scholarly journals PCN502 RETROSPECTIVE GKV [GESETZLICHE KRANKENVERSICHERUNG (STATUTORY HEALTH INSURANCE)] STUDY ON INITIAL TREATMENT OF BLADDER CARCINOMA (BCA) BY TRANSURETHRAL BLADDER RESECTION (TURB) - A COMPARATIVE ANALYSIS OF COSTS AND UROLOGICAL FOLLOW-UP THERAPIES USING STANDARD WHITE LIGHT- (WL-) VS. BLUE LIGHT- (BL-)TURB

2019 ◽  
Vol 22 ◽  
pp. S535
Author(s):  
M. Maas ◽  
A. Stenzl ◽  
M. Ketz ◽  
N. Kossack ◽  
C. Colling ◽  
...  
Keyword(s):  
Health Insurance ◽  
Comparative Analysis ◽  
Blue Light ◽  
White Light ◽  
Bladder Carcinoma ◽  
Initial Treatment ◽  
Statutory Health Insurance ◽  
Gesetzliche Krankenversicherung

scholarly journals Treatment Costs of Matrix-Associated Autologous Chondrocyte Implantation Compared With Microfracture: Results of a Matched-Pair Claims Data Analysis on the Treatment of Cartilage Knee Defects in Germany

2019 ◽  
Vol 7 (12) ◽  
pp. 232596711988658
Author(s):  
Philipp Niemeyer ◽  
Tino Schubert ◽  
Marco Grebe ◽  
Arnd Hoburg
Keyword(s):  
Health Insurance ◽  
Autologous Chondrocyte Implantation ◽  
Claims Data ◽  
Statutory Health Insurance ◽  
Cartilage Damage ◽  
Treatment Costs ◽  
Chondrocyte Implantation ◽  
Additional Costs ◽  
Autologous Chondrocyte

Background: Articular cartilage damage is caused by traumatic sport accidents or age-related degeneration and might lead to osteoarthritis, which represents a socioeconomic burden to society. Cartilage damage in the knee is commonly treated surgically with microfracture (MFX) or matrix-associated autologous chondrocyte implantation (MACI). Purpose: To quantify the initial and follow-up costs associated with MFX and MACI treatments from the viewpoint of statutory health insurance in Germany. Study Design: Economic decision analysis; Level of evidence, 2. Methods: This comparative study was based on an anonymized representative claims data set of 4 million patients covered by statutory health insurance in Germany. Patients undergoing outpatient or inpatient treatment with MACI or MFX for cartilage damage in the knee between January 1, 2012, and December 31, 2013, were included and evaluated over 5 years. Groups (MACI and MFX) were adjusted via propensity score matching before initial treatment. The matched groups were compared regarding their outpatient, inpatient, pharmaceutical, and other costs during the 5-year period. Results: In total, 127 patients per group were analyzed (59.1% male, 40.9% female; mean age, 37 years). In the year of the initial surgical procedure, costs were €14,804.13 in the MACI group and €5458.59 in the MFX group. In years 2 and 3 after initial surgery, treatment costs were comparable between patients treated with MACI (€2897.97 and €2114.87, respectively) and MFX (€2842.66 and €1967.42, respectively), with slightly higher treatment costs for those treated with MACI. In years 4 and 5 after surgery, costs were less in patients treated with MACI (€2154.79 and €1478.08, respectively) than in those treated with MFX (€2232.57 and €2061.63, respectively). Costs related to revision surgery were, on average, €3732 for MACI and €3765 for MFX. Thus, additional costs in years with revision surgery were €1672 for MACI and €1915 for MFX. Conclusion: This was the first study to analyze a large representative population claims database with propensity score matching, and results indicated that follow-up costs of patients treated with MACI and MFX began to converge over time. We found that total costs for MACI were higher than for MFX but that additional costs for MACI were lower than previously reported. Perceived morbidity may have little to do with cost.

Gesetzliche Krankenversicherung – Welche Faktoren beeinflussen die Krankenkassenwahl?

2018 ◽  
Vol 23 (01) ◽  
pp. 10-10
Author(s):  
Helena Thiem
Keyword(s):  
Health Insurance ◽  
Statutory Health Insurance ◽  
Gesetzliche Krankenversicherung ◽  
Health Econ ◽  
Customer Preferences ◽  
German Statutory Health Insurance

Pendzialek J et al. Measuring customer preferences in the German statutory health insurance. Eur J Health Econ 2017; 18: 831–845 Mit dem Gesundheitsstrukturgesetz von 1992 wurde u. a. die freie Krankenkassenwahl eingeführt. Diesem Gesetzesentwurf folgten in den letzten Jahren verschiedene weitere, die den Wettbewerb innerhalb der gesetzlichen Krankenversicherung (GKV) in Deutschland stärken und so langfristig deren Effizienz und Qualität steigern sollten. Pendzialek et al. untersuchten aus Perspektive der Versicherten, welche Attribute die freie Krankenkassenwahl beeinflussen.

