Laboratory diagnostics in light of massive changes in official health policies

1994 ◽  
Vol 40 (8) ◽  
pp. 1658-1662 ◽  
Author(s):  
B Müller

Abstract Virtually 100% of the German population has health insurance. Of this 100%, approximately 90% are members of the Statutory Health Insurance plan. This insurance plan assumes responsibility for practically all of the costs of treatment; self-participation by the patient in the costs is minimal. To counteract the financial deficits of the Statutory Health Insurance funds, the Health Care Reform Act was introduced in 1993, bringing with it massive economy measures for everyone involved in the health sector. For the practitioner sector, this new legislation provides for, among other things, revision of the structure and the reimbursement of laboratories. In this context, the originally agreed-upon introduction of lump-sum payments as reimbursement for laboratory tests was abandoned, in the face of vigorous resistance by the medical profession. Instead, the system of reimbursement for each individual test continues to apply. However, the number of tests is to be limited for each specific group of doctors. In addition, the laboratory fee in the practitioner sector is being reduced by 20%.

2012 ◽  
Vol 32 (S 01) ◽  
pp. 25-S28
Author(s):  
H. Rott ◽  
G. Kappert ◽  
S. Halimeh

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.


Author(s):  
Jan Abel Olsen

This chapter seeks to explain why most people prefer to have a health insurance plan. Two types of uncertainty give rise to the demand for financial protection: people do not know if they will ever come to need healthcare, and they do not know the full financial implications of illness. Health insurance would take away—or at least reduce—such financial uncertainties associated with future illnesses. A model is presented to show the so-called welfare gain from health insurance. This is followed by an investigation into the potential efficiency losses of health insurance, due to excess demand for services. In the last section, a different efficiency problem is discussed: when people have an incentive to signal ‘false risks’, this can lead to there being no market for insurance contracts which reflect ‘true risks’.


Author(s):  
Radomir Reszke ◽  
Łukasz Matusiak ◽  
Piotr K. Krajewski ◽  
Marta Szepietowska ◽  
Rafał Białynicki-Birula ◽  
...  

Relevant personal protective measures during the COVID-19 pandemic include face masks, possibly decreasing the risk of infection among the general population and healthcare workers (HCW) if utilized properly. The aim of the study was to assess whether different Polish HCW utilize face masks according to the 2020 World Health Organization guidance (WHO) criteria. This cross-sectional study included 1156 respondents who participated in an internet survey evaluating mask-related behaviors. All the WHO criteria were complied with by 1.4% of participants, regardless of medical profession, specialty or place of employment. HCW mostly adhered to criterion 1 (C1; strict covering of the face and mouth with the mask; 90.8%), C4 (washing/disinfecting the hands after touching/taking off the mask; 49%) and C3 (taking off the mask properly without touching the anterior surface; 43.4%), whereas C2 (avoidance of touching the mask with hands) was complied with least commonly (6.8%). HCW with mask-induced itch (31.6%) complied to C2 less often (odds ratio 0.53; p = 0.01). The study reveals that Polish HCW rarely adhere to all the 2020 WHO guidance criteria on the use of masks, whereas the adherence to particular criteria is variable and may be associated with the presence of skin-related conditions and other factors. Better compliance with the recommendations in the future is necessary to increase personal safety of HCW and prevent the transmission of SARS-CoV-2.


2020 ◽  
Vol 25 (03) ◽  
pp. 128-129

Weinhold et al. Economic impact of disease prevention in a morbidity-based financing system: does prevention pay off for a statutory health insurance fund in Germany? Eur J Health Econ 2019; 20 (8): 1181–1193 Das deutsche Gesundheitssystem wird durch vermeidbare chronische Erkrankungen in besonderem Maße belastet. Die Finanzierung geeigneter Präventionsmaßnahmen obliegt den Krankenkassen. Weinhold et al. untersuchten in einer retrospektiven Studie die ökonomischen Auswirkungen von Prävention für die GKV.


2018 ◽  
Vol 3 (1) ◽  
pp. 238146831878109 ◽  
Author(s):  
Mary C. Politi ◽  
Enbal Shacham ◽  
Abigail R. Barker ◽  
Nerissa George ◽  
Nageen Mir ◽  
...  

Objective. Numerous electronic tools help consumers select health insurance plans based on their estimated health care utilization. However, the best way to personalize these tools is unknown. The purpose of this study was to compare two common methods of personalizing health insurance plan displays: 1) quantitative healthcare utilization predictions using nationally representative Medical Expenditure Panel Survey (MEPS) data and 2) subjective-health status predictions. We also explored their relations to self-reported health care utilization. Methods. Secondary data analysis was conducted with responses from 327 adults under age 65 considering health insurance enrollment in the Affordable Care Act (ACA) marketplace. Participants were asked to report their subjective health, health conditions, and demographic information. MEPS data were used to estimate predicted annual expenditures based on age, gender, and reported health conditions. Self-reported health care utilization was obtained for 120 participants at a 1-year follow-up. Results. MEPS-based predictions and subjective-health status were related ( P < 0.0001). However, MEPS-predicted ranges within subjective-health categories were large. Subjective health was a less reliable predictor of expenses among older adults (age × subjective health, P = 0.04). Neither significantly related to subsequent self-reported health care utilization ( P = 0.18, P = 0.92, respectively). Conclusions. Because MEPS data are nationally representative, they may approximate utilization better than subjective health, particularly among older adults. However, approximating health care utilization is difficult, especially among newly insured. Findings have implications for health insurance decision support tools that personalize plan displays based on cost estimates.


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