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Prof. Dr. Heinz RothgangProf. Dr. Heinz Rothgang
Grant Awarded for Project on the Needs-Based Provision of Medical Care to Nursing Home Residents.

This year, the German Innovation Funds has provided research funding to the tune of € 300m. Of that money, € 225m. have been awarded for the implementation of new healthcare models, and €75m. for research on health services research. Around 600 applications for research funding were submitted; 62, that is one in ten, projects were approved. One of the grants was awarded to SOCIUM.

The primary aim of the project submitted by Professor Rothgang (SOCIUM) and his team is to gain a better knowledge of needs-based medical care by general practitioners and medical specialists to nursing home residents with a view to improving the needs-based provision of medical care in that setting.

The three-year project, with a total funding volume of € 854,905, will be conducted by SOCIUM in cooperation with the Institute of Public Health and Nursing Research (IPP), the Competence Center for Clinical Trials Bremen (KKSB) and the Scientific Institute of the AOK Health Insurance Fund (WidO), and with the participation of the AOK Health Insurance Fund Bremen/Bremerhaven, the Bremer Heimstiftung (a foundation that runs over 20 residential/nursing homes in Bremen), the Federal Association of Private Providers of Social Services (bpa), the Bremen Association of Social Welfare Organisations (LandesArbeitsGemeinschaft der Freien Wohlfahrtspflege Bremen/LAG) and the Bremen Association of General Practitioners (Hausärzteverband).

In a first step, routine data from the statutory health insurance funds will be examined to compare and identify differences between medical care provided by GPs and specialists to (i) nursing home residents, (ii) people in need of long-term care who are cared for in a community setting and (iii) patients not requiring long-term care. Any differences in provision will then be assessed in terms of over-, under- and misprovision by means of standardised assessment using primary data. Appropriate (or inappropriate) medical care provision is explained on the basis of a record linkage and retrospective analysis of routine health insurance data and primary data, as well as case reconstructions. In focus group discussions, potentials for improvement and possible solutions are then extrapolated from this unprecedented survey and analysis of deficits in medical provision. Building on this, the Delphi method is then applied to develop and pilot a model project. Altogether, the project should contribute to an improvement in the needs-based provision of medical care in nursing home residents.

More information about the projekt:
Needs-Based Provision of Medical Care to Nursing Home Residents (MVP-STAT)


Contact:
Prof. Dr. Heinz Rothgang
SOCIUM Research Center on Inequality and Social Policy
Mary-Somerville-Straße 3
28359 Bremen
Phone: +49 421 218-58557
E-Mail: rothgang@uni-bremen.de

This year's winners of the Berninghausen Award (from left to right): Natascha Ueckmann, Julia Borst, Ansgar Gerhardus, Heinz Rothgang and Michael Claridge. © Harald Rehling/University of BremenThis year's winners of the Berninghausen Award (from left to right): Natascha Ueckmann, Julia Borst, Ansgar Gerhardus, Heinz Rothgang and Michael Claridge. © Harald Rehling/University of Bremen
Berninghausen Prize for excellent teaching awarded to Heinz Rothgang.

Often the daily routines of university campus life fall short of the Humboldtian ideal of an interdependence between excellent research and excellent teaching. Too many students, too much expense, too little time - there are enough reasons why even at universities students are experiencing too much teacher-centred teaching. With their concept for a three-semester long research/teaching project in the Master of Public Health Programme, Heinz Rothgang and Ansgar Gerhardus have succeeded in changing that. The Master in Public Health is intricately related to practice and interdisciplinary as well, but presupposes a profound knowledge of theories and methodology. Since many students have practical experience and are headed back to practice the research part of their Master often falls short of expectations.

In the three-semester long research/teaching project therefore, students are organizede into small groups which set out to develop scientifically sound concepts of intervention and evaluation based on a health issue of their choice. But that is not all. In cooperation with partner institutions such as health insurers or clinics the students also implement their ideas in the real world. Research becomes tangible, research results are authentic, and students are especially motivated. The Master in Public Health Programme already converted its full teaching concept to projects. The student feedback clearly endorses this change. The interdependence of research and teaching, theory and practice, instruction and independent work, university and external partners is well received.

