Abstracts by keywords: Health Services Research
The positive effects of such occupational therapy interventions, which ideally take place in the home environment, were demonstrated by Graff and colleagues in a study in which not only the everyday skills of the patients improved, but also the quality of life of both dementia patients and caring relatives (8, 9). Another area in which occupational therapy plays a central role in treatment and is listed accordingly in the guidelines is rheumatic diseases, such as rheumatoid arthritis, psoriatic arthritis and spondyloarthritis (5). Although positive effects of ergotherapeutic measures have been shown for these diseases, there has been a decreasing trend in prescriptions for rheumatism patients in recent years (10). According to Thieme et al., the reasons for this are: presumably in the budgeting of the remedies combined with the fear of recourse claims by the health insurance companies, in the complexity of the prescription of remedies for those insured by the statutory health insurance companies, in the low appreciation and/or supposedly low evidence of physical therapies and in the long time constant until the noticeable onset of effects (10) . The aim of this article was therefore to present the care profile of patients with occupational therapy prescriptions over a 5-year period. For this purpose, in addition to the age structure, the sex ratio, the living space (city/countryside), the insurance status and the diagnoses of the patients were examined.
24.01.2013
Current data from a cross-sectional study of referral patients from 29 general practitioner practices in Germany suggest that around a quarter of referrals take place at the request or request of the patient [1]. Information about such transfers in Germany is mainly based on opinion pieces and experience reports. There are numerous hits on the topic in the open Internet search service Google, especially in health-related public publications and general medical publications (“medical tribune”, “Ärztezeitung”, etc.). Referrals are sometimes issued after this without any doctor-patient contact having taken place [2-3]. Such referrals can lead to oversupply and thus endanger patient safety and strain medical and solidarity-funded resources. Due to the sparse scientific data for the German care system, the aim of this work was to collect experiences and opinions from general practitioners in the context of the active demand from patients explore transfer.
24.01.2013
Health care research and health care reality are closely intertwined. A constituent part of health services research is to analyze, evaluate and contribute to optimization of the reality of care. This is particularly important in the context of statutory health insurance. The implementation and optimization of care models is one of the core tasks of a health insurance company. Scientific evidence and health care management thus form a quasi-natural unit. The implementation of the findings from health services research into everyday care provides a direct benefit for those insured by the health insurance company as well as for the statutory health insurance.
24.02.2012
Many scientific innovations are developed in the field of basic research and then, based on the results of in-vitro research, are so solidly processed through small animal experiments that the path to applying these processes to humans is cleared. Further clinical research deals with measuring the effect of the therapeutic procedure and the side effects and at the same time lays the foundation for the approval procedures of the relevant authorities in North America and Europe. In order to be able to measure the effectiveness of therapeutic procedures, special patient groups are often put together in order to measure the effect of the new procedure/medication on a placebo procedure or on other, often older, medications or medical procedures/procedures in prospective randomized studies. A fundamental bias in these studies is often a strictly selected patient population that only slightly corresponds to the overall “real world” population addressed under field conditions.
07.02.2011
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
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.