scholarly journals Comparison of Survival Between Patients Receiving General Ambulatory Palliative Care and Patients Receiving Other Palliative Care - Analysis of Data of a Statutory Health Insurance Data

2021 ◽  
Author(s):  
Kilson Moon ◽  
Laura Rehner ◽  
Wolfgang Hoffmann ◽  
Neeltje van den Berg
Keyword(s):  
Palliative Care ◽  
Health Insurance ◽  
Median Survival ◽  
Statutory Health Insurance ◽  
Survival Curves ◽  
Specialized Care ◽  
Group A ◽  
One Year ◽  
Group B

Abstract Background The care of palliative patients takes place as non-specialized and specialized care, in both ambulatory and stationary settings. However, palliative care is largely provided as non-specialized care in the ambulatory sector (AAPV). This study aimed to investigate whether the survival curves of AAPV patients differed from those of the more intensive palliative care modalities and whether AAPV palliative care was appropriate in terms of timing.Methods The study is based on claims data from a large statutory health insurance. The analysis included 4,177 patients who received palliative care starting in 2015 and who were fully insured one year before and one year after palliative care or until death. The probability of survival was observed for 12 months. Patients were classified into group A, which consisted of patients who received palliative care only with AAPV, and group B including patients who received stationary or specialized ambulatory palliative care. Group A was further divided into two subgroups. Patients who received AAPV on only 1 day were assigned to Subgroup A1, and patients who received AAPV on two or more days were assigned to Subgroup A2. The survival analysis was carried out using Kaplan-Meier curves. The median survival times were compared with the log-rank test.Results The survival curves differed between groups A and B, except in the first quartile of the survival distribution. The median survival was significantly longer in group A (137 days, n=2,763) than in group B (47 days, n=1,424, p<0.0001) and shorter in group A1 (35 days, n=986) than in group A2 (217 days, n=1,767, p<0.0001). The survival rate during the 12-month follow-up was higher in group A (42%) than in group B (11%) and lower in group A1 (38%) than in group A2 (44%).Conclusions The results of the analysis revealed that patients who received the first palliative care shortly before death suspected insufficient care, especially patients who received AAPV for only 1 day and no further palliative care until death or 12-month follow-up. Palliative care should start as early as necessary and be continuous until the end of life.

scholarly journals Continuity in palliative care – analysis of intersectoral palliative care based on routine data of a statutory health insurance

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Laura Rehner ◽  
Kilson Moon ◽  
Wolfgang Hoffmann ◽  
Neeltje van den Berg
Keyword(s):  
Palliative Care ◽  
Health Insurance ◽  
Statutory Health Insurance ◽  
Routine Data ◽  
Chi Square ◽  
Discharge Management ◽  
Care Training ◽  
Discharge From Hospital ◽  
Ambulatory Health Care

Abstract Background The goal of palliative care is to prevent and alleviate a suffering of incurable ill patients. A continuous intersectoral palliative care is important. The aim of this study is to analyse the continuity of palliative care, particularly the time gaps between hospital discharge and subsequent palliative care as well as the timing of the last palliative care before the patient’s death. Methods The analysis was based on claims data from a large statutory health insurance. Patients who received their first palliative care in 2015 were included. The course of palliative care was followed for 12 months. Time intervals between discharge from hospital and first subsequent palliative care as well as between last palliative care and death were analysed. The continuity in palliative care was defined as an interval of less than 14 days between palliative care. Data were analysed using descriptive statistics and Chi-Square. Results In 2015, 4177 patients with first palliative care were identified in the catchment area of the statutory health insurance. After general inpatient palliative care, 415 patients were transferred to subsequent palliative care, of these 67.7% (n = 281) received subsequent care within 14 days. After a stay in a palliative care ward, 124 patients received subsequent palliative care, of these 75.0% (n = 93) within 14 days. Altogether, 147 discharges did not receive subsequent palliative care. During the 12-months follow-up period, 2866 (68.7%) patients died, of these 78.7% (n = 2256) received palliative care within the last 2 weeks of life. Of these, 1223 patients received general ambulatory palliative care, 631 patients received specialised ambulatory palliative care, 313 patients received their last palliative care at a hospital and 89 patients received it in a hospice. Conclusions The majority of the palliative care patients received continuous palliative care. However, there are some patients who did not receive continuous palliative care. After inpatient palliative care, each patient should receive a discharge management for a continuation of palliative care. Readmissions of patients after discharge from inpatients palliative care can be an indication for a lack of support in the ambulatory health care setting and for an insufficient discharge management. Palliative care training and possibilities for palliative care consultations by specialists should strengthen the GPs in palliative care.