The Berninghausen Prize has been awarded yearly since 1992 by the Society of the Friends of the University of Bremen and Jacobs University Bremen and is endowed with 2.000 Euros.


Contact:
Prof. Dr. Heinz Rothgang
SOCIUM Research Center on Inequality and Social Policy
Mary-Somerville-Straße 3
28359 Bremen
Phone: +49 421 218-58557
E-Mail: rothgang@uni-bremen.de

Team of authors at SOCIUM Research Center on Inequality and Social Policy at the University of Bremen draws up Long-Term Care Report for BARMER GEK.

The ninth BARMER GEK Long-Term Care Report was presented to the public today at the Federal Press Conference. The report examines especially the effects of the most recent reforms in long-term care on the provision of care to those in need of it. The team, headed by Professor Heinz Rothgang and including Thomas Kalwitzki, Rolf Müller, Rebecca Runte und Rainer Unger, also scrutinized the regional differences in terms of long-term care requirements and provision structures. The data base for the report is primarily long-term care statistics for around 2.6 m. people in need of care, the German Socio-Economic Panel Study and routine insurance data from BARMER GEK, which covers approx. 10 percent of the population.

Main results of the Report:

  1. The reform measures taken so far are taking effect. Under the LTC Redirection Act (PNG, 2012) and the First Act to Strengthen Long-term Care (PSG I, 2015), specifically services for people with dementia were improved, and the provision of respite and part-time care was made more flexible. Figures show a marked increase in the utilization of these services in particular. Also dental care in care homes, which was also the subject of various new regulations, has been improved.

  2. The introduction of the new definition of the need for long-term care under the Second Act to Strengthen Long-term Care (PSG II, taking effect as per 1.1.2017) is a very generous, and hence very expensive, reform. It is calculated that additional expenditure will amount to more than 7 bn. Euros compared to the status quo. An increased contribution rate will generate more revenue from contributions; however, this will not suffice to cover the additional costs, even taking the surplus funds currently generated by care insurance into account. For 2017 a structural deficit of more than 3bn. Euros is anticipated.

  3. In nursing homes, the increased costs mean financial relief for those in need of long-term care and their families, and also indirectly for welfare agencies; however, nursing home revenues will not increase to the same degree. Thus, the reform does not mean that nursing homes will be better staffed. If we want higher staffing rates, further reforms will be necessary in the coming years.

  4. Immense differences can be observed from state to state in terms of the increased number of people in need of long-term care but also with regard care arrangements and the capacities within the formal care sector, and the extent of future gaps in the care workforce. It is clear from these discrepancies that long-term care must be conceptualized and planned at a regional or local level. 


Downloads (in German only):
BARMER GEK Long-Term Care Report 2016
Statement from Prof. Rothgang at the Press Conference on 24.11.2016
Presentation given by Prof. Rothgang at the Press Conference on 24.11.2016


Contact:
Prof. Dr. Heinz Rothgang
SOCIUM Research Center on Inequality and Social Policy
Mary-Somerville-Straße 3
28359 Bremen
Phone: +49 421 218-58557
E-Mail: rothgang@uni-bremen.de

Dr. rer. pol. Rolf Müller
SOCIUM Research Center on Inequality and Social Policy
Mary-Somerville-Straße 3
28359 Bremen
Phone: +49 421 218-58554
E-Mail: rmint@uni-bremen.de

Prize for “Outstanding Research-Based Teaching” in the Public Health Masters programme.

Heinz Rothgang (SOCIUM), together with Ansgar Gerhardus (IPP, University of Bremen), have received this year’s Berninghausen Award for Academic Teaching in the category “Outstanding Research-Based Teaching” in the Public Health Masters programme. The distinguishing feature of their joint seminar, which is part of a project that runs for 3 consecutive semesters, is that students draft and complete their project work and can even choose their own topics in cooperation with practical partners working e.g. in hospitals or health insurance funds. The jury was particularly impressed by the way students were able to link up with potential future fields of activity through real-life research at a very early stage of their study programme.

