Original article
The aging of our population is now accepted as an important issue at a political level - especially at a health policy level. The great burden on social systems is due, among other things, to the fact that older patients are known to be sicker than younger ones [an 80-year-old has on average just over three relevant diagnoses (van den Akker et al. 1998)], each of which is treated according to the applicable guidelines become. This results in so-called polypharmacy (at least five drugs): In the USA, men over 65 years old take five or more drugs in 44% cases, women in 57% cases, and even ten or more drugs in 12% cases (Kaufman et al. 2001). In Germany, a third of patients over 62 receive more than five medications daily (Barmer GEK Drug Regulation Report 2013). Drug side effects – particularly, of course, in these polypharmacy patients – are now the fourth most common cause of death in the United States (Light 2010).
03.04.2017
Osteoporosis is a common disease in the elderly population worldwide. According to the WHO, osteoporosis (bone loss) is classified as one of the ten most important and therefore most expensive diseases of all [1]. Osteoporosis is a systematic musculoskeletal disorder in which reduced bone strength increases the risk of fractures. Such fractures most commonly occur in the wrist, spine and hip [2]. Osteoporosis and associated fractures are an important public health problem due to the associated morbidity and disability of patients, reduced quality of life and mortality [3]. An estimated 22 million women and 5.5 million men in the EU suffer from osteoporosis [4]. The risk of osteoporosis is particularly high for women after menopause, a time when estrogen levels in a woman's body drop significantly [5]. In the German population, the annual incidence rate of osteoporosis was estimated at 6.3 million [6]. There is a significantly higher incidence rate in women (13.1 %) than in men (3.2 %) [7]. Due to demographic change in Germany, the number of osteoporosis patients will continue to rise in the future [8]. Previous research has shown a link between chronic somatic and mental illnesses such as depression [9, 10]. It can be assumed that fractures and pain as symptoms or complications of osteoporosis could lead to a reduced quality of life and depression.
03.04.2017
The German Pension Insurance (DRV) carries out a good one million medical and around 150,000 vocational rehabilitation services per year. In medical rehabilitation, there are inpatient and outpatient services in all relevant indications as well as rehabilitation services for children and adolescents (see Figure 1). Of the large number of vocational rehabilitation services (services for participation in working life), further training services and retraining are quality assured, as these are used over a longer period of time and cause a large part of the costs. According to Section 9 SGB VI, the aim of the rehabilitation of the pension insurance is to maintain or restore the professional integration of the insured and thus to avoid or eliminate a reduction in earning capacity due to illness or disability.
23.01.2017
Mild cognitive impairment (LDB) is a common mental illness that occurs in approximately 16 % of older people without dementia [1]. The incidence rate of the disease has been estimated to be approximately 63.6 per 1,000 person-years [2]. LKB is considered a transitional state between normal cognition and dementia [3]. Studies with patients in German general practices have shown that one in four patients develops dementia within three years of the first LKB diagnosis. This underlines the importance of intensive care for these patients [3]. The risk factors for LKB have been analyzed by several authors in recent years [4–12]. A 2001 study showed that elevated serum cholesterol levels in midlife significantly increased the risk of developing LKB, adjusting the regression model for age and body mass index [4]. Two years later, it was found that ethnicity, education level, results of certain tests, cortical atrophy, MR-identified infarcts, and depression measures were positively associated with the LKB diagnosis [5]. In Germany, Luck et al. in 2010 found that older age, vascular diseases and subjective memory problems increased the risk of future development of LKB [6]. Most recently, a study of 1,278 people suggested that traumatic brain injury might reduce the age of onset of LKB [10]. The aim of the present study was to re-analyze the risk factors for the development of LKB in patients in German general practices based on the previous results.
22.01.2017
On the occasion of the tenth anniversary celebration of the “Scientific Institute of TK for Benefits and Efficiency in Health Care” (WINEG), which was founded ten years ago, Hamburg's Senator for Health and Consumer Protection, Cornelia Prufer-Storcks, found clear words about the relationship between health care research and politics. She herself would like to have “a rational basis” for her decisions more often, but what politicians then do with the results produced by health services research is a different topic. Examiner Storcks, with a dose of political self-criticism: “I am of the opinion that we could draw conclusions from the results of healthcare research more quickly and decisively.”
22.01.2017
Professors Dr. med. habil. Maria Eberlein-Gonska and Dr. Jochen Schmitt, both employed at the Dresden University Medical Center, are a very special team. While Eberlein-Gonska oversees quality management at one of Germany's largest hospitals, Schmitt works in the same building on the university campus in the field of health services research, often on topics that are of particular interest to quality manager Eberlein-Gonska—a win-win situation not only for both of them, but for the hospital and for healthcare as a whole. After all, what the two professors are researching together certainly has the potential to improve the quality of care itself—at least a little bit.
22.01.2017
A systematic review with meta-analysis based on randomized and non-randomized studies. Ensuring comprehensive, highly specialized medical care is a current health policy issue in Germany (1). Innovative care models are required, especially in structurally weak regions, to ensure specialist medical care (2). But new treatment concepts are also required for the exchange of relevant patient data from highly specialized medical disciplines, such as patients with rare diseases, in order to be able to make and communicate treatment decisions in a timely manner (3). Telemedicine applications promise the possibility of overcoming these hurdles and ensuring patients receive the medical care they need (4).
22.01.2017
A wide variety of medications with different mechanisms of action are available on the German market for the treatment of diabetes mellitus. In addition to established drugs that are frequently prescribed as part of guideline-based therapy, numerous new antidiabetic drugs have been approved and, with the introduction of the AMNOG (Act on the Reform of the Market for Medicinal Products) in 2011, have also been subject to benefit assessment. Physicians and patients are therefore constantly faced with the challenge of reviewing existing therapies and, if necessary, adapting them to new options. This article examines the differences in market penetration between the various drug classes and how these new introductions affect patients' daily care.
22.01.2017
Digitalization offers an opportunity to completely rethink and implement healthcare models. Demographic trends and medical innovations make addressing this issue impossible without prior consideration, asserts Klaus Rupp, Head of Healthcare Management at Techniker Krankenkasse (TK). At Medica in Düsseldorf, he presented at the Medica Econ Forum how future healthcare models can be conceived by consistently leveraging the possibilities of digitalization in all areas – from analysis and communication to organization. Funding from the Innovation Fund has also brought the realization of various digital healthcare models closer to reality.
22.01.2017
The self-confessed smoker Hecken rarely minces his words and is one of the few speakers and interview partners in the German healthcare system who, in addition to considerable depth of content, also have immensely entertaining humorous value. But there is also a trend-setting dimension: What G-BA boss Prof. Josef Hecken pointedly explains about the innovation fund and DMP this time - in what is now the third cover interview with "Monitor Healthcare Research" - can certainly serve as a kind of guideline for the current year be considered.