association, demonstrate what is important to her: to exert as much influence as possible on the ongoing parliamentary process of the Health Care Strengthening Act (GSVG) in order to "gain more options for shaping healthcare in the regions, not fewer."
03.06.2024
„Es wird zwangsläufig zu einer Neuverteilung der Tätigkeiten zwischen den Gesundheitsprofessionen zur Sicherstellung der Gesundheitsversorgung kommen müssen.” Im Titelinterview mit „Monitor Versorgungsforschung“ spricht sich Prof. Dr. Gabriele Meyer, Professorin für Gesundheits- und Pflegewissenschaften an der Martin-Luther-Universität Halle-Wittenberg sowie ehemaliges Mitglied im Sachverständigenrat zur Begutachtung der Entwicklung im Gesundheitswesen, für eine auskömmliche Förderung der Pflegewissenschaft, vor allem aber für einen besseren Skill- und Grade-Mix, eine bessere Verständigung zwischen den Professionen sowie „im relevanten Umfang” klinisch-akademische Pflegerollen aus.
03.06.2024
The empirically based simulation model proposed here, which equally considers accessibility, patient preference, and capacity, offers, against the backdrop of the state's duty of care and the obligation to use resources economically, a scientific way of relating the importance of care to the need for hospital locations per service group. The simulation model is intended to support hospital planning (here: the allocation of service groups) by the federal states and to create guidelines for rational planning. It is also suitable for the management of financial resources within the framework of hospital reform. It enables impact analysis and does not intend to automate or otherwise impose rigid specifications. The calculations are to be viewed as examples. The weightings of all parameters are variable. However, the accessibility limits and the parameterization of the simulation model should be determined jointly by the federal and state governments in the spirit of a common target vision.
03.06.2024
The COVID-19 pandemic posed major challenges to science and society worldwide. Given the significant scientific uncertainty, decisions had to be made urgently, justified, and risks clearly communicated. It is almost inevitable that assessments can change over the course of such a situation—and retrospectively—and that mistakes happen. In order to avoid repeating past mistakes and instead learn from them for the future, we believe it is particularly important to closely examine, systematically analyze, and controversially discuss the communication and decision-making processes during the pandemic. With this article, we aim to initiate this discussion and, in our view, once again highlight problematic aspects of pandemic and crisis communication by authorities, politicians, and the media in Germany. We are aware that our view of these processes is naturally subjective. We therefore view the presentation and harmonization of complementary perspectives on crisis communication and management as an iterative process that should be continued with further texts.
03.06.2024
The aim of this study was to investigate the prevalence and factors associated with in-hospital mortality in patients with heart failure (HF). This multicenter cross-sectional study was based on data from HF patients from fourteen hospitals across Germany. A total of 19,288 inpatients (15,431 patients) were included (mean age: 79.4 years, 49.9% female). Mortality was 9.7%, increasing from 4.2% in the age group ≤65 years to 15.1% in the age group >90 years. Left heart failure with symptoms at rest, acute renal failure, respiratory failure, pneumonia, and pleural effusion were associated with an increased risk of death. Paradoxically, several chronic cardiovascular and metabolic diseases—including hypertensive heart disease, essential hypertension, pulmonary heart disease, obesity, dyslipidemia, and diabetes—were associated with a lower risk of death as secondary diagnoses. While our study provides a comprehensive snapshot of in-hospital mortality in HF patients, it also highlights the need for further studies to better understand the complex interplay of various risk factors.