Das Gesundheitswesen
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Das Gesundheitswesen · Jan 1996
[Analysis of regional differences in hospitalization rate and length of stay costs].
Performance of an analysis of hospitalised cases based on processed statutory health insurance data on inpatient treatments. Object of the examination were regional differences in the frequency of hospitalisation and in the volume of payable (invoised) days and the relevant determining parameters. ⋯ The results prompt more detailed analyses of inpatient care activities including structural parameters of the outpatient sector. Actually we can recognise certain limitations preventing a uniform patient care by statutory health insurance physicians and uniform inpatient care, in the sense imposed by the official policy to ensure such uniformity.
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Das Gesundheitswesen · Nov 1995
[Partial financing of public health services by federal insurance--conceptional restriction or future model?].
The growing deficits of community budgets force the Public Health Service to streamline its duties and activities and to develop strategies which allow reimbursement by other resources. The possibilities for part financing of tasks of the Bremen Public Health Office by local statutory health insurance funds are considered and discussed.
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Das Gesundheitswesen · Oct 1995
[The Lee-Carter model of the prognosis of mortality in Germany. Berlin Public Health Research Group--partial project "Goals and Goal Indicators for Public Health in East and West Berlin"].
A model for forecasting mortality developed by Lee and Carter is applied to data of West Germany. The logs of the age-specific death rates are modeled as a linear function of an unobserved mortality index using the singular value decomposition method. The forecasts are based on projections of all individual trends of the mortality rates. Applied to life expectancy at birth between 1969 and 1992 the model implies an increase of 2.2 years in life expectancy for men and 2.4 years for women in 2002.
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Das Gesundheitswesen · Oct 1995
[Interrater reliability of expert assessment by the health insurance medical service in determining eligibility for disability benefits].
In this paper, we present the first study on the inter-rater reliability of a standardised examination of functional disability, employed by the medical service of the German statutory health insurance system ("Medizinischer Dienst der Krankenversicherung", MDK). 215 elderly adults (mean age 84) living in 6 nursing homes in Munich were included in the study. They were assessed by three medical students and two nurses of the respective nursing homes using the standardised questionnaire of the MDK. ⋯ Reliability was particularly low for some items on mental status (such as "restlessness") or perceptions (particularly visual perception) which require clearer definition. This pattern was consistently observed for the two types of comparisons (inter-students, nurse-nurse) and for different subgroups of the study population.
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Das Gesundheitswesen · Oct 1995
[Longitudinal analysis of utilization of inpatient treatment based on insurance data of mandatory health insurance].
To investigate which of the routinely collected claims data from the German "Legal sickness funds" on hospital utilisation may be used, in addition to that prescribed by the legislator. ⋯ The parameters related to insured persons, cases and specifically personal parameters of hospital utilisation allow a detailed analysis of hospital care; different utilisation and user patterns can be investigated and possible determinants of utilisation can be identified. After technical transformation, routine data of the sickness funds can be used to obtain information relevant for health care planners as well as for quality management.