Quality management in medical rehabilitative care by the German statutory pension insurance scheme

2020 ◽  
Vol 55 (6) ◽  
Author(s):  
Marlen Zeisberger ◽  
Daniel Nowik ◽  
Larissa Beck ◽  
Stefanie Märtin ◽  
Ulrike Beckmann ◽  
...  
Keyword(s):  
Quality Management ◽  
Insurance Scheme ◽  
Pension Insurance ◽  
Rehabilitative Care

scholarly journals Breast cancer patients’ return to work (B-CARE): protocol of a longitudinal mixed-methods study aiming to explore medical and occupational rehabilitation of patients with breast cancer in Germany

BMJ Open ◽  
2019 ◽  
Vol 9 (12) ◽  
pp. e033533
Author(s):  
Kati Hiltrop ◽  
Paula Heidkamp ◽  
Christoph Kowalski ◽  
Nicole Ernstmann
Keyword(s):  
Breast Cancer ◽  
Mixed Methods ◽  
Return To Work ◽  
Cancer Survivors ◽  
Breast Cancer Survivors ◽  
Occupational Rehabilitation ◽  
Medical Rehabilitation ◽  
Insurance Scheme ◽  
Pension Insurance ◽  
Care Protocol

IntroductionIn recent years, research has been done on determinants of return to work (RTW) in cancer survivors and their long-term work outcomes. Nevertheless, little is known about the survivors’ evaluation of these outcomes in terms of job satisfaction and voluntariness. Hence, B-CARE aims at filling the research gap by providing a longitudinal cohort study investigating medical and occupational rehabilitation including an evaluation by breast cancer survivors.Methods and analysisA mixed-methods approach, combining a quantitative survey with qualitative semi-structured interviews, is used to study breast cancer survivors 5–6 years after diagnosis. These data will be linked to data from prior waves of patients during hospitalisation and 10 and 40 weeks after hospital discharge as well as routine data from the German Statutory Pension Insurance Scheme and German Cancer Society if available. The actual survey focuses on determinants of medical rehabilitation use, RTW, subsequent employment patterns post care as well as the voluntariness of and satisfaction with job changes.Ethics and disseminationA positive vote from the ethics committee of the Medical Faculty of the University of Bonn has been obtained. Data protection regulations will be adhered to for all handled data. Personal identifiers of participants will be pseudonymised. Dissemination strategies include a workshop to discuss results among stakeholders such as representatives of the German Statutory Pension Insurance Scheme, social workers and self-help groups.Trial registration numberGerman Clinical Trials Register (DRKS00016982); Pre-results.

scholarly journals Access to social security for digital platform workers in Germany and in Russia: a comparative study

2018 ◽  
Vol 7 (1-2) ◽  
pp. 17 ◽  
Author(s):  
Olga Chesalina
Keyword(s):  
Social Security ◽  
The State ◽  
Control Mechanisms ◽  
Insurance Scheme ◽  
Pension Insurance ◽  
Digital Platform ◽  
Social Law ◽  
Digital Work ◽  
The Difference ◽  
State Pension

Abstract: A common feature of platform work in Germany and Russia is that in both countries the new forms of employment can usually only be classified as self-employed work in the form of ‘solo self-employment’, despite the fact that platforms use direct and indirect control mechanisms indicating a personal or at least an economic dependency of the digital workers on the platforms. The difference is that, in Germany, as the main rule, self-employed persons are not obligatorily insured in the state pesion insurance scheme, whereas in Russia, unlike Germany, the state pension insurance scheme is mandatory for all self-employed persons.Considering the different legal frameworks in Germany and in Russia, the article analyses various reform proposals aiming at tackling the above-mentioned challenges for the social security systems, and looks for adequate responses to ensure access to social security for digital platform workers. In particular, the following questions are investigated: Is it sufficient to subsume digital work under the existing employment categories? Could it be an appropriate solution for the access of digital workers to social security to introduce a new employment category only in social law?Keywords: digital platform worker, social security, self-employed person

Insurance, size and exposure to actuarial risk: empirical evidence from nineteenth- and early twentieth-century German Knappschaften

2011 ◽  
Vol 19 (1) ◽  
pp. 75-116 ◽  
Author(s):  
Tobias Alexander Jopp
Keyword(s):  
Twentieth Century ◽  
Empirical Evidence ◽  
Financial Stability ◽  
Social Insurance ◽  
Economies Of Scale ◽  
Insurance Scheme ◽  
Pension Insurance ◽  
Insurance Benefits ◽  
Insurance Funds ◽  
Actuarial Risk

By the mid nineteenth century, German miners relied on their own job-related social insurance scheme providing them with sickness, invalidity and survivorship insurance benefits. Addressing the period from 1867 to 1913, this article investigates whether the mineworkers' insurance funds, the Knappschaften, could effectively minimise their exposure to the actuarial risk inherent in their operations – and, in fact, inherent in all such insurance schemes – by increasing the scale of pooling. Contemporary observers of the Knappschaften tended to focus on whether financial stability could be improved by exploiting economies of scale, rather than by improving the pricing techniques themselves. Evidence suggests that actuarial risk was minimised at around 5,000 contributors in a Knappschaft's pension insurance section and at about 1,000 contributors in its sickness insurance section.

