Bewertung von Ressourcen im Gesundheitswesen aus der Perspektive der deutschen Sozialversicherung

authored by: Anne Prenzler, Jan Zeidler, Sebastian Braun, J. Matthias Graf Von Der Schulenburg
Abstract: The German Institute for Quality and Efficiency in Health Care (IQWiG) suggests in its current methods paper adopting the viewpoint of the insurants of the Statutory Health Insurance (SHI) in Germany. Depending on the commission, the other social insurance providers will be considered within the analysis. Due to interdependences between the providers, this social insurance system perspective seems particularly relevant. The aim of this study is to give an overview of the health-related services of the German Statutory Health Insurance, Statutory Pension Insurance, Long-Term Care Insurance, German Social Accident Insurance and the Unemployment Insurance, to explain the reimbursement structures and to present pragmatic as well as practical recommendations for the valuation from the viewpoint of the social insurance system in Germany. The research is based on Social Security Codes and directives as well as interviews with social insurance providers and associations. It becomes apparent that the reimbursement of health care services varies between and within the different sectors which makes a standardization of costs difficult. However, this paper can be used as a basis for the development of a German standard cost list. Further research is necessary to combine the perspective of the social insurance system with the viewpoint of the patients.
Organisation(s): Institute of Health Economics
Type: Review article
Journal: PharmacoEconomics - German Research Articles
Volume: 8
Pages: 47-66
No. of pages: 20
ISSN: 1612-3727
Publication date: 07.2010
Publication status: Published
Peer reviewed: Yes
ASJC Scopus subject areas: Economics, Econometrics and Finance (miscellaneous), Pharmacology, Toxicology and Pharmaceutics (miscellaneous)
Electronic version(s): https://doi.org/10.1007/BF03320765 (Access: Closed)

BibTeX

@article{d0db988c70be4bad82f575c0513c4d38,
title = "Bewertung von Ressourcen im Gesundheitswesen aus der Perspektive der deutschen Sozialversicherung",
abstract = "The German Institute for Quality and Efficiency in Health Care (IQWiG) suggests in its current methods paper adopting the viewpoint of the insurants of the Statutory Health Insurance (SHI) in Germany. Depending on the commission, the other social insurance providers will be considered within the analysis. Due to interdependences between the providers, this social insurance system perspective seems particularly relevant. The aim of this study is to give an overview of the health-related services of the German Statutory Health Insurance, Statutory Pension Insurance, Long-Term Care Insurance, German Social Accident Insurance and the Unemployment Insurance, to explain the reimbursement structures and to present pragmatic as well as practical recommendations for the valuation from the viewpoint of the social insurance system in Germany. The research is based on Social Security Codes and directives as well as interviews with social insurance providers and associations. It becomes apparent that the reimbursement of health care services varies between and within the different sectors which makes a standardization of costs difficult. However, this paper can be used as a basis for the development of a German standard cost list. Further research is necessary to combine the perspective of the social insurance system with the viewpoint of the patients.",
author = "Anne Prenzler and Jan Zeidler and Sebastian Braun and {Von Der Schulenburg}, {J. Matthias Graf}",
note = "Funding Information: In der Literatur wird die Einnahme der gesellschaftlichen Perspektive regelm{\"a}Xig emp-fohlen. Auch die meisten internationalen Bewer-tungsinstitutionen bevorzugen die gesellschaft-liche Perspektive bei gesundheits{\"o}konomischen Evaluationen.[2] Ausnahmen bilden beispielsweise das National Institute for Health und Clinical Excellence (NICE) in GroXbritannien sowie das neuseel{\"a}ndische PHARMAC (Pharmaceutical Management Agency of New Zealand), welche vorrangig die Perspektive der jeweiligen Kosten-tr{\"a}ger (National Health Service bzw. District Health Boards) ber{\"u}cksichtigen.",
year = "2010",
month = jul,
doi = "10.1007/BF03320765",
language = "Multiple languages",
volume = "8",
pages = "47--66",
journal = "PharmacoEconomics - German Research Articles",
issn = "1612-3727",
publisher = "Adis Press",
number = "1",
}