Abstracts by keywords: Diabetes mellitus
Diabetic polyneuropathy (DPN) is associated with significantly increased healthcare costs and thus an economic burden on society and the healthcare system (Happich et al. 2008; Khdour 2020; Shillo et al. 2019). A high number of hospital stays, need for care, incapacity to work as well as follow-up costs of DPN (e.g. amputations) and an overall greater use of healthcare resources are responsible for the higher medical costs (Sadosky et al. 2015; Schroeter/Hartung 2005; Ziegler 2020) and illustrate this Burden on patients suffering from DPN. The costs tend to increase as the burden of illness increases (Happich et al. 2008).
28.11.2022
Diabetic polyneuropathy (DPN) is associated with significantly increased healthcare costs and thus an economic burden on society and the healthcare system (Happich et al. 2008; Khdour 2020; Shillo et al. 2019). A high number of hospital stays, need for care, incapacity to work as well as follow-up costs of DPN (e.g. amputations) and an overall greater use of healthcare resources are responsible for the higher medical costs (Sadosky et al. 2015; Schroeter/Hartung 2005; Ziegler 2020) and illustrate this Burden on patients suffering from DPN. The costs tend to increase as the burden of illness increases (Happich et al. 2008).
28.11.2022
Networks for the treatment of people with diabetic foot syndrome (DFS) in North Rhine, Hamburg and Berlin have submitted joint documentation. This is known as the DFS register [1] and is used for quality assurance and the identification of new findings for better care for people with DFS [2, 3]. The networks have taken further quality assurance measures, including certification by the AG Fuß of the German Diabetes Society (DDG), annual internships, training for doctors and assistants, communication tools and quality circles. In particular, they have set up a learning system with shadowing and a completely transparent comparison of all treatment numbers and a discussion about it. They have cared for an increasing number of people with DFS since 2002, with a total of around 60,000 people at the end of 2016. The following health insurance companies support these efforts through selective contracts: AOK Nordost, AOK Rheinland/Hamburg, BARMER, Bundesknappschaft, mhplus BKK, DAK Gesundheit, IKK classic, KKH, pronova BKK and SVLFG. Similar models have been implemented in other regions. This overview compiles the results of all analyzes that have become public in Germany that have examined the effects of specialized care for people with DFS in networks. The evaluations range from surveys in the DFS register to population-based surveys by independent scientists.
24.07.2017
Diabetes mellitus is a chronic metabolic disease in which the blood sugar concentration is permanently elevated due to limited insulin action or release (American Diabetes Association 2012). In the long term, diabetes increases the risk of concomitant and secondary diseases such as cardiovascular diseases, retinal damage and diabetic foot syndrome. As a "widespread disease" with a large number of sufferers, diabetes mellitus is of considerable relevance to public health. On an individual level, the disease is associated with restrictions on quality of life and life expectancy; on a societal level, it is associated with high costs for the healthcare system (Koster et al. 2012).
24.07.2017
In Germany, an estimated 250,000 people with diabetes currently have a foot lesion and around 1 million diabetics are at increased risk of suffering a foot injury. This makes diabetic foot syndrome (DFS) one of the main complications of patients with diabetes mellitus, with the most significant consequences of diabetic foot problems being ulcers (deep substance defects, commonly ulcers - often in the form of chronic wounds) as well as small (minor) and high (major) Amputations are [1]. Although the DMP diabetes mellitus type 2 has been in existence since 2003 and the DMP diabetes mellitus type 1 since 2005, in which over four million diabetics now take part [2] and thus outpatient care for diabetics has improved overall, they appear to have increased complication rates microangiopathy, especially that of diabetic foot syndrome, does not have a positive effect. When checking the level of target achievement of the fund's own DMP Diabetes, the AOK Nordost noticed that the once-a-year foot examination specified here was not carried out without interruption for all diabetics, and that if an abnormal foot status was detected, there was not always a referral or a late referral to a specialist The treatment and further treatment of the abnormal foot was only initiated with a long delay and amputations occurred, although only low levels of severity were consistently stated in the DMP documentation. In 2011, the “Gesundheitskasse” took this as an opportunity to conclude a contract with doctors who are particularly qualified to care for DFS patients in accordance with Section 73c SGB V, which is intended to improve diabetologically qualified outpatient care for insured persons with DFS. This article presents the first evaluations of the DFS contract, with which AOK Nordost was able to meet its self-imposed goal of reducing amputations among its insured persons with diabetic foot syndrome.
31.03.2016
When discussing surrogates and endpoints, one quickly comes to the question of which treatment results and characteristics are actually relevant for the patient. The appropriate expression “patient-relevant endpoint” is anchored in the legal basis for early benefit assessment according to Section 35a SGB V.1 While in other places there is explicit talk of a “therapy-relevant higher benefit” or “therapy-relevant side effects” (cf. e.g. § 35 Para. 1b SGB V), is clearly aimed at the patient. In the associated dossier specifications for Section 35a SGB V, module 3.3.6 mentions patient preferences as a data source to be taken into account.2 Thus, the importance of patient-relevant endpoints and patient preferences has increased with the AMNOG (Law on the Reorganization of the Medicines Market), but what role they play in concrete terms plays is still to be clarified. Nevertheless, the IQWiG (Institute for Quality and Efficiency) commissioned pre-AMNOG for two pilot studies on preference measurement (Conjoint Analysis, Analytical Hierarchy Process), one of which has already been published. IQWiG also focuses on patient preferences in its current method paper (see IQWIG (2013); IQWIG (2010b); IQWIG (2011)).
24.01.2013
The Defined Daily Dose (DDD) is a theoretical quantity that was developed as an international standard comparison quantity for drug consumption research. It indicates the assumed mean maintenance dose per day in adults for an active ingredient in its main indication. In Germany, the official German version of the ATC classification (Anatomical-Therapeutic-Chemical Classification) including the DDD information is published by the DIMDI (German Institute for Medical Documentation and Information) (DIMDI 2010). This is based on the version of the WHO, which is responsible for creating the internationally standardized ATC/DDD system (Fricke et al. 2011). Both the WHO and the AOK Scientific Institute (WIdO), which in turn publishes the methodology of the ATC classification and DDD determination for Germany, point out that the DDD is a calculated quantity that is not related to the therapeutic or prescribed dose may be confused. For longitudinal drug consumption research, the DDDs must be kept stable and are therefore unsuitable as a basis for decision-making for questions regarding drug reimbursement, pricing and therapy (Fricke et al. 2011).
02.10.2012
According to the latest figures from the International Diabetes Federation (IDF), Germany is the country with the highest diabetes prevalence in Europe. 12% 20 to 79 year olds are affected, a total of around 7.5 million people. In Germany, around 90% are type 2 diabetics, while around 5-10% are type 1 diabetics. Patients are cared for by 50,000 to 60,000 general practitioners nationwide (approx. one doctor per 1,500 inhabitants), around 1,100 specialist practices with diabetologists and around 350 special clinics. The aim of treating patients with diabetes is to prevent complications such as macroangiopathy (coronary heart disease, stroke, arterial occlusive disease), microangiopathy (eye and kidney damage), neuropathy or diabetic foot syndrome and to maintain the quality of life of those affected. In addition to lifestyle adjustments or medication measures, structured patient training is essential for successful diabetes treatment. Although there are still serious deficits in patient training despite disease management programs (DMP), patient training in Germany can be of a high standard compared to other countries.
23.09.2012
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.