Healthcare Systems Research Ethics and Reality IALS. Boston, October Dr. med. Heidrun Sturm Ph.D., MPH

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1 Healthcare Systems Research Ethics and Reality IALS Boston, October Dr. med. Heidrun Sturm Ph.D., MPH Dr. med. Heidrun Sturm, MPH PhD 1

2 Heidrun Sturm, M.D., MPH, PhD About me

3 The Role of Health Systems Research 1 2 2a 2b What is Health Systems Research Health Systems Research Contribution and Challenges Demography and Chronic diseases Market Orientation in Health Care and Ethics

4 The Healthcare-Arena Health needs Morbidity Demography Preferences Society Outcomes Life-Expectancy Quality of Life Resources spent HC-System Research Epidemiology Health Economics Solutions Prevention Technical Innovation Process of Care Provision Academia & HC-Industry Medicine, Epidemiology Life-Science / Med.Tech Provider-Organizations Framework Resources (Personnel, HC-System Finances) Structures Politics Policies and regulations Stakeholders

5 Health Policy and Systems Research (WHO-Definition) seeks to understand and improve how societies organize themselves in achieving collective health goals. Inter-disciplinary: Epidemiology Public Health Medicine Economics Sociology Anthropology Political science Service Delivery Quality, Cost- Effectiveness Financing and Allocation

6 The Role of Health Systems Research 1 2 What is Health Systems Research Health Systems Research Contribution and Challenges Demography and Chronic diseases Market Orientation in Health Care and Ethics

7 Evidence - Challenges of Ageing Today s 65 year-olds have almost a quarter of their lifetime ahead of them

8 Aging Society Dr. med. Heidrun Sturm, MPH PhD

9 Morbidity in ,0% 10,0% 20,0% 30,0% 40,0% 50,0% 60,0% Hypertonie Arthrose Rückenschmerzen Schwerhörigkeit Osteoporose COPD Diabetes mellitus Lungenentzündung Demenz Makuladegeneration Glaukom Rheumatoide Arthritis Krebs insgesamt Herzinfarkt Taubheit

10 Pointing out future callenges COMMON RECOMMENDATIONS: Disease prevention Inter-professional guidelines and pathways Reduction of unnecessary care Improve co-ordination (DMP etc) Implement efficient structures (interdisciplinary) MARKET ORIENTATION

11 The Role of Health Systems Research 1 2 What is Health Systems Research Health Systems Research Contribution and Challenges Demography and Chronic diseases Market Orientation in Health Care and Ethics

12 Market-orientation: increased competition Integrated Care Contracts ( 140 SGB V) Purchaser Physician association Payer Health Insurance (Pharm.) Industry Provider Physician

13 Incentives and Ethics - Examples Schizophrenia Network in Lower Saxonie, managed by a Management- Organisation I3G GmbH is an independent affiliate of Janssen-Cilag (Johnson&Johnson) Insurance Save Pharmaceutical Industry supports physician networks with e.g. patient information, secretary etc. Provider Improve care Pharma Immage

14 Incentives and Ethics - Examples Favors per prescriptions: How Physician Networks and Pharmaceutical Industry support each other Dr. med. Heidrun Sturm, MPH PhD Der Spiegel, 2 4 /

15 Incentives and Ethics - Examples Rebates for specific substances Insurance prescribing Provider Pharma

16 Incentives and Ethics - Examples: Three sided Integrated Care Contract IT-documentation and therapy-support system for epileptic children Providers: Academic Centers Management-Organisation GPs and pediatricians can join Pharma: Telemedical Communication-Platform Financing Training Insurance Save Insurer: Reimbursement of participating providers Provider Improve care Pharma Immage

17 Different Stakeholders in Baden-Württemberg Dr. med. Heidrun Sturm, MPH PhD

18 Kontakt: hs 2 Healthcare-Strategies Dr. med. Heidrun Sturm MPH, PhD Blaihofstr Tübingen Tel. +49 (0) Mobil +49 (0) Die vorliegenden Präsentationsfolien unterliegen dem Copyright der Firma hs 2 Healthcare-Strategies. Die Nutzung ist ausschließlich hs 2 Healthcare-Strategies vorbehalten. Dr. med. Heidrun Sturm, MPH PhD 22

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