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Abstracts by keywords: care research

Reform of hospital financing: Revenue-independent provision fees for acute maternity facilities

Since 2003, hospital services have been reimbursed through the case-volume-dependent, flat-rate reimbursement system of the G-DRG (German Diagnosis Related Groups) (Section 17b (1) Sentence 1 KHG/Reimbursement Institute 2023). Diagnosis, severity of the illness, and the operations and procedures performed, along with other parameters if applicable, are entered into the patient classification system for grouping (Reimbursement Institute 2023). Although other countries, such as the United Kingdom, Finland, and the Netherlands, also use DRG systems, Germany has a strong performance and volume incentive compared to other countries1. Despite the additional refinancing of nursing care through the nursing budget introduced in 2020 (Reimbursement Institute 2023), there is no case-volume-independent refinancing of necessary provision (Federal Ministry of Health 2023).

04.12.2023
Increasing skin cancer prevalence with low uptake of skin cancer screening

Early detection, the so-called skin cancer screening, has been a service since 2008 that legally insured people aged 35 and over can use every two years free of charge. Dermatologists and doctors from certain specialist groups with appropriate training examine the skin for suspicious changes that should be removed. The analyzes carried out here describe the status quo and development trends in utilization. The basis of the analyzes is the anonymized research database of AOK Nordost with its approximately 1.75 million insured persons. The results presented capture the development between 2008 - the year skin cancer screening was introduced as an insurance benefit - and the year 2015. All AOK Nordost insured persons aged 35 and over who were fully insured within the year under consideration and in the three federal states of Berlin , Brandenburg and Mecklenburg-Western Pomerania are part of the study population. In 2008, the study population comprised approximately 1.23 million insured people. By 2015, it had fallen to around 1.19 million insured people (see Table 1). For some analyses, nationalities were examined. Nationality can be viewed as an indicator of differences in individual risk factors – such as skin type.

04.06.2018
Seasonal pollen allergies in children and adolescents – utilization and persistence of specific immunotherapy

Pollen-related allergic rhinitis (hay fever) is one of the most common allergic diseases in children and adolescents (Schmitz et al. 2017). In Germany, the 12-month prevalence of medically diagnosed hay fever among 3 to 17 year olds is 9.9% (Poethko-Müller et al. 2018). This results in an allergic reaction of the nasal mucosa and the conjunctiva to certain pollen, for example that of birch, which leads, among other things, to increased secretion, sneezing, restrictions in nasal breathing and itching. Although the symptoms of a pollen allergy can be very stressful and severely limit the quality of life and academic success, they are often trivialized (Greiner et al. 2011). In addition, high direct and indirect economic costs are attributed to allergic rhinitis and its secondary diseases, for example bronchial asthma and later COPD (Pfaar et al. 2014).

04.06.2018
Development of antibiotic prescriptions for children and adolescents

As part of the 1st Northeast Children's Report of the Northeast Health Sciences Institute of the AOK Nordost, the development of antibiotic use in the pediatric setting was also examined (Witte et al. 2017). In general usage and also in the clinical context, antibiotics refer to active ingredients that inhibit the growth of bacteria or kill them. Due to decades of excessive and untargeted use of antibiotics, the increase in insensitivity of bacterial pathogens has developed into a significant public health problem worldwide. Patients and doctors are increasingly confronted with bacterial strains that are resistant to many common antibiotic agents (WHO 2011). As a result of the increase in so-called multi-resistant pathogens, the duration of treatment, the severity of the disease and the risk of death from serious infections are increasing. The same applies to the resulting costs of appropriate medical care (Aloush et al. 2006; Maragakis et al. 2008; Song et al. 2003; Qavi et al. 2005).

06.12.2017
Diagnoses and therapies for psychogenic eating disorders in Berlin, Brandenburg and Mecklenburg-Western Pomerania between 2010 and 2016

Psychogenic eating disorders include various types of eating disorders that differ in their symptoms. Psychogenic eating disorders include anorexia nervosa (AN), also known as “anorexia”. In addition to bulimia nervosa (BN), also known as “bulimia” or “eating addiction”, and binge eating disorder (BES, also “eating addiction”), AN is one of the most researched forms of eating disorders. Depending on the type of eating disorder, different symptoms are characteristic of psychogenic eating disorders (DGPM/DKPM 2010). The risk of chronicity in eating disorders is high. Those affected usually have to struggle with the disease for several years, require several treatment attempts and the symptoms sometimes persist even after successful therapy. In addition, it is assumed that most of those affected do not attract attention in the healthcare system and that only a fraction of those who do seek treatment (Hoek 2006; DGPM/DKPM 2010; Smink 2016). In addition, eating disorders are accompanied by numerous physical sequelae. The earlier the disease breaks out, the higher the risk of chronic damage (Holtkamp/Herpertz-Dahlmann 2005). In addition, deaths due to an eating disorder are often due to the physical consequences. Overall, mortality in eating disorders is significantly higher: in bulimia by a factor of 1.9 and in anorexia by a factor of 5.9 (Smink 2016).

06.12.2017

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