Further information:
TV Report in Buten un Binnen "Outstanding Teaching at the University of Bremen" (in German only)
University of Bremen Press Office Press Release, 9th November 2016


Contact:
Prof. Dr. Heinz Rothgang
SOCIUM Research Center on Inequality and Social Policy
Mary-Somerville-Straße 3
28359 Bremen
Phone: +49 421 218-58557
E-Mail: rothgang@uni-bremen.de

Innovation Report 2016Innovation Report 2016
The Evaluation of Pharmaceutical Products Introduced in 2013 and The Pharmaceutical Market Restructuring Act (AMNOG) Five Years on.

This is the fourth edition of the Innovation Report, drawn up by researchers at SOCIUM since 2013 (authors of the present edition are Daniela Boeschen, Dörte Fuchs, Judith Günther and Gerd Glaeske). The volume focuses primarily on 23 pharmaceutical produts that were launched on the German market in 2013, evaluating them in terms of their therapeutic benefit according to the standards of evidence-based medicine (EBM), their development on the market, and actual medical outcomes in the years 2013-14 on the basis of routine data from the Techniker Krankenkasse health insurance fund (TK).

The Pharmaceutical Market Restructuring Act (Arzneimittelmarktneuordnungsgesetz, or AMNOG) came into force on 1st January 2011, and requires that, without exception, all new prescription drugs available to patients covered by statutory health insurance must be tested for efficacy and above all for added benefits to patients that comparable existing therapies do not achieve. Altogether 156 testing procedures have been completed since 2011.

Overall, in 56.4 per cent of the procedures it was confirmed that the new drugs had an added benefit over a comparable therapy. This conclusion had already been reached by the Federal Joint Committee (Gemeinsamer Bundesausschuss, or G-BA, the highest decision-making body of the joint self-government of physicians, dentists, hospitals and health insurance funds in Germany) when it assessed the 100th active substance in late 2014. At the time, even the degree of additional benefit was differentiated: in 21 per cent of cases, and in the oncological drug market segment as much as 43 per cent, a significant additional benefit was ascertained. Negligible additional benefit was ascertained in 26 per cent of the cases assessed, and in eight per cent of the cases the benefit was not quantifiable. Frequently, however, there was no additional benefit for all of the patients with the indications in question, but rather only for certain subpopulations (approx. 40 per cent of cases), which meant that only a relatively small proportion of the patients benefited from the new drug (22 per cent).

The political intent of the legislation was to introduce a differentiation, regulated by statutory law, of the innovative degree of new pharmaceutical products in order to distinguish whether and to what extent they may be found to have a more positive therapeutic effect than approved comparative therapies. This objective was fulfilled in most cases, but experts were not always unanimous in their assessments. In fact, there were, and still are, discrepancies between the assessments of the German Institute for Quality and Cost Effectiveness in the Health Care Sector (Institut für Qualität und Wirtschaftlichkeit im Gesundheitswesen, or IQWiG), which compiles the dossiers preparatory to the decisions, and the conclusive decisions of the G-BA. For example, in 2014, IQWiG compiled 36 assessments for 33 active substances (not including orphan drugs). The G-BA did not endorse these assessments in all cases; in ten cases the G-BA reached a different conclusion on added benefits, and in five cases it increased or reduced the maximal degree of beneficial effects, which amounts to an adjustment rate of 30.3 per cent. It is conceivable that IQWiG carries out very strict assessments of the available evidence, while the G-BA takes aspects of provision more strongly into account.

