Andreas Reimann

Report of the European respiratory society/European cystic fibrosis society task force on the care of adults with cystic fibrosis

The improved survival in people with cystic fibrosis has led to an increasing number of patients reaching adulthood. This trend is likely to be maintained over the next decades, suggesting a need to increase the number of centres with expertise in the management of adult patients with cystic fibrosis. These centres should be capable of delivering multidisciplinary care addressing the complexity of the disease, in addition to addressing the psychological burden on patients and their families. Further issues that require attention are organ transplantation and end of life management. Lung disease in adults with cystic fibrosis drives most of the clinical care requirements, and major life-threatening complications, such as respiratory infection, respiratory failure, pneumothorax and haemoptysis, and the management of lung transplantation require expertise from trained respiratory physicians. The taskforce therefore strongly reccommends that medical leadership in multidisciplinary adult teams should be attributed to a respiratory physician adequately trained in cystic fibrosis management. The task force suggests the implementation of a core curriculum for trainees in adult respiratory medicine and the selection and accreditation of training centres that deliver postgraduate training to the standards of the HERMES programme. Respiratory physicians, trained in adult CF management, should lead multidisciplinary teams taking care of patients http://ow.ly/SgRgj

Evaluation von Kosten der ambulanten Behandlung bei Mukoviszidose in Deutschland

ZusammenfassungZiel:Hauptziele der Studie sind die Ermittlung realer Ressourcenverbräuche der ambulanten Behandlung bei Mukoviszidose (zystische Fibrose [CF]) und ein Vergleich mit der aktuellen Vergütung.Methodik:In sieben verschiedenen Behandlungszentren für CF-Patienten wurden im Jahr 2006 Patientendaten, Ressourcenverbräuche und Behandlungszeiten von Ärzten bzw. Patienten dokumentiert. Zur Bewertung der Ressourcenverbräuche wurde eine detaillierte Analyse real angefallener Kostendaten vorgenommen.Ergebnisse:Die Kosten für die ambulante Behandlung betragen durchschnittlich 488 Euro pro Patient (n = 326) und Quartal. Bei einer Vergütung von durchschnittlich 253 Euro sind die Kosten der Einrichtungen lediglich zu knapp 52% gedeckt. Außerdem zeigen sich teilweise erhebliche zeitliche und finanzielle Belastungen der Patienten, eine Beeinträchtigung der Lebensqualität mit zunehmendem Alter und Kosten für verordnete Arzneimittel von durchschnittlich 21 603 Euro pro Jahr und Patient.Schlussfolgerung:Die derzeitige personelle Ausstattung liegt bereits unter den Anforderungen des europäischen Konsenses zur Versorgung von CF-Patienten. Die Vorschläge zur Kalkulation einer kostendeckenden Vergütung im Rahmen dieser Studie können als Argumentationsgrundlage bei Kostenträgern über zukünftige Vergütungsstrukturen genutzt werden.AbstractPurpose:Main objective of this study is to assess and evaluate resource use in outpatient treatment of cystic fibrosis (CF) in Germany and to compare this with current reimbursement. Methods: Results: Conclusion: Key Words: Med Klin 2009;104:529–35.Methods:Outpatient treatment was evaluated in seven different CF centers.Clinical patient data, resource use, and time consumption were recorded in 2006. A micro-costing approach was used to price resource use data.Results:Mean costs of 488 Euros per patient (n = 326) and quarter occurred. Remuneration (252 Euros per patient/quarter) covered only 52% of the total costs. Furthermore, a considerable time and financial burden for patients as well as decreasing quality of life with increasing age were found. Costs for medication came to 21,604 Euros per patient/year.Conclusion:Human resources in German CF centers today already are below the requirements set by the European consensus for standards of CF care. It will be crucial in assuring a high level of patient care to reach a cost-covering reimbursement scheme in Germany.PURPOSE Main objective of this study is to assess and evaluate resource use in outpatient treatment of cystic fibrosis (CF) in Germany and to compare this with current reimbursement. METHODS Outpatient treatment was evaluated in seven different CF centers.Clinical patient data, resource use, and time consumption were recorded in 2006. A micro-costing approach was used to price resource use data. RESULTS Mean costs of 488 Euros per patient (n = 326) and quarter occurred. Remuneration (252 Euros per patient/quarter) covered only 52% of the total costs. Furthermore, a considerable time and financial burden for patients as well as decreasing quality of life with increasing age were found. Costs for medication came to 21,604 Euros per patient/year. CONCLUSION Human resources in German CF centers today already are below the requirements set by the European consensus for standards of CF care. It will be crucial in assuring a high level of patient care to reach a cost-covering reimbursement scheme in Germany.

Resource usage in outpatient care and reimbursement for cystic fibrosis in Germany.

Objective of this study is to assess and evaluate resource use in outpatient treatment in Germany and to compare it with remuneration.

