scholarly journals Pharmacotherapy costs and medicines reimbursement policies of osteoporosis in the Republic of Bulgaria and Republic of North Macedonia

Pharmacia ◽  
2020 ◽  
Vol 67 (4) ◽  
pp. 199-207
Author(s):  
Lidija Chakuleska ◽  
Rumyana Simeonova ◽  
Nikolay Danchev
Keyword(s):  
Health Insurance ◽  
National Health Insurance ◽  
The Other ◽  
Reimbursement Policy ◽  
Ibandronic Acid ◽  
Number Of Patients ◽  
Insurance Funds ◽  
The Republic ◽  
Health Insurance Funds ◽  
The Cost

The aim of the present study was to analyze and compare the number of health insured persons suffering from osteoporosis and antiosteoporotic drugs reimbursed by the National Health Insurance Funds (NHIF) in the Republic of Bulgaria (RBG) and Republic of North Macedonia (RNM) for the period 2015–2018. The reimbursement cost paid by the NHIF for the same period in both countries was surveyed. The results show an increase in both the number of patients with osteoporosis and the cost of the treatment. The most prescribed drug in R. Bulgaria is denosumab and it has the highest costs respectively, while in R.N. Macedonia the most prescribed and respectively the most expensive treatment is the bisphosphonate ibandronic acid, tablets of 150 mg. The trend of rising costs in both countries is likely to continue due to the increasing number of patients with osteoporosis. The number of patients and cost of pharmacotherapy in RNM and RBG are increasing but the reimbursement policy in RNM is more restrictive in terms of reimbursed medicines. On the other side, the RNM is with a higher level of reimbursement that might positively affect the cost of pharmacotherapy.

scholarly journals Is there Health Insurance in Greece outside EOPYY? Feasibility analysis of creating an independent, private Health Fund for Employees of the Banking Sector

2016 ◽  
Vol 9 (1) ◽  
Author(s):  
Kyriakos Souliotis Souliotis ◽  
Petros Tsantilas ◽  
Xenophon Contiades
Keyword(s):  
Health Insurance ◽  
National Health Insurance ◽  
Banking Sector ◽  
Feasibility Analysis ◽  
Insurance Fund ◽  
Health Insurance Fund ◽  
State Budget ◽  
Insurance Funds ◽  
Private Entity ◽  
Health Insurance Funds

Τhe funding impasse and the operational malfunction of the new organization (EOPOYY) in 2011 necessitated the provision for an exemption from this rule, applicable to health insurance funds which could prove their sustainability outside EOPYY. The objective of this paper is to assess the feasibility and viability of the creation of an independent health insurance fund for<br />employees of the banking sector, which would operate as a private entity and would not burden the state budget with its deficits. The paper aims to develop a paradigm for further analyses as we move towards the establishment of a new, national, health insurance structure.

Medicine Expenditure and Trends in National Health Insurance Funds Sudan

2018 ◽  
Vol 4 (3) ◽  
pp. 144-149
Author(s):  
Mousnad Mousnad MA ◽  
Palaian Palaian S ◽  
Shafie Shafie AA ◽  
Mohamed Ibrahim MI
Keyword(s):  
Health Insurance ◽  
National Health Insurance ◽  
National Health ◽  
Insurance Funds ◽  
Health Insurance Funds

Charter of the Kazan Society of Physicians for the provision of medical care to participants in the sickness funds established by law on June 3, 1912

1913 ◽  
Vol 13 (2) ◽  
pp. 91-110
Keyword(s):  
Health Insurance ◽  
Medical Care ◽  
Insurance Fund ◽  
Health Insurance Fund ◽  
Medical Assistance ◽  
Medical Aid ◽  
Insurance Funds ◽  
The Law ◽  
Health Insurance Funds ◽  
The City

The Kazan Society of Physicians for the Provision of Medical Aid to the Participants of the Health Insurance Funds Established on the Basis of the Law of June 23, 1912 "has the goal of providing medical assistance to the participants of the Health Insurance Fund established on the basis of the Law of June 23, 1912 in the city of Kazan and its environs.

scholarly journals Financial sustainability of home care in the health system of the Republic of Serbia

2013 ◽  
Vol 141 (3-4) ◽  
pp. 214-218 ◽  
Author(s):  
Dejan Konstantinovic ◽  
Vesna Lazarevic ◽  
Valentina Milovanovic ◽  
Mirjana Lapcevic ◽  
Vladan Konstantinovic ◽  
...  
Keyword(s):  
Health Insurance ◽  
Healthcare Services ◽  
Home Healthcare ◽  
Fixed Costs ◽  
Home Therapy ◽  
Healthcare Centre ◽  
Therapy Services ◽  
The Republic ◽  
The Cost ◽  
Therapy Team

