Das Gesundheitswesen
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Das Gesundheitswesen · Dec 2011
Comparative Study[Comparison of hand surgery in the German and Italian DRG systems].
Diagnosis-related groups (DRGs) are a patient classification system grouping related types of patients treated to the resources they consumed. In this analysis we compared the Italian and the German DRG systems regarding hand surgery with an emphasis on reimbursement of clinical cases. The 15 most common hand surgical diagnoses and their corresponding operative treatment in our clinic in 2009 were processed using a DRG grouper. ⋯ The consumption of resources for finger replantation is not adequately represented in the Italian DRG system compared to finger amputation. Reimbursement of inpatient care is influenced by multiple factors not being subject to the free market economy. For this reason only descriptive comparison is feasible.
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Das Gesundheitswesen · Dec 2011
[Social medicine in medical faculties: realisation of the topic in the specialty "social medicine, occupational health"].
The 9 (th) Revision of German Medical Licensing Regulations for Physicians has come into effect on October 1 (st) 2003. Social medicine was separated into the fields "occupational health, social medicine" and the various cross-sectional modules: epidemiology, biometry, medical computer science; health economics, health-care system, public health; prevention, health promotion; rehabilitation, physical medicine, naturopathic treatment. This paper studies the realisation of teaching in the field social medicine at German medical faculties. ⋯ The realisation of teaching is different between the faculties concerning the number of hours, teaching methods and number of students per year. The motivation of the students is one of the problems, but also the lack of acceptance within the clinic. Specific resources and exchange between the faculties are necessary concerning e-learning, which is offered at only few faculties so far, but interest for a more intensive usage exists. Potentials of social medicine are the promotion of awareness among the students and the "identification of basics for medical acts in the social security system". Social medicine offers the possibility to connect the theoretical institutes with the clinic.
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Das Gesundheitswesen · Aug 2011
Review Comparative Study[Authorization and reimbursement of orphan drugs in an international comparison].
This paper analyses schemes to promote the authorisation of and reimbursement for orphan drugs. ⋯ On the one hand, the use of special criteria for drug admission, HTA, and reimbursement promotes R&D for orphan drugs. On the other hand, high opportunity costs arise, because huge efforts are made for a minority of patients. A solution for this moral dilemma may be the application of "rule of rescue" or of "no cure, no pay" programmes.
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Das Gesundheitswesen · Aug 2011
[Prevalence of helmet use in children and adolescents in Germany and preventable bicycle-related head injuries].
Head injuries are the main cause of death in bicycle-related accidents among children and adolescents. According to a Cochrane Review, the risk of head injury (OR 0.31; 95% CI 0.26-0.37) or brain injury (OR 0.31; 95% CI 0.23-0.42) decreases by 69% if a helmet is worn. This study presents the prevalence of helmet use in cycling children and adolescents in Germany and the proportion of head injuries that could be prevented by wearing helmets. The potential effects of increased helmet wearing rates on the population attributable risk percentage for head injuries (PAR%) are demonstrated. ⋯ Particularly older children and adolescents hardly use bicycle helmets, hence the rate of preventable head injury is high. Efforts towards increasing helmet use should address all age groups with a particular focus on school-aged children and adolescents.
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Das Gesundheitswesen · Jul 2011
Comparative Study[Measurement of patient preferences in ambulatory health-care centres (MVZ)--a comparison of quality of treatment between MVZ and family general practitioners].
The measurement of patient preferences on the basis of perceived quality of care in a comparison of two ambulatory health-care centres (medizinisches Versorgungszentrum, MVZ) with traditional ambulatory care consisting of single ambulatory practices was undertaken. The influence of the patients' perceived quality of care on patients' preference for an MVZ or traditional ambulatory care setting was analysed. Determinants of the patients' preference were identified. ⋯ The judgment in favour of the ambulatory health-care centres (MVZ) could be explained by organisational structures typical of these centres, e. g., the increased information sharing and cooperation amongst doctors. The identified determinants of the patients' "preference" indicate a practical approach for attaining a preference position in the health market, both for medical care centres as well as for single medical practices.