scholarly journals FertiPROTEKT, Oncofertility Consortium and the Danish Fertility-Preservation Networks – What Can We Learn From Their Experiences?

2019 ◽  
Vol 13 ◽  
pp. 117955811984586 ◽  
Author(s):  
Michael von Wolff ◽  
Claus Yding Andersen ◽  
Teresa K Woodruff ◽  
Frank Nawroth
Keyword(s):  
Fertility Preservation ◽  
Insurance Companies ◽  
Medical Society ◽  
Network Structures ◽  
Transfer Of Knowledge ◽  
Large Country ◽  
Protection Measures ◽  
Health Insurance Companies ◽  
Fertility Protection ◽  
Policy Challenge

Fertility preservation is an increasingly important discipline. It requires close coordination between reproductive medicine specialists, reproductive biologists, and oncologists in various disciplines. In addition, it represents a particular health policy challenge, since fertility-protection measures are to be understood as a treatment for side effects of gonadotoxic treatments and would therefore normally have to be reimbursed by health insurance companies. Therefore, it is inevitable that fertility-preservation activities should organise themselves into a network structure both as a medical-logistic network and as a professional medical society. The necessary network structures can differ significantly at regional, national, and international level, as the size of the regions to be integrated and the local cultural and geographical conditions, as well as the political conditions are very different. To address these issues, the current review aims to point out the basic importance and the chances but also the difficulties of fertility-protection networks and give practical guidance for the development of such network structures. We will not only discuss network structures theoretically but also present them based on three established, different sized networks, such as the Danish Network ( www.rigshospitalet.dk ), representing a centralised network in a small country; the German-Austrian-Swiss network FertiPROTEKT® ( www.fertiprotekt.com ), representing a centralised as well as decentralised network in a large country; and the Oncofertility® Consortium ( www.oncofertility.northwestern.edu ), representing a decentralised, internationally oriented network, primarily serving the transfer of knowledge among its members.

Online Patient Consultation

2020 ◽  
Vol 158 (04) ◽  
pp. 345-350
Author(s):  
Christian Juhra ◽  
Jörg Ansorg ◽  
David Alexander Back ◽  
Dominik John ◽  
Andrea Kuckuck-Winkelmann ◽  
...  
Keyword(s):  
New Technologies ◽  
Communication Technologies ◽  
Phone Call ◽  
Insurance Companies ◽  
Personal Contact ◽  
Software Products ◽  
Patient Consent ◽  
Health Insurance Companies ◽  
Patient Consultation ◽  
Certified Software

AbstractNew communication technologies allow patients to communicate with their physicians from anywhere using computer or smartphone. Adding video to the mere phone call optimizes the personal contact between patient and physicians regardless of distance. Legal and reimbursements requirements must be taken into account, especially only certified software products must be used. In addition, patient consent is needed and confidentiality must be assured. The video patient consultation can be reimbursed by the health insurance companies. As with all new technologies, the introduction of these video consultations faced some challenges. Although patients and physicians have expressed great interest in this technology, it has been rarely used so far. The current COVID crisis increased the need for video consultations resulting in an increasing use of video patient consultation. It can be expected that this demand will still exists after the COVID crisis.

scholarly journals Which health-related reasons lead to prehospital emergency care and how does subjective emergency status connect to subsequent care?

2021 ◽  
Author(s):  
Silke Piedmont ◽  
Anna Katharina Reinhold ◽  
Jens-Oliver Bock ◽  
Enno Swart ◽  
Bernt-Peter Robra
Keyword(s):  
Health Insurance ◽  
Emergency Care ◽  
Third Party ◽  
Insurance Companies ◽  
Prehospital Emergency Care ◽  
Health Related ◽  
Life Threatening ◽  
Prehospital Emergency ◽  
Health Insurance Companies ◽  
Reported Data

Abstract Objectives/Background In many countries, the use of emergency medical services (EMS) increases steadily each year. At the same time, the percentage of life-threatening complaints decreases. To redesign the system, an assessment and consideration of the patients’ perspectives is helpful. Methods We conducted a paper-based survey of German EMS patients who had at least one case of prehospital emergency care in 2016. Four health insurance companies sent out the questionnaire to 1312 insured persons. We linked the self-reported data of 254 respondents to corresponding claims data provided by their health insurance companies. The analysis focuses a.) how strongly patients tend to call EMS for themselves and others given different health-related scenarios, b.) self-perceived health complaints in their own index case of prehospital emergency care and c.) subjective emergency status in combination with so-called “objective” characteristics of subsequent EMS and inpatient care. We report principal diagnoses of (1) respondents, (2) 57,240 EMS users who are not part of the survey and (3) all 20,063,689 inpatients in German hospitals. Diagnoses for group 1 and 2 only cover the inpatient stay that started on the day of the last EMS use in 2016. Results According to the survey, the threshold to call an ambulance is lower for someone else than for oneself. In 89% of all cases during their own EMS use, a third party called the ambulance. The most common, self-reported complaints were pain (38%), problems with heart and circulation (32%), and loss of consciousness (17%). The majority of respondents indicated that their EMS use was due to an emergency (89%). We could detect no or only weak associations between patients’ subjective urgency and different items for objective care. Conclusion Dispatchers can possibly optimize or reduce the disposition of EMS staff and vehicles if they spoke directly to the patients more often. Nonetheless, there is need for further research on how strongly the patients’ perceived urgency may affect the disposition, rapidness of the service and transport targets.

