Original article
Commentary by Dr. Dr. Klaus Piwernetz, medimaxx health management GmbH, Munich, and Univ.-Prof. Dr. Dr. hc Edmund A. M. Neugebauer, President of the Brandenburg Medical School.
30.03.2021
Learning from patients' treatment courses has become virtually indispensable since the beginning of the COVID-19 pandemic. This is the only way to accelerate epidemiological research and the development of new drugs and vaccines, enabling the rapid development of active ingredients and vaccines to combat the pandemic. Thus, the principle of research-based healthcare becomes a necessity, at least in the case of COVID-19. The situation is different in other therapeutic areas, such as oncology. "Monitor Versorgungsforschung" spoke with Dr. Benedikt Westphalen (CCC Munich/LMU) and Dr. Katja Janssen (Roche Pharma AG) about the lessons learned from the crisis and the opportunities and challenges of a networked, learning system.
30.03.2021
With a „Model 2023“ (1) developed within its own management team, the Independent Patient Counseling Service (UPD) aims to eliminate the need for regular retendering and achieve permanent institutional stability. With this proposal, the current patient counseling service – a non-profit limited liability company (gGmbH) newly established in 2016 after the contract was awarded to Sanvartis GmbH and set up as UPD gGmbH – seeks to contribute constructively to the ongoing discussion on the restructuring of the UPD according to Section 65b of the German Social Code, Book V (SGB V) (2). This section of the Social Code stipulates, among other things, that „funding is to be awarded anew for a period of seven years,“ with the next award due in 2023. The team led by Managing Director Thorben Krumwiede intends to use the time until then for „patient-centered development of the patient counseling service,“ including expanding the scope of counseling, creating new counseling formats and channels, and, above all, developing feedback mechanisms and utilizing and even providing data to drive change and conduct healthcare research.
30.03.2021
When the coronavirus pandemic began to show its ugliest side about a year ago, with images circulating around the world of military trucks transporting coffins full of Covid-19 victims to crematoria in Bergamo, fears grew in Germany as well that our healthcare system – especially hospitals – would collapse under the mass influx of Covid-19 patients. In hindsight, we know that this was a miscalculation. However, it was understandable at the beginning of the pandemic to urge hospitals to keep as many beds as possible free for potential Covid-19 patients and to pay so-called "reserve bed" payments (1) as compensation for the associated loss of revenue. For every patient not treated as a full or partial inpatient compared to the pre-pandemic year (2019), hospitals receive a uniform flat rate of €560 per day during this period – totaling over €13 billion (as of March 15, 2021). The question is: What was this money actually used to finance? And: Was the money used well?
30.03.2021
As a response to the COVID-19 pandemic, the German healthcare system has also canceled elective surgeries and prioritized urgent operations, similar to adult surgery departments. This was intended to free up additional staff for the care of intensive care patients and create additional intensive care capacity. For a description of the situation, please refer to the important joint statement published in 2020 by the German Society for Pediatric Surgery (DGKCH), the German Society for Pediatrics and Adolescent Medicine (DGKJ), and the German Society for Pediatric Infectious Diseases (DGPI) on the "Management of Pediatric Surgical Patients in the COVID-19 Pandemic.".
30.03.2021
The management of SARS-CoV-2 infections and the pandemic will shape our healthcare system in the coming years. Doctors in private practice play a crucial role in this. They are already caring for around 80 percent of all Covid-19 patients. The number of studies on disease progression in outpatient care is still too sparse compared to inpatient and intensive care settings. Health services research instruments are particularly suitable for recording the various dimensions of a Covid-19 disease. There is currently a good opportunity to use registries to build good data sets for future research questions. An overarching national Covid-19 register including outpatient care would be ideal. Various registry studies have already started. But more research activities are needed.
30.03.2021
„Many of these mathematical models, as we are seeing now with Covid-19, consider the pandemic independently of how human behavior changes in response to the infection. They model the spread of the pandemic very well; they try to capture as many details as possible and depict it realistically.“ This is what Prof. Dirk Brockmann, physicist and professor at the Institute of Biology at Humboldt University in Berlin, said in an interview with the „TAZ“ newspaper. He is right and gets to the heart of the matter with every model: its inherent uncertainty. Nevertheless, Brockmann says, there are excellent models that can outline various possible scenarios, even if it is not clear which scenario will ultimately occur. However, he adds, „it is already a gain to know what it might look like.“ Many researchers from various disciplines worldwide are working on this question – especially in mathematics and physics. Health services research is – with very few exceptions – not involved.
30.03.2021
When the University of Bremen established a professorship for nursing science services research in the Faculty of Human and Health Sciences in April 2014 and also founded a corresponding department at the Institute for Public Health and Nursing Research, this was remarkable in two respects. The University of Bremen is one of the youngest universities in Germany, but at the same time one of the few long-standing university locations for nursing science. A focus on nursing science care research was therefore, on the one hand, a commitment to the scientific discipline of nursing science and, on the other hand, a clear indication that this also results in a mandate for the evidence-based design of care. The professorship and the department head are Prof. Dr. Karin Wolf-Ostermann.
30.03.2021
Exakt ein Monat liegt zwischen dem am 19.12. letzten Jahres erfolgten Zero-Covid-Aufruf und der am 19.1.2021 publizierten No-Covid-Strategie. Beiden Ansätzen gemein ist die Ansicht, dass die bisherige Präventionsstrategie, die Pandemie mit dem Ansatz „flatten the curve“ zu bekämpfen, gescheitert ist. Der große Unterschied besteht jedoch darin, dass die Adepten von Zero-Covid wirklich NULL meinen, indem sie nicht nur eine europaweite „solidarische Pause“ von einigen Wochen fordern, sondern einen superharten Shutdown mit einer absoluten Beschränkung direkter Kontakte auf ein Minimum – in der Freizeit, aber auch am Arbeitsplatz. Die No-Covid-Strategie hingegen möchte zwar auch ein schnelles Absenken der Infektionszahlen auf Null erreichen, jedoch harte Lockdowns durch eine Vermeidung der Wiedereintragung in sogenannte „Grüne Zonen“ durch lokale Mobilitäts-Kontrollen, Tests und Quarantänen ersetzen, die durch ein rigoroses Ausbruchsmanagement bei sporadischem Auftreten neuer Fälle ergänzt werden. Wo ist der Unterschied?
30.03.2021
In a cover interview with "Monitor Versorgungsforschung" (Health Services Research Monitor), Prof. Dr. Wolf-Dieter Ludwig, the long-time chairman of the Drug Commission of the German Medical Association, explains in great detail the study basis on which the four currently available Covid-19 vaccines were approved and what a 95 percent relative efficacy actually means – "really quite little." Furthermore, in his opinion, "the communication to date to the public regarding the efficacy and safety of the vaccines against SARS-CoV-2 has been inadequate," as Ludwig states in the interview. He also considers the initial pricing proposals of BioNTech/Pfizer to be "irresponsible" given the billions of people who need to be vaccinated.