[Evaluating the effectiveness of a disease management program diabetes in the German Statutory Health Insurance: first results and methodological considerations].

Disease management programs (DMPs) were implemented in the German Statutory Health Insurance (SHI) in a nationwide rollout in 2002. The explicit goal of the programs is to improve coordination and quality of care for the chronically ill (Sect. 137f, SGB V).

Patients with type 2 diabetes benefit from primary care-based disease management: a propensity score matched survival time analysis.

This study aimed to assess the impact of a nationwide German diabetes mellitus disease management program (DMP) on survival time and costs in comparison to routine care. The authors conducted a retrospective observational cohort study using routine administration data from Germany's largest sickness fund to identify insured suffering from diabetes in 2002. A total of 95,443 insured with type 2 diabetes mellitus who were born before January 1, 1962 met the defined inclusion criteria, resulting in 19,888 pairs of DMP participants and nonparticipants matched for socioeconomic and health status using propensity score matching methods.

Life prolonging of disease management programs in patients with type 2 diabetes is cost-effective.

Aim: Our objective was to examine the cost-effectiveness of disease management programs (DMPs) for type 2 diabetes mellitus (T2DM) taking into account their life prolonging effect.

Methods: We compared real life costs in 19,888 propensity score matched pairs of T2DM DMP participants and T2DM patients in routine care (RC) according to sickness funds data. We estimated mean annual costs for survivors, last year of life costs for decedents, the influence of ageing on costs, incremental cost-effectiveness ratio and effects on hospitalization.

German diabetes management programs improve quality of care and curb costs.

This paper reports the results of a large-scale analysis of a nationwide disease management program in Germany for patients with diabetes mellitus. The German program differs markedly from "classic" disease management in the United States. Although it combines important hallmarks of vendor-based disease management and the Chronic Care Model, the German program is based in primary care practices and carried out by physicians, and it draws on their personal relationships with patients to promote adherence to treatment goals and self-management.

[§ 116b SGB V (social insurance code, book five) for rheumatology patients. An empirical assessment on the basis of administrative data].

Background: The choice between outpatient and inpatient care is currently undergoing major changes within the German health care system with the amendment of § 116b SGB V. This study investigates what proportion of hitherto inpatient rheumatologic care could potentially be given on an outpatient basis.

Methods: The analysis is based on administrative inpatient data from 2004 to 2008 covering approximately 23.

[Analysis of mortality and convergence tendencies in inpatient care of stroke and myocardial infarction].

Background: An increase in the convergence of medical services toward specialized hospitals with high case numbers as well as the effects on quality of care are often assumed to be the result of diagnosis-related groups (DRGs; case-based lump-sum reimbursement). Estimates of the extent to which these effects occur in emergency diagnoses are not available.

Methods: Claims data relating to approximately 23.

Direct non-medical and indirect costs for families with children with congenital cardiac defects in Germany: a survey from a university centre.

Introduction: Parents of children with congenital cardiac disease suffer from psychological stress and financial burdens. These costs have not yet been quantified.

Materials And Methods: In cooperation with paediatricians, social workers, and parents, a questionnaire was devised to calculate direct non-medical and indirect costs.

Financial incentives in the German Statutory Health Insurance: new findings, new questions.

Objectives: This paper presents findings of a mandatory three-year evaluation of a prevention bonus scheme offered in the German Statutory Health Insurance (SHI). Its objective is to describe the rationale behind the programs, analyze their financial impact and discuss their implications on potentially conflicting goals on solidarity and competition.

Methods: The analysis included 70,429 insured enrolled in a prevention bonus program in a cohort study.

[Analysis of selection inventives for health insurances after introduction of the morbidity-oriented risk compensation scheme: an empirical analysis].

Background: The risk compensation scheme (RCS) in the Statutory Health Insurance (SHI) was implemented in 1994 to discourage risk selection between sickness funds. However, several expertise papers have concluded since then that the sociodemographic risk adjusters in place could not adequately curb risk selection. To minimise incentives for risk selection in the Statutory Health Insurance (SHI) further, the RCS was refined in 2009 by adding 80 diseases as additional risk adjusters.

Wealth inequality and tuberculosis elimination in Europe.

In Europe, wealth inequality is directly related to tuberculosis (TB) notification (R2 = 0.69), while in countries with lower TB rates, higher proportions of TB cases occur in foreign-born persons. Particularly during times of financial upheaval, efforts to eliminate TB must address social inequality.

[Convergence tendencies in inpatient oncological care after implementation of diagnosis-related groups in Germany].