scholarly journals Economic burden of bronchiectasis in Germany

2018 ◽  
Vol 53 (2) ◽  
pp. 1802033 ◽  
Author(s):  
Roland Diel ◽  
James D. Chalmers ◽  
Klaus F. Rabe ◽  
Albert Nienhaus ◽  
Robert Loddenkemper ◽  
...  
Keyword(s):  
Matched Control ◽  
Financial Burden ◽  
Chronic Obstructive Lung Disease ◽  
Insurance Companies ◽  
Chronic Obstructive ◽  
Health Insurance Companies ◽  
Comorbidity Index ◽  
German Statutory Health Insurance ◽  
Direct Expenditure

Estimates of healthcare costs for incident bronchiectasis patients are currently not available for any European country.Out of a sample of 4 859 013 persons covered by German statutory health insurance companies, 231 new bronchiectasis patients were identified in 2012. They were matched with 685 control patients by age, sex and Charlson Comorbidity Index, and followed for 3 years.The total direct expenditure during that period per insured bronchiectasis patient was EUR18 634.57 (95% CI EUR15 891.02–23 871.12), nearly one-third higher (ratio of mean 1.31, 95% CI 1.02–1.68) than for a matched control (p<0.001). Hospitalisation costs contributed to 35% of the total and were >50% higher in the bronchiectasis group (ratio of mean 1.56, 95% CI 1.20–3.01; p<0.001); on average, bronchiectasis patients spent 4.9 (95% CI 2.27–7.43) more days in hospital (p<0.001). Antibiotics expenditures per bronchiectasis outpatient (EUR413.81) were nearly 5 times higher than those for a matched control (ratio of mean 4.85, 95% CI 2.72–8.64). Each bronchiectasis patient had on average 40.5 (95% CI 17.1–43.5) sick-leave days and induced work-loss costs of EUR4230.49 (95% CI EUR2849.58–5611.20). The mortality rate for bronchiectasis and matched non-bronchiectasis patients after 3 years of follow-up was 26.4% and 10.5%, respectively (p<0.001). Mortality in the bronchiectasis group was higher among those who also had chronic obstructive lung disease than in patients with bronchiectasis alone (35.9% and 14.6%, respectively; p<0.001).Although bronchiectasis is considered underdiagnosed, the mortality and associated financial burden in Germany are substantial.

scholarly journals Thriving in a changing world – opportunities and challenges for private health insurance companies

2018 ◽  
Vol 1 (2018/1) ◽  
Keyword(s):  
Health Insurance ◽  
Private Health Insurance ◽  
Health Impact ◽  
Insurance Market ◽  
Insurance Companies ◽  
Full Potential ◽  
Global Trends ◽  
Health Insurance Companies ◽  
Health Insurance Market

The health insurance market in Poland reflects global trends – such as the rising awareness of personal health impact on quality of life. As a consequence, the health insurance market has seen substantial growth during the last years, which is forecasted to continue at over 20 percent more than life or P&C insurance globally. However, private health insurance has not yet unlocked its full potential.

scholarly journals Day Surgery Development Aspects in Slovakia

2020 ◽  
Vol 31 (2) ◽  
pp. 477
Author(s):  
Beáta Gavurová ◽  
Adela Klepáková ◽  
Ladislava Ivančová
Keyword(s):  
Health Care ◽  
Health Insurance ◽  
Pilot Study ◽  
Healthcare System ◽  
Social Groups ◽  
Day Surgery ◽  
Insurance Companies ◽  
Social Sphere ◽  
The Social ◽  
Health Insurance Companies

The day surgery is a highly effective tool for providing health care which has been used in Slovakia only for the last decade. The unified system of payment for inpatient or outpatient (day care) surgeries causes the reduction of health insurance companies´ spending. Incorrectly configured and economically demotivating system of refunding is a cause of lagging behind the European average in utilization of day surgery. Without the evaluation of day surgery it is not possible to link the progress in the social sphere, which leads to the restriction of day surgery availability for some social groups and thus the subsequent stagnation of day surgery in Slovakia. This contribution presents a pilot study conducted in Slovakia and its partial findings focused on the development and trends in the implementation of day surgery in order to increase the efficiency healthcare system.

scholarly journals Development of medical insurance in the Russian Federation. At the crossroads. What's next?

