Challenges for the German Health Care System.

The German Health Care System (GHCS) faces many challenges among which an aging population and economic problems are just a few. The GHCS traditionally emphasised equity, universal coverage, ready access, free choice, high numbers of providers and technological equipment; however, real competition among health-care providers and insurance companies is lacking. Mainly in response to demographic changes and economic challenges, health-care reforms have focused on cost containment and to a lesser degree also quality issues.

[School meals at secondary schools: an analysis in the district of St. Wendel in the Province Saarland, Germany].

Introduction: This study focuses on the nutrition of young people in schools. The Saarland state government mandates the implementation of the "quality standards for school meals", developed by the Germany Society of Nutrition (Deutschen Gesellschaft für Ernährung, DGE) in schools offering school meals. This research evaluates the state of implementation.

Economic impact of alternative adjuvant chemotherapy regimens for stage III colon cancer.

Background: Adjuvant treatment of stage III colon cancer represents a significant economic burden for the German health care system. The available chemotherapy regimens have significantly different medical and economic profiles.

Methods: A modeling study based on published clinical trials was performed to assess costs of 5 different regimens (Mayo Clinic, LV5FU2, FOLFOX-4, Xelox, Capecitabine) from the perspective of the statutory sickness funds.

Adjuvant chemotherapy for colon cancer--analysis of treatment costs from the perspective of statutory sickness funds.

Objective: The aim of this study was to calculate sickness funds' costs associated with the application of three different adjuvant chemotherapy regimens for patients with stage III colon cancer treated in different settings (inpatient/outpatient) in Germany.

Methods: Standard procedures according to national guidelines were defined for inpatient and outpatient diagnostics and treatment. Costs associated with the three commonly used standard treatment regimens were calculated from the perspective of statutory sickness funds.

The changing nature of contracts in German health care.

The flexibility inherent in the German health care system is fairly limited. The contracting environment itself is characterized by bilateral cartels negotiating the terms covering their respective members. Looking at some recently implemented reforms, namely structural contracts and experimental settings, the paper assesses the potential for sickness funds to take on a more active role.