Abstracts by keywords: ophthalmology
The affiliated doctor system is a long-established form of integrative and cross-sectoral care (Hahn et al., 2015a, 2015b; Wienke and Mündnich, 2011). Both care approaches are also currently in the focus of German politics: (More) integrated care has been repeatedly demanded for almost 20 years now (Mühlbacher et al., 2006). The innovation fund, which became German law in the Supply Strengthening Act of June 10, 2015, provides 225 million euros per year to "new forms of care that aim to improve cross-sector care and have sufficient potential to be permanently included in care". (German Bundestag, 2015). In the classic understanding of affiliated doctors, a doctor who primarily works as a panel doctor/outpatient treats his patients using inpatient resources in a hospital in an affiliated department. For this purpose, the attending doctor has a contract with the hospital to be able to use the infrastructure (including staff) in the hospital. The attending doctor and the hospital are paid independently of each other. While the affiliated doctor accounts for his work using the uniform assessment scale (EBM), the hospital receives a so-called affiliated doctor DRG.
31.03.2016
The affiliated doctor system is a long-established form of integrative and cross-sectoral care (Hahn et al., 2015a, 2015b; Wienke and Mündnich, 2011). Both care approaches are also currently in the focus of German politics: (More) integrated care has been repeatedly demanded for almost 20 years now (Mühlbacher et al., 2006). The innovation fund, which became German law in the Supply Strengthening Act of June 10, 2015, provides 225 million euros per year to "new forms of care that aim to improve cross-sector care and have sufficient potential to be permanently included in care". (German Bundestag, 2015). In the classic understanding of affiliated doctors, a doctor who primarily works as a panel doctor/outpatient treats his patients using inpatient resources in a hospital in an affiliated department. For this purpose, the attending doctor has a contract with the hospital to be able to use the infrastructure (including staff) in the hospital. The attending doctor and the hospital are paid independently of each other. While the affiliated doctor accounts for his work using the uniform assessment scale (EBM), the hospital receives a so-called affiliated doctor DRG.
31.03.2016
Intravitreal surgical medication administration (IVOM) has been a standard service for surgical ophthalmologists (ophthalmic surgeons) since 2005. “Macugen” was approved by the European regulatory authority EMA on January 31, 20061. Ranibizumab (“Lucentis”) was approved on February 22, 20072. With the MARINA and ANCHOR approval studies for “Lucentis”, the company Genentech was able to demonstrate that a monthly administration of 0.5 mg ranibizumab leads to visual acuity stabilization in around 95% of patients and that a clinically significant improvement in visual acuity can be achieved in around 34% of patients3,4. This medical breakthrough in the treatment of wet AMD prompted a large number of ophthalmologists in Baden-Württemberg, among others, to offer the treatment of wet AMD with bevacizumab in 2005 in order to help all those patients who would otherwise at least have to wait until the EMA approval and the availability of “Lucentis” in Germany would have suffered irreversible loss of vision. Bevacizumab and ranibizumab have an identical mechanism of action5. This means that a significant proportion of those insured by AOK Baden-Württemberg with wet AMD were already on bevacizumab therapy at the time “Lucentis” was launched on the market in February 2007.
31.03.2015
The realignment of care structures to optimize health care across the various service sectors is one of the most important health policy challenges for several decades. Even though medical care in Germany is still characterized by good accessibility and a high level of quality, the frequently discussed challenges in care - keywords include demographic development, multimorbidity, a shortage of doctors and skyrocketing costs - are increasingly threatening to ensure this level of care. Assuming that supply needs can no longer be adequately met in terms of quality and logistics via traditional forms of organization, the structures as a whole must be put to the test and, if necessary, redesigned. In the last ten years in particular, lawmakers have increasingly implemented a variety of laws and reforms to strengthen intersectoral cooperation. With the GKV Health Reform Act in 2000, integrated care was incorporated into German legislation for the first time and reformulated with the GKV Modernization Act of 2004. This formed the basis for selective contractual relationships between health insurance companies and service providers and was instrumental in the increasing importance of cross-sector forms of care. The most recent health care reform as part of the Care Structure Act (VstG), which came into force in January 2012, does not create a breakthrough for cross-sector care models, but it does set certain prerequisites for better interlinking of the service sectors. With the change in § 87 b SGB V, the importance of doctor networks in particular is experiencing a new dynamic. Doctors are significantly more motivated to participate in cooperative models through the possibility of separate remuneration regulations and fee volumes for networked practices.