As in the Innovation Report 2015, almost half of the new active substances introduced are for use in oncology. A close look at the TK’s expenditure for new drugs in 2013 shows that many of these new oncology products follow close behind the front runner Teriflunomid, a product for treating multiple sclerosis. The soaring costs of pharmacotherapy, brought on by high-priced pharmaceuticals now available on the market, especially in the areas of oncology and immunology, is causing excessive budgetary strain on Germany’s solidarity-based healthcare system, and there is an urgent need to amend the criteria for pricing new substances – that is one of the major conclusions drawn in the Innovation Report. The AMNOG was introduced as a learning system, and should therefore be amended when shortcomings and weaknesses become clear. This also applies to the tardy assessment of many pharmaceuticals of which too little is known about benefits to patients directly after approval. This is true of the majority of drugs newly available on the market – namely oncology products. Studies are urgently needed that document treatment outcomes in the three years following authorisation, thus allowing a more comprehensive assessment of the benefits and risks of the drugs in question. Reimbursement prices should ultimately be negotiated on the basis of that assessment. In terms of assessing new pharmaceutical products, AMNOG is undoubtedly a step in the right direction, but the legislation should be improved on an ongoing basis to establish more a reliable basis for decision-making.

Downloads (in German only):
Long Version: Innovationsreport 2016
Short Version: Innovationsreport 2016

Press Conference statement by Gerd Glaeske
Press Conference presentation by Gerd Glaeske


Contact:
Prof. Dr. Gerd Glaeske
SOCIUM Research Center on Inequality and Social Policy
Mary-Somerville-Straße 3
28359 Bremen
Phone: +49 421 218-58559
E-Mail: gglaeske@uni-bremen.de

Experts compare notes on long-term care

On 17th May 2016, Dr. Sunwoo Duk and Ju Hee Hwang from the Korea Institute for Health and Social Affairs (KIHASA), on a two-day visit to Germany, were welcomed at the Health, Long-Term Care and Pensions department at SOCIUM. Together with their interpreter Chang Kyu Chung, the guests discussed developments in long-term care with Professor Rothgang and Dr. Lorraine Frisina-Doetter. The long-term care system in South Korea is currently undergoing reforms, and Dr. Sunwoo, a leading researcher in long-term care policy, and colleague Ms. Ju Hee Hwang, were interested in learning about the German experience, especially as concerns the definition of eligibility requirements and expansion of entitlement benefits. During the talk, the possibility of future cooperation between the two research institutes was also explored.

Prior to the meeting Dr. Sunwoo and Ms. Hee Hwang were given a tour of the Arsten Care Centre by Frank Markus, Managing Director of the Residenz-Gruppe Bremen, which runs the Centre. The visit was mediated by Frau Bitter-Wirtz from the Bremen branch of the Federal Association of Private Providers of Social Services (bpa).

Further information: KIHASA

Prof. Dr. Gerd GlaeskeProf. Dr. Gerd Glaeske
Expert team to Professor Gerd Glaeske presents two new expertise reports on morbidity-oriented risk structure compensation (Morbi RSA).

Gerd Glaeske (SOCIUM, University of Bremen), together with Wolfgang Greiner (Universität Bielefeld), Jan Dietzel and Carsten Neumann (both IGES), presents an expert assessment on criteria, analyses and alternatives relating to ancillary research for Morbi RSA. Gerd Glaeske, Jean Dietzel and Carsten Neumann have also published a second expertise report on questions of disability.

Following an initiative by 11 state health insurers, both reports propose alternatives for independent ancillary research on ways of improving Morbi RSA. The first report analyses the actual impacts of the present method of disease selection, and develops and evaluates a number of appropriate alternatives without a predetermined conclusion.

The second ancillary research report focuses on issues related to the necessity of indirect measurement of morbidity in the Morbi RSA or whether it can be abandoned in favour of a pure morbidity orientation.


Contact:
Prof. Dr. Gerd Glaeske
SOCIUM Research Center on Inequality and Social Policy
Mary-Somerville-Straße 3
28359 Bremen
Phone: +49 421 218-58559
E-Mail: gglaeske@uni-bremen.de

Prof. Dr. Heinz RothgangProf. Dr. Heinz Rothgang
German Health Minister Hermann Gröhe has appointed Professor Heinz Rothgang member of the Advisory Board for the Implementation of the New Definition of the Need for Long-Term Care.

