Prof. Dr. A Mühlbacher (University of Applied Sciences Neubrandenburg)
Europäische Union - Seventh Framework Programme
3 Mio. EUR
Forschungsschwerpunkt Gesundheitsökonomie und Gesundheitspolitik am Institut für Epidemiologie, Sozialmedizin und Gesundheitssystemforschung, MHH
Medical University of Warwa, Polen
S. Bethge (M.Sc. PH), J. Buhl (M.A. Soz.), K. Hoeper (Dipl.-Kffr., Dipl.-Volksw.), S. Jensen (Dipl.-Ök.), S. Schauer (B.A., MPH), C.J. Rupprecht (AOK Rheinland/Hamburg)
Spending more on healthcare often doesn’t result in improving quality, effectiveness and access to service. In several countries higher rates of physician consultations, hospital beds, or medical prescriptions per citizen result in wasting resources as compared to other countries, which have introduced modern co-payment systems, provided with safeguards, like “annual caps” or “doughnut holes”. In the latter case the overuse of resources caused by moral hazard is reduced by empowering patients. Resources that are wasted because of poor management are no longer available to reimburse innovative pharmaceuticals, buy new equipment, shorten waiting lists and improve other essential quality indicators.
To improve and modernize health care financing systems different reforms are being implemented in United States and in Europe. But even experienced executives of US health insurance companies admit that: “Our current payment system is making cost, quality, and coverage problems worse by rewarding volume regardless of quality or outcomes and paying for procedures and services regardless of whether they are appropriate or needed. These systems value expensive technology over patient-centered care and pays richly for acute care but not for the primary and preventive care that keeps people healthier. The good news is that we can realign payment incentives to drive quality improvement and foster better use of our health care resources. To get to better quality, we don’t need to pay more: we need to pay smarter.
Health care financing reforms implemented in Central and Eastern Europe have proven various technical and political difficulties. Scientifically validated tools to help decision-makers choosing the right financing mechanisms in the different areas of healthcare systems are vastly needed.
A key marker of the successful healthcare system is the extent to which it facilitates the delivery of efficient, effective and equitable care. While healthcare systems differ in such core elements as the characteristics of the population base or funding, reimbursement and pricing systems, the design and implementation of reform measures is mainly geared towards optimizing the relationship between input and output (quality, outcome) factors.
1. To investigate the effect of different financing methods and incentives on the quality, effectiveness and equity of access to health care in four patient groups affected by:
• pharmaceutical care
• hospital care
• outpatient care
• integrated care
2. To develop collaborative practice models of healthcare, in the context of financing treatment of chronic diseases
3. To establish the feasibility and effectiveness of developed models in the settings of each partner healthcare system
• Clinical issues: quality outcomes, clinical efficacy and safety
• Economic issues: cost control, cost-effectiveness, utilization of resources
The project is funded by European Commission within the Seventh Framework Programme for Research and Technological Development. Grant Agreement no: HEALTH-F3-2010-261369 (www.interqualityproject.eu).