scholarly journals Satisfaction with rehabilitative health care services among German and non-German nationals residing in Germany: a cross-sectional study

BMJ Open ◽  
2017 ◽  
Vol 7 (8) ◽  
pp. e015520 ◽  
Author(s):  
Patrick Brzoska ◽  
Odile Sauzet ◽  
Yüce Yilmaz-Aslan ◽  
Teresia Widera ◽  
Oliver Razum
Keyword(s):  
Health Care Services ◽  
Diversity Management ◽  
Patient Survey ◽  
Medical Rehabilitation ◽  
Care Process ◽  
Pension Insurance ◽  
Foreign National ◽  
Cross Sectional ◽  
Rehabilitative Care ◽  
Rehabilitative Services

ObjectivesRehabilitation following medical conditions is largely offered as in-patient service in Germany. Foreign-national residents use rehabilitative services less often than Germans and attain less favourable treatment outcomes. These differences are independent of demographic, socioeconomic and health characteristics. Satisfaction with different aspects of rehabilitative care presumably affects the effectiveness of rehabilitative services. We compared the degree of satisfaction with different domains of the rehabilitative care process between Germans and non-German nationals residing in Germany.MethodsWe used data from a cross-sectional rehabilitation patient survey annually conducted by the German Statutory Pension Insurance Scheme. The sample comprises 274 513 individuals undergoing medical rehabilitation in 642 hospitals during the years 2007–2011. Participants rated their satisfaction with different domains of rehabilitation on multi-item scales. We dichotomised each scale to low/moderate and high satisfaction. For each domain, a multilevel adjusted logistic regression analysis was conducted to examine differences in the levels of satisfaction between German and non-German nationals. Average marginal effects (AMEs) and 99.5% CI were computed as effect estimates. AMEs represent differences in the probability for the occurrence of the outcome.ResultsTurkish nationals had a higher probability for being less satisfied with most aspects of their rehabilitation, with AMEs ranging between 0.05 (99.5% CI 0.00 to 0.09) for ‘satisfaction with psychological care’ and 0.11 (99.5% CI 0.08 to 0.14) for ‘satisfaction with treatments during rehabilitation’. Patients from former Yugoslavia and from Portugal/Spain/Italy/Greece were as satisfied as Germans with most aspects of their rehabilitation.ConclusionsTurkish nationals are less satisfied with their rehabilitative care than other population groups. This may be attributable to the diversity of the population in terms of its expectations towards rehabilitation. Rehabilitative care institutions need to provide services that are sensitive to the needs of all clients. Diversity management can contribute to this process.

Quality management in the prophylaxis of venous thrombembolism - Results of a survey including 464 medical and surgical patients

VASA ◽  
2011 ◽  
Vol 40 (2) ◽  
pp. 123-130
Author(s):  
Klein-Weigel ◽  
Richter ◽  
Arendt ◽  
Gerdsen ◽  
Härtwig ◽  
...  
Keyword(s):  
Renal Function ◽  
High Risk ◽  
Quality Management ◽  
High Risk Group ◽  
Surgical Patients ◽  
Medical Patients ◽  
Risk Status ◽  
Vte Prophylaxis ◽  
Safety Concerns

Background: We surveyed the quality of risk stratification politics and monitored the rate of entries to our company-wide protocol for venous thrombembolism (VTE) prophylaxis in order to identify safety concerns. Patients and methods: Audit in 464 medical and surgical patients to evaluate quality of VTE prophylaxis. Results: Patients were classified as low 146 (31 %), medium 101 (22 %), and high risk cases 217 (47 %). Of these 262 (56.5 %) were treated according to their risk status and in accordance with our protocol, while 9 more patients were treated according to their risk status but off-protocol. Overtreatment was identified in 73 (15.7 %), undertreatment in 120 (25,9 %) of all patients. The rate of incorrect prophylaxis was significantly different between the risk categories, with more patients of the high-risk group receiving inadequate medical prophylaxis (data not shown; p = 0.038). Renal function was analyzed in 392 (84.5 %) patients. In those patients with known renal function 26 (6.6 %) received improper medical prophylaxis. If cases were added in whom prophylaxis was started without previous creatinine control, renal function was not correctly taken into account in 49 (10.6 %) of all patients. Moreover, deterioration of renal function was not excluded within one week in 78 patients (16.8 %) and blood count was not re-checked in 45 (9.7 %) of all patients after one week. There were more overtreatments in surgical (n = 53/278) and more undertreatments in medical patients (n = 54/186) (p = 0.04). Surgeons neglected renal function and blood controls significantly more often than medical doctors (p-values for both < 0.05). Conclusions: We found a low adherence with our protocol and substantial over- and undertreatment in VTE prophylaxis. Besides, we identified disregarding of renal function and safety laboratory examinations as additional safety concerns. To identify safety problems associated with medical VTE prophylaxis and “hot spots” quality management-audits proved to be valuable instruments.

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