Introduction. Over the last several years, during the economic crisis, the Ministry of Health and the Republican Health Insurance Fund (RHIF) have been faced with new challenges in the sphere of healthcare services financing both in the primary as well as other types of health insurance in the Republic of Serbia (RS). Objective. Analysis of cost?effectiveness of two models of organization of home treatment and healthcare in the primary insurance, with evaluation of the cost sustainability of a single visit by the in?home therapy team. Methods. Economic evaluation of the cost of home treatment and healthcare provision in 2011 was performed. In statistical analysis, the methods of descriptive statistics were employed. The structure of fixed costs of home healthcare was developed according to the RS official norms, as well as fixed costs of providing services of home therapy by the Healthcare Centre "New Belgrade". The statement of account for provided home therapy services was made utilizing the RHIF price list. Results. The results showed that the cost of home healthcare and therapy of the heterogeneous population of patients in the Healthcare Centre "New Belgrade" was more cost?effective in relation to the cost of providing home therapy services according to the RS official norms. Conclusion. Approved costs utilized when making a contract for services of home therapy and healthcare with the RHIF are not financially sustainable. It was shown that the price of 10 EUR for each home visit by the in?home therapy team enables sustainability of this form of providing healthcare services in RS.

scholarly journals Information Needs of Patients Undergoing Bariatric Surgery in Germany: A Qualitative Interview Study

2021 ◽  
Author(s):  
Jessica Breuing ◽  
Nadja Könsgen ◽  
Katharina Doni ◽  
Annika Lena Neuhaus ◽  
Dawid Pieper
Keyword(s):  
Bariatric Surgery ◽  
Health Insurance ◽  
Support Groups ◽  
Information Needs ◽  
Information Dissemination ◽  
Information Provision ◽  
Nutritional Counseling ◽  
Qualitative Interview Study ◽  
Insurance Funds ◽  
Health Insurance Funds

Abstract BackgroundObesity is a worldwide problem with different treatment options. Bariatric surgery is an effective treatment for severe obesity; however, it leads to drastic changes (e.g., changes in everyday life and eating behavior) for patients, which may lead to information needs. Our aim was to identify the information needs of patients undergoing bariatric surgery and to explore the information provision within the healthcare process of bariatric surgery in Germany.MethodsWe conducted n=14 semi-structured telephone interviews between April 2018 and April 2019. The interview guide was designed prior to the interviews and consisted of 4 main sections (demographic information, pre- and postoperative healthcare provision, information needs). The audio-recorded interviews were transcribed verbatim and analyzed using qualitative content analysis with MAXQDA software.ResultsThere were unmet information needs with two factors (time: pre/postoperative and categories of information: general/specific) to be considered. Due to the patients’ description of information, we categorized information into general (different surgical procedures, general nutritional information) and specific (occurring simultaneously with a problem) information. Most patients felt well informed concerning general information. However, it was pointed out that it was not possible to provide complete information preoperatively, as the need for information only arises when there are postoperative (specific) problems. In addition, there seems to be a high demand for specific postoperative information regarding nutrition and nutrition-related problems. However, patients stated that postoperative nutritional counseling is not reimbursed by health insurance funds. The information conveyed in support groups and the exchange of experiences are highly valued by patients. However, some patients describe the information provided within the support groups as unfiltered, frightening or exaggerated.ConclusionOverall, there were unmet information needs. Reimbursement by health insurance funds could increase the use of postoperative nutritional counseling and thus serve existing information needs. Support groups enable an exchange of experiences and therefore offer low-barrier access to information. Cooperation between support groups and healthcare professionals in information provision could be an approach to improving existing information needs or to avoiding the development of information gaps. Furthermore, the development and implementation of a digital solution for (postoperative) information dissemination could be helpful.

scholarly journals A fogászati ellátás finanszírozása Németországban, az Egyesült Királyságban, Magyarországon és Lengyelországban

2016 ◽  
Vol 157 (14) ◽  
pp. 547-553
Author(s):  
Gyula Marada ◽  
Ákos Nagy ◽  
Andor Sebestyén ◽  
Dóra Endrei ◽  
Márta Radnai ◽  
...  
Keyword(s):  
Oral Health ◽  
Oral Surgery ◽  
Health Indicators ◽  
The Other ◽  
European Countries ◽  
Dental Services ◽  
East European ◽  
Insurance Funds ◽  
Health Insurance Funds ◽  
Oral Health Indicators

Introduction: Dental treatments have the highest rate among medical interventions and their reimbursement is also significant. Aim: The aim of the study was to compare the outcome of the reformed healthcare system process on public dental services in four European countries. Method: Assessment base for the comparison of reimbursement of dental treatments and dental fee schedules provided by the health insurance funds were used. The following indicators were examined: the ratio of public dental services and the main oral health indicators. Among dental fee schedules, reimbursement of general dental activity, prevention, operative dentistry, endodontic and oral surgery were selected. Results: The lowest value of population to active dentist ratio was found in Germany (population to active dentist ratio: 1247) and the highest in Hungary (population to active dentist ratio: 2020). Oral health indicators showed significant differences between the West-European and East-European countries. On the other hand, the ratio of completely edentulous people at the age of 65yrs did not show great variations. Reimbursement of public dental treatments indicated significantly higher value in Germany and the United Kingdom compared to the other countries. Conclusions: Reimbursement of public dental services varies considerably in the selected European countries. Orv. Hetil., 2016, 157(14), 547–553.

