The statutory health insurance has spent about 40 billion Euros on pharmaceutical products and bandaging material in 2016. In order to prevent an unjustified loading of the solidary system, the legislator requires assessments of the efficiency of medical prescriptions. But the procedures used so far have been criticized nation-wide because – among other reasons – practices with a broad treatment range had a disadvantage and expensive drugs were not prescribed out of fear of regress – patients were rather transferred to specialists. With that, the safety of the patient can be on the line. In order to prevent over- and undertreatment and to maintain freedom of therapy for panel doctors, a transparent and effective management system is an essential goal.
The WirtMed study aims at developing and testing new procedures intended to help the Associations of Statutory Health Insurance Physicians analyze and control future efficiency and quality of the prescription of medication and to manage it reasonably. Five sub-studies will be conducted in order to examine different aspects of prescription and its management on the basis of routine health insurance data. Furthermore, strategies will be developed in order to improve the management instruments. Two of the sub-studies will be carried out, among others, by the Institute of General Practice of the Universty Hospital Erlangen.
Research question and method
The WirtMed study focuses on the perception of the program of the KV Bayern (Association of Statutory Health Insurance Physicians Bavaria) and its relevant micro-effects. Via focus groups and partly-structured individual interviews, the practitioner´s experiences will be collected. Within the scope of the research project we will also deal with their individual problems, experiences or possible alternatives to the current management and evaluation models.
Relevance for doctors and patients
It is our goal to open up new pathways to a more just medication evaluation. Disadvantages of for example practices with a broad treatment range should be prevented through reasonable management. Simultaneously, an improvement of the treatment quality is worth aiming at. What does that mean for the patients? They receive the necessary and adequate therapy they deserve and that the doctor can prescribe to the best of his knowledge and conscience.
Within the WirtMed study, the Institute of General Practice of the UK Erlangen will cooperate with the consortium leader Department for General Practice of the Philipps University Marburg (project manager is Prof. Dr. med. N. Donner-Banzhoff) for the two sub-studies in a consortia project funded by the Innovation Fund of the Joint Federal Committee. The KV Bayern is an additional cooperation partner for one of these sub-studies. The projects duration is set to be 3 years starting on April 1st, 2018.