The Second Act to Strengthen Long-Term Care (Zweites Pflegestärkungsgesetz - also known as PSG II) came into force on 1st January 2016 and provides among other things a new assessment and a new system of five care grades to replace the previous three care categories. Under the new legislation, moreover, people in need of long-term care will have equal access to benefits irrespective of whether they are affected by physical or mental disabilities.

The Advisory Board has been set up to provide scientific and practical expertise and advice during the preparatory phase and, from January 2017, when the legislation is implemented. Moreover, the Board will support the Federal Association of Statutory Heath Insurance Funds (GKV-Spitzenverband), the Medical Review Board of the Statutory Health Insurance Funds (MDS) and the federal associations of long-term care facilities in preparation for the transition to the new assessment procedure. Once introduced, it will monitor the new procedures for practicability and applicability and the counselling of care receivers and their relatives on how the changes will affect them.

The new Board will continue the work of the previous Advisory Board for Reviewing the Definition of the Need for Long-Term Care and the Advisory Board on the Specification of the new Definition of the Need for Long-term Care, of which Heinz Rothgang was also a member.

Further information: German Ministry of Health


Contact:
Prof. Dr. Heinz Rothgang
SOCIUM Research Center on Inequality and Social Policy
Mary-Somerville-Straße 3
28359 Bremen
Phone: +49 421 218-58557
E-Mail: rothgang@uni-bremen.de

Logo Logo "Joint Action on Health Workforce Planning and Forecasting"
Conference and Workshop on Workforce Planning in the Healthcare Sector at House of Sciences and SOCIUM.

The EU Joint Action on Health Workforce Planning and Forecasting (www.healthworkforce.eu), which was inaugurated in 2013 for a period of three years, provides a central platform for the exchange of data, experience and concepts on workforce planning in the healthcare sector among European member states. Since 2013 the Joint Action Executive Board has until now met six times in different European cities; this time, the 7th meeting was held in Bremen. Professor Rothgang and his team, who represent Germany in the Joint Action, hosted a conference at the House of Sciences and the executive board at SOCIUM.

At the half-day conference, the Bremen project group presented its findings from a feasibility study on workforce planning in the healthcare sector and discussed them in the context of European developments in health care. In their study, the group examined the benefits of a European handbook on good practice standards for planning methods and discussed these with representatives from the medical and care professions, the chamber of pharmacists, midwives, the state health authorities and health insurance funds. Paolo Michelutti, project manager for parallel studies in Italy, Portugal and Romania, gave an account of the work of the Joint Action on Health Workforce Planning and Forecasting. Leon van Berkel from the European Commission gave a keynote talk on current EU schemes in the professional healthcare sector.

On 28th and 29th January a Joint Action Executive Board meeting was held at SOCIUM with work package leaders and representatives of the European Commission.


Contact:
Prof. Dr. Heinz Rothgang
SOCIUM Research Center on Inequality and Social Policy
Mary-Somerville-Straße 3
28359 Bremen
Phone: +49 421 218-58557
E-Mail: rothgang@uni-bremen.de

Cover Arzneimittelreport 2015Cover Arzneimittelreport 2015
First analysis of expenditure on cytostatic drugs in statutory health insurance.

For the fifteenth time, the team of authors around Gerd Glaeske and Christel Schicktanz published the BARMER GEK Pharmaceutical Report 2015. By analysing the representative secondary data of prescriptions, expenditures and regional distributions of 8.6 million BARMER GEK insured, the pharmaceutical provision has been depicted convincingly. Special attention was drawn to the areas of supply where there is potential for improvement, i.e. drugs with unnecessary risks, preparations that are too frequently or too seldom prescribed as well as drugs with unnecessary costs.

Download:
BARMER GEK Arzneimittelreport 2015
Power Point Presentation at the press conference by Prof. Glaeske


Contact:
Prof. Dr. Gerd Glaeske
SOCIUM Research Center on Inequality and Social Policy
Mary-Somerville-Straße 3
28359 Bremen
Phone: +49 421 218-58559
E-Mail: gglaeske@uni-bremen.de