Abstracts by keywords: healthcare research.
Rare diseases form a heterogeneous group of mostly complex clinical pictures. They often take a chronic course, accompanied by disability and/or reduced life expectancy, and often lead to symptoms as early as childhood. About 80% of the rare diseases are genetic or partly caused, they are rarely curable (BMG 2019) (Orphanet 2020) (Fig. 1). Due to the rare occurrence of familial hypophosphatemic rickets - including XLH - and the insufficient data in Germany, the aim of this health services research was to collect epidemiological data and to present the health care situation and pharmacoepidemiology of patients with a confirmed E83.30 ICD-10 diagnosis. For the retrospective analyses, routine data and billing data from statutory health insurance (GKV) were used, which are becoming increasingly important in health services research (Neubauer et al. 2014).
01.02.2021
Of all the discussions about “Big Data”, we are only interested in a small excerpt here: the ideas that have been made explicit on this topic in German health research or that have implicitly influenced the discussion. It is important to examine this section in more detail because biomedical research worldwide is in the process of significantly expanding its range of instruments. Unfortunately, the term “big data” does little to help us understand this process – on the contrary. It is about the historically unprecedented opportunity to observe large numbers of people with regard to the natural development of their health and to study the application and impact of interventions available on a mass scale. This approach has potential that has not yet been realized. The question of what access Germany will find to this development arises precisely from this perspective.
04.06.2018
Health services research has gained in importance over the last decade because it is becoming increasingly clear that the majority of scientifically based decisions in health care are based on data that have been carried out under the ideal conditions of an experimental study. These ideal conditions make it possible to demonstrate 'efficacy', which means that an expected effect was very likely brought about by the intervention suspected of causing this effect. Under these ideal conditions, however, it is not possible to test whether the effect proven as efficacy can also be induced under everyday conditions (effectiveness) if the naturally occurring confounding factors (confounders) such as comorbidity or therapies for concomitant diseases cannot be ruled out. The differences in the methods for proving efficacy and effectiveness have been described (Porzsolt et al. 2015). In order to be able to make reliable care decisions, however, information on effects that occur under everyday conditions is required. The Lancet addressed the significant problem of overuse that will be with us in the next decade (Berwick 2017; Brownlee et al. 2017). This problem can neither be quantified nor solved without depicting the reality of care (under everyday conditions).
03.04.2017
On January 1st, 2012, with the GKV-VStG, the legislator laid the foundation for the development of a new care structure, the "outpatient specialist medical care" (ASV). With the new version of § 116b SGB V (§ 116b SGB V "new"), since the beginning of 2012, not only hospitals but also contract doctors have been included in the regulations. The ASV essentially pursues two goals: Firstly, it is intended to contribute to overcoming the sectoral boundaries in the German health care system and, secondly, to achieve improved interdisciplinary coordination of diagnostics and therapy among the service providers. For the first time in the German healthcare system, the ASV is intended to open up the possibility for registered panel doctors and hospitals to work and work together across sectors under the same conditions (cf. e.g. G-BA 2015a; Klakow-Franck 2014b: 154 and 2015: 6). The introduction of the ASV was not least in the interest of panel doctors (cf. e.g. Klakow-Franck 2014b: 153), because under the existing regulations (§116b SGB V "old") they had to fear that the comparatively financially strong hospitals there is increasing competition with a correspondingly tougher competitive situation in the healthcare market. Contract doctors had also repeatedly filed lawsuits against hospital approvals under Section 116b SGB V "old" (cf. SVR 2012: 259).