WS09.3 Professional quality of life among CF healthcare providers

Objectives Professional quality of life (ProQOL) is a validated concept used across various helping professions. It appears relevant considering the level of functioning of healthcare professionals (HCP). We aimed to describe ProQOL among HCP serving patients with cystic fibrosis (CF) and to explore the association with demographic and work-related variables. Methods HCP from 15 German CF-centers were asked to fill in a questionnaire regarding demographic and work-related information and the Professional Quality of Life Scale measuring Compassion Satisfaction (CS), Burnout (BO), and Secondary Traumatic Stress (STS). Results Preliminary results based on N = 57 responding HCP ( M = 45.5 years; 77% female; 23% physicians, 32% nurses, 45% allied healthcare professionals) revealed that CS ( M = 37.9±4.7) was reported more frequently compared to BO ( M = 21.3±3.7) and STS ( M = 19.6±3.9). No differences were found for gender or age, profession, and full-time versus part-time work, neither for duration of work experience nor for general or CF-specific case load. Years of serving patients with CF was significantly correlated with STS ( r = 0.34; p = 0.011). Conclusion The study group is characterized by a high level of professional satisfaction and relatively low levels of burnout and secondary traumatic stress. However, cumulative secondary traumatic stress may occur over the years when serving patients with CF. Selection effects will be discussed, as well as the possible benefits to screen HCP for ProQOL.

Evaluation von Kosten der ambulanten Behandlung bei Mukoviszidose in Deutschland@@@Cost Analysis for Ambulatory Treatment of Cystic Fibrosis Patients in Germany. Overview of the Prospective Study Results: Übersicht über die Ergebnisse einer prospektiven Studie

ZusammenfassungZiel:Hauptziele der Studie sind die Ermittlung realer Ressourcenverbräuche der ambulanten Behandlung bei Mukoviszidose (zystische Fibrose [CF]) und ein Vergleich mit der aktuellen Vergütung.Methodik:In sieben verschiedenen Behandlungszentren für CF-Patienten wurden im Jahr 2006 Patientendaten, Ressourcenverbräuche und Behandlungszeiten von Ärzten bzw. Patienten dokumentiert. Zur Bewertung der Ressourcenverbräuche wurde eine detaillierte Analyse real angefallener Kostendaten vorgenommen.Ergebnisse:Die Kosten für die ambulante Behandlung betragen durchschnittlich 488 Euro pro Patient (n = 326) und Quartal. Bei einer Vergütung von durchschnittlich 253 Euro sind die Kosten der Einrichtungen lediglich zu knapp 52% gedeckt. Außerdem zeigen sich teilweise erhebliche zeitliche und finanzielle Belastungen der Patienten, eine Beeinträchtigung der Lebensqualität mit zunehmendem Alter und Kosten für verordnete Arzneimittel von durchschnittlich 21 603 Euro pro Jahr und Patient.Schlussfolgerung:Die derzeitige personelle Ausstattung liegt bereits unter den Anforderungen des europäischen Konsenses zur Versorgung von CF-Patienten. Die Vorschläge zur Kalkulation einer kostendeckenden Vergütung im Rahmen dieser Studie können als Argumentationsgrundlage bei Kostenträgern über zukünftige Vergütungsstrukturen genutzt werden.AbstractPurpose:Main objective of this study is to assess and evaluate resource use in outpatient treatment of cystic fibrosis (CF) in Germany and to compare this with current reimbursement. Methods: Results: Conclusion: Key Words: Med Klin 2009;104:529–35.Methods:Outpatient treatment was evaluated in seven different CF centers.Clinical patient data, resource use, and time consumption were recorded in 2006. A micro-costing approach was used to price resource use data.Results:Mean costs of 488 Euros per patient (n = 326) and quarter occurred. Remuneration (252 Euros per patient/quarter) covered only 52% of the total costs. Furthermore, a considerable time and financial burden for patients as well as decreasing quality of life with increasing age were found. Costs for medication came to 21,604 Euros per patient/year.Conclusion:Human resources in German CF centers today already are below the requirements set by the European consensus for standards of CF care. It will be crucial in assuring a high level of patient care to reach a cost-covering reimbursement scheme in Germany.PURPOSE Main objective of this study is to assess and evaluate resource use in outpatient treatment of cystic fibrosis (CF) in Germany and to compare this with current reimbursement. METHODS Outpatient treatment was evaluated in seven different CF centers.Clinical patient data, resource use, and time consumption were recorded in 2006. A micro-costing approach was used to price resource use data. RESULTS Mean costs of 488 Euros per patient (n = 326) and quarter occurred. Remuneration (252 Euros per patient/quarter) covered only 52% of the total costs. Furthermore, a considerable time and financial burden for patients as well as decreasing quality of life with increasing age were found. Costs for medication came to 21,604 Euros per patient/year. CONCLUSION Human resources in German CF centers today already are below the requirements set by the European consensus for standards of CF care. It will be crucial in assuring a high level of patient care to reach a cost-covering reimbursement scheme in Germany.