Background: An increase of the convergence of medical services towards specialised hospitals with high case numbers is often assumed as a result of the implementation of diagnosis-related groups (DRG; case-based lump sum reimbursement). So far, estimates of the extent to which this effect occurs after the recent implementation of DRGs are not available in Germany.

Method: Claims data of about 23,600,000 insured within the inclusive period 2004-2007 were analysed.

Preliminary analysis of short-term financial implications of a prevention bonus program: first results from the German Statutory Health Insurance.

Objectives: With the implementation of the Health Care Modernization Act in 2004 sickness funds in Germany were given the opportunity to award bonuses to their insured for health-promoting behavior. The aim of this study was to investigate the financial implications of a prevention bonus program from a sickness fund perspective.

Method: The investigation was designed as a controlled cohort study (matched pair study) comprising 70,429 members in each group.

Checking concordance between findings and diagnoses in sonographic reports by a knowledge-based documentation system.

Purpose: Sonographic reports are examiner-dependent and may not always be reliable. We investigated concordance between documented findings and diagnostic conclusions--not the objective correctness of both--with the help of a knowledge-based documentation system.

Materials And Methods: The knowledge-based documentation system SonoConsult (SC) is routinely used in the ultrasound unit of a gastroenterological clinic for more than four years.

Triclabendazole for the treatment of fascioliasis and paragonimiasis.

Fascioliasis and paragonimiasis, which are caused by liver flukes (Fasciola) and lung flukes (Paragonimus), are emerging public health problems. Several hundred millions of people are at risk of the two diseases that cause considerable morbidity and delay socio-economic development. Triclabendazole, a benzimidazole derivative, has been routinely used since 1983 in veterinary medicine to control infections with Fasciola spp.

Efficacy of a single milbemycin oxime administration in combination with praziquantel against experimentally induced heartworm (Dirofilaria immitis) infection in cats.

The efficacy of a combination of milbemycin oxime and praziquantel in preventing the establishment of experimentally induced heartworm (Dirofilaria immitis) infection was investigated in a study involving 24 young domestic short-hair cats. The animals were inoculated with 50 infective larvae on day 0. Subsequently they were divided into two groups of 12 animals each.

A diagnostic expert system for structured reports, quality assessment, and training of residents in sonography.

Background: The quality of medical reports on diagnostic procedures has a considerable impact on the quality of medical care. Handwritten or otherwise unstructured reports tend to be incomplete, whereas structured questionnaires are of limited flexibility and not considered case-adequate. Thus, medical reports of this kind may promote an incomplete and misleading documentation and, therefore, be problematic with respect to their reliability.

Efficacy of milbemycin oxime against fourth-stage larvae and adults of Ancylostoma tubaeforme in experimentally infected cats.

The efficacy of milbemycin oxime against fourth-stage (L4) larvae and adults of Ancylostoma tubaeforme was investigated in a trial involving 24 young domestic shorthair cats. The animals were inoculated with approximately 300 infective stage three (L3) larvae and divided into three groups. After 12 days, eight cats (group 1) were treated with medicated tablets containing 4 mg milbemycin and 10 mg praziquantel to test the efficacy against L4 larvae; eight cats in group 2 were treated with the same tablets after 33 days to test the efficacy against adult worms; and eight cats in group 3 were treated with a placebo tablet.

The efficacy of triclabendazole and other anthelmintics against Fasciola hepatica in controlled studies in cattle.

In eight controlled tests 274 cattle were used to assess the efficacies of triclabendazole, albendazole, clorsulon, nitroxynil, oxyclozanide and rafoxanide against Fasciola hepatica. Against one-, two- and four-week-old early immature fluke the mean efficacies of triclabendazole given orally at 12 mg/kg were 88.1, 95.

The effects of triclabendazole on the lung fluke, Paragonimus uterobilateralis in the experimental host Sigmodon hispidus.

The new veterinary drug triclabendazole (Fasinex) was tested for its anthelmintic activity against adult Paragonimus uterobilateralis in experimentally infected cotton rats, Sigmodon hispidus. After a single dose of 50, 100 or 150 mg/kg b.w.

Quantitative description of the development of Babesia ovis in Rhipicephalus bursa (hemolymph, ovary, eggs).

The development and infection dynamics of Babesia ovis in the hemolymph, ovaries, and eggs of Rhipicephalus bursa are described quantitatively, based mainly on examination of Giemsa-stained smears. After alimentary infection of female ticks, their hemolymph became infected 5 days after repletion (p.repl.