Abstracts by key term: Health services research
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
The aim of the study was to analyze DRG-attributable effects on the care process in and around the hospital. On the basis of 30 representatively selected hospitals in Lower Saxony and using a differentiated methodology, it was possible to show: 1. The quality of direct patient care in the hospital has largely not changed due to the introduction of the DRG. 2. There is no evidence for a targeted selection of lucrative treatment cases. 3. The phenomenon of a "bloody dismissal" cannot be proven. 4. An increase in unplanned readmissions ("revolving door effect") in the course of the introduction of the DRG cannot be proven. 5. The hospitals have created the essential prerequisites for the operational implementation of the DRG system; a future-oriented strategic alignment and a consistent process design has only been partially implemented. 6. The working conditions have changed in the course of the introduction of the DRG, with the documentation and coding effort being overestimated. 7. The medium-sized and large hospitals are largely economically successful even under DRG conditions because they can use the opportunities for strategic realignment, while this is much more difficult for the smaller hospitals.
01.04.2010
The aim of the present analysis is to compare treatment costs between insulin-glargine and NPH-insulin-based therapies in patients with diabetes mellitus. Using a representative sample of health insurance data, simultaneous co-medication in the indication groups bolus insulin, oral antidiabetics, test strips and lancets/needles over three calendar years was determined for a total of six payers. During the analysis period (2006 - 2008), the aggregated absolute annual treatment costs per diabetes patient for insulin glargine-based therapies tended to be slightly below the costs of the respective NPH comparison groups. The analysis of the individual costs shows that the higher procurement costs for insulin glargine are overcompensated by savings in bolus insulin and test strip consumption. The present database analysis confirms the results of previously published health care research studies, according to which, from the perspective of statutory health insurance (GKV), there is a cost-neutrality between insulin glargine and NPH insulin-based treatment regimens under real care conditions.
01.12.2009
According to estimates from individual doctors, the vaccination status of around 40 percent of patients does not correspond to the current recommendations of the Standing Vaccination Commission. However, reliable data on the vaccination protection of outpatient primary care patients is sparse. Methods: In this study, standardized vaccination-related data were collected from patients from 118 primary care practices. Results: The results of the survey (n=557) suggest that vaccination gaps exist among older general practitioner patients and that factors influencing vaccination rates in the general practitioner sector in Germany have both patient and, in some cases, practice-specific characteristics. Conclusion: Relevant data on vaccination protection could be collected using a representative cross-sectional survey. As part of applied family medicine research, the present study contributes to improving the data situation on vaccinations in older adults.
01.10.2009
Patient coaching as an innovative service in healthcare serves the purpose of promoting therapy adherence (compliance, adherence), active participation and self-management of patients in overcoming their illness, taking into account individual preferences. In this episode, examples are given of the efficiency reserves that can be expected from patient coaching compared to the effects of drug discount agreements, and that some health insurance companies have integrated patient coaching programs into their care management as pilot projects. A classification matrix is presented for more transparency of coaching programs. In addition, numerous open questions are addressed, which could be answered by appropriate health services research.
01.10.2009
Direct contracts started out as discount contracts for pharmaceuticals. In the meantime, however, it is becoming apparent that they are covering more and more areas of care through general practitioner and specialist contracts. Everyone should benefit from these contracts: Health insurance companies have a better influence on the service, service providers receive better remuneration and patients better care. But it shouldn't cost more either. Whether this is successful can only be shown by means of health services research. It should also be noted that direct contracts must not put you in a worse position than standard care. This specification, which has received little attention in the previous discussion, is a steep template for health services research.
01.06.2009
In the course of the Europeanization of the healthcare system, interest in healthcare system comparisons has also increased noticeably. Looking beyond one's own health policy inevitably enables the strategic further development of best-practice approaches in the health sector. The instruments of the open method of coordination (OMK) adopted by the EU are proving to be a creative driving force in the development of a Europe-wide comparison of health systems. Health policy reform processes triggered by this should also undergo a regular controlling process at the health care level, which requires the targeted methodical use of health care research. As a result, a European model of health services research could be on the health policy agenda in the foreseeable future.
01.03.2009
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.