Original article
Mit den selektivvertraglichen Lösungen des § 140 a ff hat der Gesetzgeber schon im Jahre 2000 reagiert und eine Möglichkeit für innovative Versorgungsmodelle geschaffen, die die Fallstricke des gegenwärtigen Systems umgehen. Leistungserbringer und Krankenkassen können alternative Lösungen vereinbaren – zur Probe oder auf Dauer. Roland Berger Strategy Consultants hatten im Oktober 2002 in einer Studie prognostiziert, dass im Jahre 2020 rund 35% der Versicherten und ca. 20% des Gesamtvolumens des Gesundheitsmarktes transsektoral integriert versorgt würden1. Wir wissen heute, dass dies bei weitem nicht so ist.
04.06.2018
When you think of Bayreuth, you can't help but think of the Wagner Festival, which has been performed there since 1876. Richard Wagner was a revolutionary and innovator in musicology during his time. The University of Bayreuth, founded in 1972, has remained true to this innovative spirit and has developed many interdisciplinary degree programs that have positioned themselves well among the competition. However, Bayreuth certainly doesn't automatically bring to mind health services research. The establishment of health economics in research and teaching began there as early as the 1980s. It was recognized early on that the convergence of health economics and health sciences—initially primarily in the field of medicine, but later also in pharmaceutical sciences and nursing sciences—was necessary to address the increasing complexity of healthcare in a solution-oriented manner.
04.06.2018
Zehn Expertinnen und Experten beleuchteten anlässlich des schon traditionellen IQWiG-Herbstsymposiums 2018 die Art und Weise wie Evidenz kommuniziert wird oder besser: werden sollte. Aufgearbeitet wurden von renommierten Kommunikations-wissenschaftlern die Grundlagen, Barrieren und Erfolgsfaktoren effektiver Gesundheitskommunikation, unter besonderer Berücksichtigung von Internet und Fakenews. Doch die richtigen – so der Veranstaltungstitel - „Saure Früchte vom Baum der Erkenntnis“ kamen von IQWiG-Leiter Prof. Dr. Jürgen Windeler selbst, der nicht nur erklärte, dass viele zu kommunizierende Ergebnisse „zum Teil schwer verständlich, zum Teil kontraintuitiv und in einer ganze Reihe von Fällen beides gleichzeitig“ seien, nicht selten tatsächlichen oder vermeintlichen Erfahrungen von Einzelnen widersprächen, aber – das wohl schlimmste – obendrein auch noch falsch sein können.
04.06.2018
The symposium “Endpoints in Oncology: Impulses for Future Clinical Research and Benefit Assessment” took place for the fourth time. According to Wolfgang van den Bergh, editor-in-chief of the Ärzte Zeitung and director of news and politics at Springer Medizin - the organizer of the symposium - “to provide impulses and keep the discussion going” was and is the goal of the professional meeting sponsored by Pfizer and MSD Berlin. Not only were new findings discussed in the context of the endpoint discussion, but this year it was made particularly clear how far apart the perspectives of the individual and the system are, perhaps even further than ever.
04.06.2018
Where do individual European countries stand when it comes to implementing a patient record (ePA)? The Institute for Applied Health Services Research (inav) investigated this question on behalf of the Münch Foundation. In the publication “European Scorecard on the status of the implementation of electronic patient records at national level / First Update 2018” it is once again clear: Germany is doing poorly with regard to the ePA - in contrast to the Scandinavian countries.
04.06.2018
In retail research, spatial interaction models have been used for decades to estimate and analyze customer inflows, including in the area of local supply in the food trade, which is closely related to healthcare (Wieland 2011, 2015a). These models have now also found their way into regional health services research (Bauer/Groneberg 2016, Fülop et al. 2011, Jia et al. 2015). Before the exemplary application of spatial interaction models takes place, some general considerations must first be made about the usefulness of their use.
04.06.2018
In the healthcare system, users are increasingly required to be able to find, understand, assess and apply health information to their own situation in order to make decisions, for example, about the treatment and care of illnesses or the recovery and maintenance of health. The knowledge, motivation and skills to deal with health-related information are referred to by experts as health literacy (Sørensen et al. 2012). Health literacy is the interaction of personal abilities and the requirements and complexity of situations and systems in which people move (Schaeffer et al. 2018). But people often face difficulties in dealing with health information.
04.06.2018
Dementia is a chronic disease that affects between 5 % and 7 % of people aged 60 years and over [1]. The number of people suffering from dementia is expected to rise to 66 million worldwide by 2030 and to 115 million by 2050. In Germany the prevalence is very high with over a million people suffering from dementia [2]. Since dementia is associated with poor quality of life [3] and psychiatric disorders (e.g. depression and anxiety) [4,5], there is a need for better prevention, diagnosis, treatment and management measures regarding this neurodegenerative disease.
04.06.2018
Delivering bad news poses a special challenge for every doctor. We would like to argue pointedly that a doctor who has mastered the diagnosis and treatment of illnesses but is not able to convey his sympathy and offer of support to the patient is one not fulfilling a significant part of his professional duties. The reality of everyday medical practice and clinic shows, however, that the doctor can hardly find the time required to let the person seeking help speak out and to translate the patient's problem into a billable format. This medical limitation is all the more critical given that numerous studies have shown that professional doctor-patient communication has a positive effect on the success of care (1,2). Placebo research also shows that everything the doctor does in interaction with the patient has a therapeutic effect, including communication in particular (3). The “perception of life-changing diagnoses by patients and their relatives” has rarely been examined through surveys. For them, the transmission of bad news is an exceptional psychological situation that requires special attention and mindfulness (3, 4). One of the first surveys on the subject was conducted among Iranian nurses, which also included the transmission of cancer diagnoses (5). With the present survey we want to show that ultimately the perception of the conversation by the patient and/or his relatives and not the conversation itself should be the indicator for the value of the conversation.
04.06.2018
The most comprehensive study on the prevalence of COPD to date is the international Burden of Obstructive Lung Disease (BOLD) study (Buist & McBurnie, 2007). In Germany, the Hanover region took part in this work. The lung function was examined in 683 volunteers over the age of 40 and a survey was carried out as to their state of health. Overall, more than 13 percent of the study participants in the Hanover area were diagnosed with COPD, a good 7 percent had a mild, 5 percent a moderate and almost 1 percent a severe disease stage. Since the test subjects came from the Hanover metropolitan region, it cannot be said with certainty whether the numbers are representative for the whole of Germany. However, the overall evaluation of the BOLD study suggests this. According to this, every tenth of the more than 9,000 study participants in the twelve countries involved suffers from chronic obstructive pulmonary disease in stage II or higher. The current figures on the development of COPD in Germany were based on 6.8 million COPD cases in 2010. By 2030, the number of people affected is expected to rise to 7.9 million. (Geldmacher & Biller, 2008). COPD is also important from an economic perspective. One study determined the total costs of COPD by weighting the costs per level of severity. The main part of the costs is caused by hospital stays (26%), medications (23%) and early retirement (17%). (Herse & Kiljander, 2015); (Grønseth & S.-A., 2014); (Nowak & Dietrich, 2004). Early detection of COPD is of great importance, as timely cessation of exposure to the triggering noxa can at least partially prevent disease progression. (Vogelmeier & Buhl, 2018). There is also evidence that the natural course of the disease can be significantly influenced by the early onset of drug treatment. (Troosters & Celli, 2010).