Abstracts by key term: Evaluation
Die vom Gemeinsamen Bundesausschuss (G-BA) beschlossene Richtlinie über die Verordnung von Heilmitteln in der vertragsärztlichen Versorgung (Heilmittel-Richtlinie/HeilM-RL) dient der Sicherung der medizinischen Versorgung von Versicherten der gesetzlichen Krankenversicherung mit Heilmitteln. Dabei ist der allgemein anerkannte Stand der medizinischen Erkenntnisse für eine ausreichende, zweckmäßige und wirtschaftliche Versorgung zu berücksichtigen. Die HeilM-RL sowie der Katalog verordnungsfähiger Heilmittel (Heilmittelkatalog/HMK) sind dabei kontinuierlich nach dem allgemein anerkannten Stand der medizinischen Erkenntnisse zu überprüfen und fortzuschreiben. Dem G-BA obliegt dabei eine Beobachtungs- und Überprüfungspflicht, die in seiner Verfahrensordnung festgelegt sowie durch die ständige Rechtsprechung des Bundessozialgerichtes konkretisiert wird [1, 2].
01.06.2026
MedicalContact AG's Casaplus geriatric training program has been offering telephone health coaching for multimorbid geriatric patients since 2007, and approximately 30,000 patients have already benefited from it. The critical success factors for such a program are the risk-based identification of suitable candidates, participant recruitment, and individualized support from specially trained medical professionals. Since 2017, the Casaplus program has been further developed in collaboration with the VIACTIV health insurance company and DCC Risikoanalytik GmbH to include AI-based components for both the prediction of modifiable risks during the identification process and the use of risk-adjusted propensity scores during the evaluation of smartCasaplus coaching. The current evaluation results from the VIACTIV health insurance company show that, taking into account allocation effects and program costs, an average return on investment of 1.7 was achieved over the first four program years.
02.02.2024
While in the United States (the “motherland” of health services research [8,13,16]) more than one billion US dollars have been invested in research projects since 2009 to expand the health services research concepts of comparative effectiveness research (CER) and patient-centered outcomes research ( PCOR) in everyday research [3-7], health services research in Germany is still at an early stage of development [8]. At least in Baden-Württemberg, there has been a state-funded program to promote health services research since 2011 [17,18]. Here, too, the discipline has not yet been implemented across the board in research and teaching, and health services research has not yet been included as a compulsory subject in the study regulations for human medicine by the medical faculties in Baden-Württemberg (as of December 2013). The possibilities for anchoring health care research in studies are therefore limited, especially since content relevant to health care research has hardly been implemented in the cross-sectional area (QB) “health economics, health system, public health care” that was included in the licensing regulations in 2003 and in socio-medical teaching [9-12] . The question therefore arises as to how health services research can be successfully implemented into medical studies in order to sensitize future doctors and scientists to the issues facing the discipline. In addition to the QB and socio-medical teaching, corresponding teaching content could be implemented in the clinical subjects and as part of a compulsory elective course (WPV). In principle, the requirements for an elective course are regulated differently at the universities in Baden-Württemberg; in Tübingen (according to the study regulations of May 6, 2013) a minimum number of hours of 40 teaching units is required.
31.03.2015
Individual lifestyles, living conditions, coping potential, adequate medical and social care, prevention and rehabilitation influence both the state of health, quality of life and well-being in old age as well as the costs incurred in the medical and nursing sectors. Geriatric patients have a higher risk of hospitalization and usually suffer not only from a chronic illness, but from other (co-)morbidities. Cross-indication, preventative geriatric case management is a promising approach to improving the quality of life and self-management skills of those affected and at the same time reducing hospital expenses.
05.10.2012
The development in health care includes the implementation of contracts between different players as one of the main regulating factors. Contracts don't run by themselves; it's not enough to agree on content and sign it. The evaluation must be taken into account and planned as early as when the contract is concluded, and not only after 3 years, but continuously and concomitantly. The appropriate source for the information, as well as the type and amount of information required, depends on the type of contract and the content of the contract. In order to consider selective contracts with doctors or groups, data and evaluations from random samples of relevant size, which also allow regionally valid considerations and extrapolations, are required. Evaluations from billing data are not sufficient here because they do not adequately reflect medical behavior.
23.09.2012
The disease management programs (DMP) aim to improve medical care for chronically ill patients across the board. The goal of the treatment program is to coordinate patient treatment throughout the entire course of a chronic illness and across the boundaries of individual service providers and to optimize the patient's health based on medical evidence. On the one hand, it is about minimizing the “variance” of treatment by the practitioner (Glaeske 2011) and enabling treatment principles for treatment by the medical profession based on medical evidence. On the other hand, the patient should also be actively involved in the treatment process. In the doctor-patient interaction, treatment goals should be set in terms of lifestyle changes or the achievement of medical values. The treatment steps and the health condition are recorded in a documentation form by the treating doctor. As part of the legal evaluation of the DMP, service expenditure and survey data on health-related quality of life are also collected for a sample of patients. This data is linked and evaluated – in a pseudonymized form – at the individual level.
24.02.2012
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.