Abstracts by keywords: health insurance
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
Immigration to Germany, which has increased significantly since 2014 and increased sharply since 2015, also poses new challenges for the health care system in particular when it comes to ensuring health care. The previously insufficiently researched problem of overcoming language barriers, cultural differences and logistical challenges to ensure optimal access to healthcare, but also to ensure that migrants receive healthcare that meets their needs, should be examined in this study – the first “Berlin Migrant Study” – by GeWINO be discussed and presented. The North East Health Sciences Institute (GeWINO) of the AOK Nordost has been monitoring the development of health care for people with a migrant background for some time now, also within the framework of the “International Health Insurance” focus, and, together with regional partners, is looking for quick and unbureaucratic solutions to improve the health care of migrants in Berlin, Brandenburg and Mecklenburg-Western Pomerania. The aim of the first “Berlin Migrant Study” was to provide data and facts on the current development of health care for migrants in Berlin in order to support the planning and development of regional structures to overcome the challenges posed by migration in the German health care system and to address these through innovative measures AOK Nordost to be added. The first “Berlin Migrant Study” was carried out by the North East Health Sciences Institute (GeWINO) of the AOK Nordost in cooperation with the bbw Bildungswerk der Wirtschaft in Berlin und Brandenburg eV and the bbw Hochschule Berlin in 2015. The second “Berlin Migrant Study”, which is being carried out in the same constellation, has already been started and GeWINO will continue to devote itself to the topic in the future.
31.03.2016
One of the biggest health policy challenges in the coming decades will be the increase in mental illnesses. From 2009 to 2010 alone, health insurance companies recorded an increase in the number of patients requiring treatment of 21.4 % [1]. According to forecasts, the number of patients will continue to increase in the future and, according to the World Health Organization, mental illness will be the second most common widespread disease in 2020 [2]. Consequently, the resulting effects on our healthcare system and, not least, the resulting costs are a central topic of discussion [3]. In Germany e.g. B. According to calculations by the Federal Institute for Occupational Safety and Health, direct costs of 16 billion euros per year (as of 2011) arise due to illnesses from the depressive form [4]. These are expected to double to 32 billion euros by 2030 [4]. One reason for this is, among other things, the increasing number of prescriptions of antidepressants. This increased by 7% between 2010 (1176 DDD = defined daily dose) and 2011 (1257 DDD) [5]. According to the German Society for Psychiatry and Psychotherapy, Psychosomatics and Neurology (DGPPN), this development will continue in the future. This can be explained by the fact that due to demographic change, an increase in older people is to be expected and they are often affected by depression [2].
31.03.2015
When it comes to health matters, patients are anything but used to taking responsibility for themselves and their health. SGB V already emphasizes that they have shared responsibility and a duty to cooperate. However, it assigns the main responsibility to statutory health insurance. In the past, the traditional way of thinking in medicine often led to patients being seen as objects of medicine without their own responsibility (Schmid et al., page 14). In this context, the focus of care on acute, episodic and one-dimensional diseases is specifically mentioned, not least due to ever-increasing specializations (Müller-Mundt and Schaeffer, page 143).