Acupuncture for chronic pain within the research program of 10 German Health Insurance Funds—Basic results from an observational study

2007 ◽  
Vol 15 (4) ◽  
pp. 238-246 ◽  
Author(s):  
W. Weidenhammer ◽  
A. Streng ◽  
K. Linde ◽  
A. Hoppe ◽  
D. Melchart
Keyword(s):  
Chronic Pain ◽  
Health Insurance ◽  
Observational Study ◽  
Research Program ◽  
German Health ◽  
Insurance Funds ◽  
Health Insurance Funds

scholarly journals Digitization in the German Health Care System - An Analysis of the Status Quo Using the Example of the Dental Sector

2020 ◽  
Vol 5 (3) ◽  
Author(s):  
Christian Maier ◽  
Tizian Juschkat
Keyword(s):  
Health Care ◽  
Health Insurance ◽  
Data Processing ◽  
Healthcare Industry ◽  
Electronic Data ◽  
German Health Care System ◽  
German Health ◽  
Insurance Funds ◽  
Health Insurance Funds ◽  
Cost Plan

According to the Federal Ministry of Economics and Energy, the German healthcare industry is growing faster than the economy as a whole but is regularly far behind compared to the rate of digitalization. Nonetheless, the healthcare industry offers great potential for digital applications. The brief overview at hand uses the example of treatment and cost plans in the dental field to illustrate the state of digitalization in the German health care system. The primary goal is to examine whether it is possible to transfer the principle of electronic data medium exchange for hospital settlements and the associated electronic data processing to the transmission of treatment and cost plans in the dental field. Anselstetter's (1984) expertise is fundamentally used to evaluate the benefits of electronic data processing and to a treatment and cost plan under critical evaluation. In order to determine relevant benefit effects for health insurance funds and dentists, a transfer and processing form of the treatment and cost plan is used based on a generated model. Applying this model can assist health insurance funds to identify effects regarding time, personnel reduction, and more efficient use of existing personnel structures. It also provides health insurance companies and dentists with an overview of the possible benefits of electronic data transmission and processing. Nonetheless, one of the problems is that it is not possible to calculate the expected costs due to the lack of empirical examinations. Consequently, a detailed cost- benefit evaluation of an electronic transmission and processing of the treatment and cost plans is unfeasible.

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 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.

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.

Back to the future: Polish health care reform

2003 ◽  
Vol 36 (4) ◽  
pp. 385-403 ◽  
Author(s):  
Rachel Filinson ◽  
Piotr Chmielewski ◽  
Darek Niklas
Keyword(s):  
Health Care ◽  
Health Insurance ◽  
Health Care Workers ◽  
Universal Health Insurance ◽  
Care Workers ◽  
Insurance Funds ◽  
Physician Resistance ◽  
Polish Government ◽  
Health Insurance Funds ◽  
Universal Health

In January 1999, the Polish government implemented a new law reorganizing the health care in the country. This paper includes an outline of the changes, the main impact of which consisted of introduction of universal health insurance administered by Health Insurance Funds (‘‘Kasy Chorych’’). In June 2001 and 2002, a survey of insurance administrators and health care workers provided data concerning the reception of the new system, the perceived inadequacies, and the postulated changes. The intended objective of privatization of health provisions appears as remote as it was before the changes. The major obstacles are identified as political hurdles, physician resistance, and continued dependence on state allocations.

scholarly journals What Are the Potential Advantages and Disadvantages of Merging Health Insurance Funds? A Qualitative Policy Analysis from Iran

2020 ◽  
Author(s):  
Mohammad Bazyar ◽  
Vahid Yazdi-Feyzabadi ◽  
Nouroddin Rahimi ◽  
Arash Rashidian
Keyword(s):  
Health Care ◽  
Health Insurance ◽  
Health Care Services ◽  
Health Care Expenditures ◽  
Advantages And Disadvantages ◽  
Care Services ◽  
Wide Range ◽  
Insurance Funds ◽  
Rich Data ◽  
Health Insurance Funds

Abstract Background:In countries with health insurance systems, the number and size of insurance funds along with the amount of risk distribution among them are a major concern. One possible solution to overcome problems resulting from fragmentation is to combine risk pools to create a single pool. This study aimed to investigate the potential advantages and disadvantages of merging health insurance funds in Iran. Methods:In this qualitative study, a purposeful sampling with maximum variation was used to obtain representativeness and rich data. To this end, sixty-seven face-to-face interviews were conducted. Moreover, a documentary review was used as a supplementary source of data collection. Content analysis using the 'framework method' was used to analyze the data. Four trustworthiness criteria, including credibility, transferability, dependability, and confirmability, were used to assure the quality of results. Results:The potential consequences were grouped into seven categories, including stewardship, financing, population, benefit package, structure, operational procedures, and interaction with providers. According to the interviewees, controlling total health care expenditures; improving strategic purchasing; removing duplication in population coverage; centralizing the profile of providers in a single database; controlling the volume of provided health care services; making hospitals interact with single insurance with a single set of instructions for contracting, claiming review, and reimbursement; and reducing administrative costs were among the main benefits of merging health insurance funds. The interviewees enumerated the following drawbacks as well: the social security organization’s unwillingness to collect insurance premiums from private workers actively as before; increased dissatisfaction among population groups enjoying a generous basic benefits package; risk of financial fraud and corruption due to gathering all premiums in a single bank; and risk of putting more financial pressure on providers in case of delay in reimbursement with a single-payer system. Conclusion:Merging health insurance schemes in Iran is influenced by a wide range of potential merits and drawbacks. Thus, to facilitate the process and lessen opponents’ objection, policy makers should act as brokers by taking into account contextual factors and adopting tailored policies to respectively maximize and minimize the potential benefits and drawbacks of consolidation in Iran.

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