Gemeinsame Selbstverwaltung: Bedingungen der Aufgabenwahrnehmung

2019 ◽  
Vol 68 (6-7) ◽  
pp. 519-536
Author(s):  
Thomas Gerlinger
Keyword(s):  
Health Insurance ◽  
Medical Profession ◽  
Insurance Companies ◽  
Regulatory Change ◽  
Self Administration ◽  
Insurance Funds ◽  
Health Insurance Companies ◽  
Joint Federal Committee ◽  
Health Insurance Funds ◽  
Regulated Competition

Zusammenfassung Ein vielgestaltiger Wandel in Gesundheitssystem und Gesundheitspolitik erschwert den Verbänden der Ärzte und Krankenkassen die Wahrnehmung ihrer Aufgaben im Rahmen der gemeinsamen Selbstverwaltung. Erstens steigert die mit der Einrichtung des Gemeinsamen Bundesausschusses verbundene transsektorale Ausweitung der korporatistischen Verhandlungssystemen die Komplexität der Akteurs- und Interessenkonstellationen in der gemeinsamen Selbstverwaltung. Zweitens trägt der ordnungspolitische Wandel in Richtung auf einen regulierten Wettbewerb zu einer Binnendifferenzierung der Interessen in der Ärzteschaft und bei den Krankenkassen bei. Drittens erschwert auf der Seite der Ärzteschaft zusätzlich die Ausdifferenzierung von Disziplinen, Versorgungseinrichtungen und -formen sowie von beruflichen Identitäten die für das Funktionieren der gemeinsamen Selbstverwaltung erforderliche Aggregation von Interessen und die Kompromissfindung. Abstract A multi-faceted change in the health system and health policy makes it difficult for associations of doctors and health insurance companies to carry out their tasks within the framework of joint self-government. First, the transsectoral expansion of corporatist bargaining systems associated with the establishment of the Joint Federal Committee increases the complexity of stakeholder and stakeholder constellations in joint self-government. Second, regulatory change towards regulated competition contributes to an internal differentiation of interests in the medical profession and in the health insurance funds. Third, on the side of the medical profession, the differentiation of disciplines and care as well as of occupational identities further complicates the aggregation of interests and compromise-finding necessary for the functioning of joint self-administration.

scholarly journals How was cognitive behavioural therapy for mood disorder implemented in Japan? A retrospective observational study using the nationwide claims database from FY2010 to FY2015

BMJ Open ◽  
2020 ◽  
Vol 10 (5) ◽  
pp. e033365 ◽  
Author(s):  
Yuta Hayashi ◽  
Naoki Yoshinaga ◽  
Yosuke Sasaki ◽  
Hiroki Tanoue ◽  
Kensuke Yoshimura ◽  
...  
Keyword(s):  
Health Insurance ◽  
Observational Study ◽  
National Health Insurance ◽  
National Health ◽  
National Health Insurance Scheme ◽  
Behavioural Therapy ◽  
Health Insurance Scheme ◽  
Insurance Scheme ◽  
Cognitive Behavioural ◽  
Number Of Patients

ObjectivesTo clarify the dissemination status of cognitive behavioural therapy (CBT) in Japan under the national health insurance scheme.DesignRetrospective observational study.SettingNational Database of Health Insurance Claims and Specific Health Checkups of Japan.ParticipantsPatients who received CBT under the national health insurance scheme from fiscal years (FY) 2010 to 2015.Primary and secondary outcome measuresWe estimated the change rate and the standardised claim ratio (SCR) for the number of patients receiving CBT and analysed the association between the CBT status and several regional factors.ResultsWe found that (a) a total of 60 304 patients received CBT during the study period; (b) the number of patients receiving CBT was highest in the first year (−1.8% from FY2010 to FY2015); (c) the number of patients who received CBT per 100 000 population decreased (or remained at zero) in most prefectures (32 out of 47); (d) there was a maximum 424.7-fold difference between prefectures in the standardised claim ratio for CBT and (e) the number of registered CBT institutions was significantly associated with the number of patients who received CBT.ConclusionsThe provision of CBT did not increase in the first 6 years (FY2010–2015) after its coverage in Japan’s national health insurance scheme. Further studies including a questionnaire survey of registered CBT institutions are required to get more detailed information on the dissemination of CBT in Japan.

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