2019 ◽  
Vol 14 (2) ◽  
Author(s):  
Igor M. Akulin ◽  
Lubov Yu. Zhiguleva
Keyword(s):  
Health Care ◽  
Health Insurance ◽  
National Health ◽  
Insurance Companies ◽  
Health Insurance System ◽  
National Health Care ◽  
Health Insurance Companies ◽  
Compulsory Health Insurance ◽  
The Russian Federation ◽  
Additional Payment

The RF health care reform is gaining momentum. A thorough consideration should be given to the discussion on the need to exclude health insurance companies from the compulsory health insurance system (CHI). Formation of the National Health Care System of Russia is the main problem of the national health care at this stage of reforms. Additional payment for medical services in the CHI by the general public is not advisable. Changes in the regulatory framework of the CHI system is deemed to be the basis for reforming the system of compulsory and voluntary health insurance in Russia.   

Brain Tumors Presumed Malignant without Biopsy-Evaluation and Treatment Problems

2021 ◽  
Vol 8 (2) ◽  
Author(s):  
Ioana Soare ◽  
◽  
Petru-Emil Muntean ◽  
Roxana Mirica ◽  
◽  
...  
Keyword(s):  
Neural Network ◽  
Brain Tumors ◽  
Disability Pension ◽  
Palliative Treatment ◽  
Treatment Protocol ◽  
Assistive Technologies ◽  
Insurance Companies ◽  
Short Term ◽  
Oncological Treatment ◽  
Health Insurance Companies

Patients with brain tumors may have the following issues: tumors are in deep or vital regions; they refuse the biopsy; the neurosurgeon does not reach the tumoral tissue and the biopsy is irrelevant; advanced cases, considered “outside the surgical and oncological therapeutic resources”. These patients cannot receive oncological treatment or radiotherapy because of the restrictive indications of the insurers (health insurance companies) or because of the risk of allegations of malpractice. Patients will not receive some social security rights (short term sick leave, disability pension) in the same way as cancer patients, but only as a patient with a common illness. Patients can receive palliative treatment, can be hospitalized in oncology departments. We propose to discuss a separate diagnostic and treatment protocol for this group of patients, based on laboratory (ctDNA) and imagistic criteria. Assistive technologies using Computer Vision Model combined with Convolutional Neural Network may help classificate and diagnose these tumors.

Extending the Boundaries of Medicine

1996 ◽  
Vol 17 (8) ◽  
pp. 263-263
Author(s):  
R J H
Keyword(s):  
Health Insurance ◽  
England Journal ◽  
Alternative Medicine ◽  
New England ◽  
Holistic Approach ◽  
National Institutes Of Health ◽  
Insurance Companies ◽  
Core Content ◽  
Look Ahead ◽  
Health Insurance Companies

Readers may be surprised to see the article "Separation or Synthesis: A Holistic Approach to Therapeutics" in this issue. There are no core content statements related to this article. Yet, from time to time, I exercise my editorial prerogative to publish something that is outside the usual—to stimulate, to look ahead to what may be important in the future, and to provoke our readers. There is a great deal of interest today in alternative medicine. An article in The New England Journal of Medicine reports that nearly one third of Americans use some form of alternative medical therapy.1 There is now an Office of Alternative Medicine at the National Institutes of Health supporting grants in this field, and some health insurance companies recently began providing (for an added premium) coverage for these therapies.

New options for surgeons to improve malnutrition in the outpatient setting

2021 ◽  
Vol 100 (2) ◽  
Keyword(s):  
Health Insurance ◽  
Nutritional Status ◽  
Perioperative Period ◽  
Outpatient Setting ◽  
Surgical Patients ◽  
Insurance Companies ◽  
Negative Factor ◽  
Health Insurance Companies ◽  
Limited Period

Malnutrition is a significant negative factor for surgical patients in the entire perioperative period. However, this factor can be controlled and is easy to detect in the outpatient setting. Starting from May 1, 2020, surgeons have the possibility to prescribe sipping under certain conditions for a limited period of 4 weeks. Thereby they have become able to strongly impact any altered nutritional status both preoperatively and postoperatively. The authors describe scoring questionnaires used for the detection of malnutrition and required by health insurance companies. Additionally, prescribing conditions and potential mistakes in the outpatient setting are analysed.

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