Abstracts by keywords: cost effectiveness analysis
Orthopedic operations are among the most common operations in German hospitals and, according to initial forecasts, will continue to gain in importance as society ages [1, 2]. In order to avoid immobilization damage and to specifically support the healing process, mobilization measures should be started as early as possible during operations on knee joints, which must be carried out (almost) exclusively passively in the early postoperative phase. This is particularly true if the patient cannot or is not allowed to carry out any active self-exercises [3-7]. In addition to physiotherapeutic treatments, the use of motor-driven movement splints (Continuous Passive Motion - CPM splints) has become established in practice for passive movement of the joints. In the knee area, CPM movement splints are often used after endoprosthetic joint replacements, cartilage, tendon and ligament reconstructions as well as for exercise-stable osteosynthesis [8-13]. Numerous studies deal with the rehabilitative aftercare of patients after joint operations, but only rarely in the context of outpatient follow-up treatment in Germany. This work focuses on the actual care situation of patients in Germany in the sense of real world evidence. The starting point is a process cost analysis that documents the postoperative follow-up treatment of patients after knee joint surgery. The focus is on evaluating the cost-effectiveness of different treatment alternatives. Postoperative mobilization can be accomplished through the use of CPM motion splints, physical therapy, or a combination of both. The use of physiotherapy is regulated via the Therapeutic Products Directive; CPM movement splints are listed in the list of aids according to Section 139 SGB V as externally powered movement splints for the knee joint, among other things [14].
04.06.2018
With the Statutory Health Insurance Competition Strengthening Act (GKV-WSG), the Institute for Quality and Efficiency in Health Care (IQWiG) has been given the additional task of carrying out the economic evaluation of medicines in the form of cost-benefit assessments. In their last article for this magazine (MVF 1/2009: 32-37), the head of IQWiG, Prof. Dr. med. Peter Sawicki and two of his employees briefly presented the methodology newly developed by IQWiG and its motivation. Against the background of many years of research in health economics, the conclusion is disappointing. Neither the internationally applied standards of scientific research were taken into account, nor were the long-standing experiences of other comparable assessment agencies such as the National Institute for Health and Clinical Excellence (NICE) taken into account in the specific design of the cost-benefit assessment. The hope remains that with the presentation and discussion of the recently commissioned pilot studies, the influence of health economics experts will increase again in order to move the German special approach in cost-benefit assessment more towards the standards accepted in health economics.
01.04.2009
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.