Die Perspektive der Privaten Krankenversicherung bei der Bewertung von Ressourcenverbräuchen im Rahmen von gesundheitsökonomischen Evaluationen

Sinnhaftigkeit und Umsetzung

authored by

A. Lange, A. Prenzler, J. M. Graf Von Der Schulenburg

Abstract

At first this paper discusses under which conditions a health economic evaluation from the perspective of the Private Health Insurance (PHI) seems reasonable. Subsequent, a systematic overview of relevant resource use as well as its valuation from the perspective of the PHI is given. This includes all relevant cost domains from ambulatory and inpatient care as well as a detailed description of relevant data resulting from drug usage. For prescriptions the legal framework (e. g., reference pricing) is applied to list all relevant co-payments or discounts (e. g., for pharmaceutical companies) which have to be considered in patented as well as off-patent drugs. For ambulatory services the medical fee schedule should be considered. Regarding inpatient stays, general hospital services as well as treatment by chief physician and special accommodation have to be taken into account. As a result, for the first time, a pragmatic as well as a practical approach is presented to value resource usage within the German health care system in future studies from the perspective of the private health insurance.

Organisation(s)

Institute of Health Economics

Type

Review article

Journal

Gesundheitsokonomie und Qualitatsmanagement

Volume

17

Pages

185-191

No. of pages

7

ISSN

1432-2625

Publication date

08.2012

Publication status

Published

Peer reviewed

Yes

ASJC Scopus subject areas

Health Policy

Sustainable Development Goals

SDG 3 - Good Health and Well-being

Electronic version(s)

https://doi.org/10.1055/s-0031-1282020 (Access: Closed)