Situation review of care deficits and management programs for Multiple Sclerosis in Germany

Lennart Weegen,Anke Walendzik,Sarah Mostardt,Lasse Korff,Jürgen Wasem,Sonja Ivancevic

doi:10.5334/ijic.1293

Abstract

Background: The provision of care to chronically ill patients in Germany is regarded as deficient. In order to improve quality of care and to cut costs of chronic care, the German legislator has gradually introduced integrated care programs to the statutory health insurance (SHI) since the beginning of 1990s. According to current estimates, between 120,000 and 180,000 people suffer from the chronic disease multiple sclerosis (MS) in Germany [1]. MS causes a significant economic burden as about one out of three patients is affected by early retirement in consequence of MS [2]. Due to its broad range of neurologic symptoms, MS is characterized by a strong need for interdisciplinary and cross-sectoral care programs. Against this background, it was aim of the study to identify existing deficits in MS care, as the identification of deficits provides the basis for the development of efficient health care structures. In a second step, the study addresses the question whether care management programs for MS exist and how they are designed. Methods: Initially, a systematic literature review regarding care deficits and management programs for MS was conducted in the medical databases Embase and Scopus. The systematic search was supplemented by further internet search. Currently, expert interviews regarding care deficits are conducted with representatives from e.g. SHI funds, associations of involved professionals and patient organizations. Furthermore, the 40 largest SHI funds in Germany are surveyed by means of a standardized questionnaire regarding the existence of management programs for MS and their content. The empirical analysis is carried out anonymously.

Highlights

The provision of care to chronically ill patients in Germany is regarded as deficient
On average 3.5 years pass by until the diagnosis multiple sclerosis (MS) is made, new diagnostic tests and criteria allow a diagnosis within a few months after onset of the disease
With regard to MS therapy, especially disease modifying therapy, it has been ascertained that therapy rate is too low and dropout rate is too high

Summary

Introduction

The provision of care to chronically ill patients in Germany is regarded as deficient. Sonja Ivancevic, Researcher, University of Duisburg-Essen, Institute for Health Care Management and Research, Germany Jürgen Wasem, Professor, University of Duisburg-Essen, Institute for Health Care Management and Research, Germany Correspondence to: Lennart Weegen, University of Duisburg-Essen, Institute for Health Care Management and Research, Germany, E-mail: lennart.weegen@medman.uni-due.de

Results

Conclusion