Analyse der Erlössituation bei der ambulanten Behandlung nach 116 b SGB V am Beispiel des Marfan-Syndroms
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Analyse der Erlössituation bei der ambulanten Behandlung nach 116 b SGB V am Beispiel des Marfan-Syndroms. / Manow, Marie-Luise; Paulsen, Nesrin; Rybczynski, Meike; Mir, Thomas; Bernhardt, Alexander M J; Treede, Hendrik; Ohm, Gunda; Fuisting, Bettina; Rehder, Uwe; Meier, Florian; Vogler, Marina; Meinertz, Thomas; Overlack, Karin; von Kodolitsch, Yskert.
in: MED KLIN-INTENSIVMED, Jahrgang 105, Nr. 8, 08.2010, S. 529-537.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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TY - JOUR
T1 - Analyse der Erlössituation bei der ambulanten Behandlung nach 116 b SGB V am Beispiel des Marfan-Syndroms
AU - Manow, Marie-Luise
AU - Paulsen, Nesrin
AU - Rybczynski, Meike
AU - Mir, Thomas
AU - Bernhardt, Alexander M J
AU - Treede, Hendrik
AU - Ohm, Gunda
AU - Fuisting, Bettina
AU - Rehder, Uwe
AU - Meier, Florian
AU - Vogler, Marina
AU - Meinertz, Thomas
AU - Overlack, Karin
AU - von Kodolitsch, Yskert
PY - 2010/8
Y1 - 2010/8
N2 - BACKGROUND: The Marfan syndrome is a typical rare disease with multiorgan involvement and the need for specialized interdisciplinary medical care. A novel German legal directive according to section sign 116 b of the Social Statutes Book V (116 b SGB V) improves options for reimbursement and thus encourages specialized hospitals to provide ambulatory care for rare diseases such as Marfan syndrome. The authors provide the first economic analysis of section sign 116 b in a German Marfan center.METHODS: The costs were assessed in 184 cases with Marfan syndrome receiving medical care in the Hamburg Marfan Clinic. The authors assessed the financial profit both according to payments received from invoices established according to the 116 b directive [reimbursement (116b)] and from calculations according to section sign 117 SGB V [reimbursement (117)].RESULTS: A total of 117 patients traveled to the Marfan clinic (64%) < 50 km, 27 patients (15%) between >or= 50 and 100 km. The total costs for ambulatory care were 71,606.28 Euro. The reimbursement (116b) was 55,549.87 Euro and the reimbursement (117) was 11,776.00 Euro.CONCLUSION: Many patients accept long distances of traveling to receive specialized ambulatory medical care. However, for optimal patient management specialized centers need to cooperate intensively with local health care providers. The novel legal directive according to section sign 116 b has significantly improved reimbursement for Marfan centers and allows for improving the quality of medical care.
AB - BACKGROUND: The Marfan syndrome is a typical rare disease with multiorgan involvement and the need for specialized interdisciplinary medical care. A novel German legal directive according to section sign 116 b of the Social Statutes Book V (116 b SGB V) improves options for reimbursement and thus encourages specialized hospitals to provide ambulatory care for rare diseases such as Marfan syndrome. The authors provide the first economic analysis of section sign 116 b in a German Marfan center.METHODS: The costs were assessed in 184 cases with Marfan syndrome receiving medical care in the Hamburg Marfan Clinic. The authors assessed the financial profit both according to payments received from invoices established according to the 116 b directive [reimbursement (116b)] and from calculations according to section sign 117 SGB V [reimbursement (117)].RESULTS: A total of 117 patients traveled to the Marfan clinic (64%) < 50 km, 27 patients (15%) between >or= 50 and 100 km. The total costs for ambulatory care were 71,606.28 Euro. The reimbursement (116b) was 55,549.87 Euro and the reimbursement (117) was 11,776.00 Euro.CONCLUSION: Many patients accept long distances of traveling to receive specialized ambulatory medical care. However, for optimal patient management specialized centers need to cooperate intensively with local health care providers. The novel legal directive according to section sign 116 b has significantly improved reimbursement for Marfan centers and allows for improving the quality of medical care.
KW - Adolescent
KW - Adult
KW - Ambulatory Care/economics
KW - Child
KW - Child, Preschool
KW - Cooperative Behavior
KW - Costs and Cost Analysis
KW - Female
KW - Germany
KW - Health Care Costs/legislation & jurisprudence
KW - Health Expenditures/legislation & jurisprudence
KW - Health Services Accessibility/economics
KW - Hospitals, Special/economics
KW - Humans
KW - Infant
KW - Interdisciplinary Communication
KW - Male
KW - Marfan Syndrome/economics
KW - Middle Aged
KW - National Health Programs/economics
KW - Outpatient Clinics, Hospital/economics
KW - Patient Care Team/economics
KW - Rare Diseases
KW - Referral and Consultation
KW - Reimbursement Mechanisms/economics
KW - Young Adult
U2 - 10.1007/s00063-010-1090-y
DO - 10.1007/s00063-010-1090-y
M3 - SCORING: Zeitschriftenaufsatz
C2 - 20824410
VL - 105
SP - 529
EP - 537
JO - MED KLIN-INTENSIVMED
JF - MED KLIN-INTENSIVMED
SN - 2193-6218
IS - 8
ER -