scholarly journals Replacement of endoprosthetic implants within a two years follow-up period: a statutory health insurance routine data analysis

2012 ◽  
Vol 13 (1) ◽  
Author(s):  
Roland Linder ◽  
Hardy Müller ◽  
Brigitte Grenz-Farenholtz ◽  
Caroline Wagner ◽  
Martin Stockheim ◽  
...  
Keyword(s):  
Health Insurance ◽  
Data Analysis ◽  
Statutory Health Insurance ◽  
Routine Data

Hämophiliebehandlung als ganzheitliches Konzept der Patientenversorgung

2012 ◽  
Vol 32 (S 01) ◽  
pp. 25-S28
Author(s):  
H. Rott ◽  
G. Kappert ◽  
S. Halimeh
Keyword(s):  
Health Insurance ◽  
Effective Treatment ◽  
International Research ◽  
Statutory Health Insurance ◽  
Interdisciplinary Team ◽  
Legal Basis ◽  
University Hospitals ◽  
Innovative Treatment ◽  
Social Law ◽  
Treatment Concepts

SummaryA top quality, effective treatment of haemophilia requires an integrated therapeutical concept and an excellent cooperation of an interdisciplinary team. Since years different models are discussed in Germany in order to enlarge the offers for a suitable care of patients with hard to treat diseases. The healthpolitical targets are expressed in the changes of the Code of Social Law number V (SGB V) and in innovations in the statutory health insurance. This new legal basis provides opportunities to implement innovative treatment concepts outside university hospitals and paves the way for ambulant haemophilia centres to offer an integral care, all legally saved by a contract.The Coagulation Centre Rhine-Ruhr reveals as an example how haemophilia treatment in accordance with guidelines and with the latest results of international research can be realise in an ambulatory network.

Gamma Knife surgery combined with resection for treatment of a single brain metastasis: preliminary results

2010 ◽  
Vol 113 (Special_Supplement) ◽  
pp. 90-96 ◽  
Author(s):  
M. Yashar S. Kalani ◽  
Aristotelis S. Filippidis ◽  
Maziyar A. Kalani ◽  
Nader Sanai ◽  
David Brachman ◽  
...  
Keyword(s):  
Survival Data ◽  
Initial Treatment ◽  
Median Survival Time ◽  
Local Tumor Control ◽  
Survival Duration ◽  
Tumor Control ◽  
Local Tumor ◽  
Systemic Control ◽  
Cranial Metastasis

Object Resection and whole-brain radiation therapy (WBRT) have classically been the standard treatment for a single metastasis to the brain. The objective of this study was to evaluate the use of Gamma Knife surgery (GKS) as an alternative to WBRT in patients who had undergone resection and to evaluate patient survival and local tumor control. Methods The authors retrospectively reviewed the charts of 150 patients treated with a combination of stereotactic radiosurgery and resection of a cranial metastasis at their institution between April 1997 and September 2009. Patients who had multiple lesions or underwent both WBRT and GKS were excluded, as were patients for whom survival data beyond the initial treatment were not available. Clinical and imaging follow-up was assessed using notes from clinic visits and MR imaging studies when available. Follow-up data beyond the initial treatment and survival data were available for 68 patients. Results The study included 37 women (54.4%) and 31 men (45.6%) (mean age 60 years, range 28–89 years). In 45 patients (66.2%) there was systemic control of the primary tumor when the cranial metastasis was identified. The median duration between resection and radiosurgery was 15.5 days. The median volume of the treated cavity was 10.35 cm3 (range 0.9–45.4 cm3), and the median dose to the cavity margin was 15 Gy (range 14–30 Gy), delivered to the 50% isodose line (range 50%–76% isodose line). The patients' median preradiosurgery Karnofsky Performance Scale (KPS) score was 90 (range 40–100). During the follow-up period we identified 27 patients (39.7%) with recurrent tumor located either local or distant to the site of treatment. The median time from primary treatment of metastasis to recurrence was 10.6 months. The patients' median length of survival (interval between first treatment of cerebral metastasis and last follow-up) was 13.2 months. For the patient who died during follow-up, the median time from diagnosis of cerebral metastasis to death was 11.5 months. The median duration of survival from diagnosis of the primary cancer to last follow-up was 30.2 months. Patients with a pretreatment KPS score ≥ 90 had a median survival time of 23.2 months, and patients with a pretreatment KPS score < 90 had a median survival time of 10 months (p < 0.008). Systemic control of disease at the time of metastasis was not predictive of increased survival duration, although it did tend to improve survival. Conclusions Although the debate about the ideal form of radiation treatment after resection continues, these findings indicate that GKS combined with surgery offers comparable survival duration and local tumor control to WBRT for patients with a diagnosis of a single metastasis.

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