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Outcomes Research/ Health Services Research

Every day, there are about 890 new diagnoses of dementia and about 590 new diagnoses of stroke in Germany. Those numbers are vividly illustrating the huge importance of both widespread diseases, dementia and stroke, in health politics and their consequences for the social security system in Germany. Population-based registries for the purpose of Outcomes Research of dementia and stroke are therefore the scientific focus of the IZPH, according to the slogan, ‘you can only manage what you measure’.

Digital Dementia Registry Bavaria (digiDEM Bayern)

Erlangen Stroke Project (ESPro)

Bavarian Dementia Survey (BayDem)

Health Technology Assessment

In Germany, a growing number of people get injured or die due to dangerous implanted medical devices and prostheses. In 2017 alone, in total 14,000 injuries, deaths and other problems related to medical devices were reported. Usually, the recall of medical devices or announcements of security warnings are left to the manufacturers themselves instead of being carried out by public authorities. Since 2010, there are about 1,000 recalls per year and three per day on average, initiated by manufacturers. In the same time, there were only six recalls mandated by public authorities. Implant registries are therefore required in order to secure sustainably and effectively citizens of defective medical devices, in particular dangerous implants and prostheses. In cooperation with the leading-edge cluster Medical Valley EMN, the IZPH is analyzing the requirements regarding the structure and content of implant registries in order to secure the safety of citizens. Concepts of quality assurance, transparency of data, public reporting and aspects of an independent funding of implant registries are prioritized. The work and publications of the IZPH regarding implant registries had an impact on the draft legislation „Entwurf eines Gesetzes zur Errichtung eines Deutschen Implantateregisters (Implantateregister-Errichtungsgesetz – EDIR)“ of the Federal Ministry of Health (BMG), published in January 2019.

  • Zhang S, Gaiser S, Kolominsky-Rabas PL; National Leading-Edge Cluster Medical Technologies “Medical Valley EMN”
    Cardiac implant registries 2006-2016: a systematic review and summary of global experiences
    BMJ Open 2018; 12. April (IF 2.73)
    Link to the publication
  • Zhang S, Kriza C, Schaller S, Kolominsky-Rabas PL; National Leading-Edge Cluster Medical Technologies ‘Medical Valley EMN’.
    Recalls of cardiac implants in the last decade: what lessons can we learn?
    PLoS One. 2015;11:10(5) (IF 4.01)
    Link to the abstract
  • Kolominsky-Rabas PL, Djanatliev A, Wahlster P, Gantner-Bär M, Hofmann BM, German R, Reinhardt ER, Sedlmayr M, Schüttler J, Kriza C, on behalf of the ProHTA Project Group
    Technology foresight for medical device development through hybrid simulation: the ProHTA Project
    Technological Forecasting and Social Change. 2015;97:105-114 (IF 3.005)
    Available online 17 January 2014
    Link to the abstract

Health Economics

For the first time ever, the German health expenditures exceeded the threshold of 1 billion euros per day in 2017. According to Destatis, the health expenditures amounted to 374 billion euros in total for the year 2017, which is s share of 11.3% of the gross domestic product. The high increase occurred in particular due to high health care costs for chronic diseases. In respect to the demographic development in Germany, associated with an ageing of the population, a further increase of health care costs in the area of age-related diseases can be expected. On the one hand, the IZPH is therefore focusing on cost-of-illness studies of widespread diseases with high public health relevance, such as dementia, stroke, and heart failure. In Germany, the annual costs of the widespread disease heart failure are about 23,000 euros per patient, the lifetime costs are about 113,000 euros per patient. Those studies are fundamental for the health care planning of payers, service Providers, and health care politicians. On the other hand, the IZPH is doing health economic evaluations of pharmacological and non-pharmacological treatments. Furthermore, novel methodological approaches are explored in order to provide a transparent display of the benefit of innovative health technologies and in order to facilitate a comprehensible and balanced reimbursement decision for the actors of the conjoint self-administration in the German health care system (G-BA, GKV-Spitzenverband).

  • Lesyuk W, Kriza C, Kolominsky-Rabas PL
    Cost-of-illness studies in heart failure: a systematic review 2004-2016
    BMC Cardiovascular Disorders 2018; 18:74 (IF 1.97)
    Link to the publication
  • Nickel F, Barth J, Kolominsky-Rabas PL
    Health economic evaluations of non-pharmacological interventions for persons with dementia and their informal caregivers: a systematic review
    BMC Geriatrics 2018; 18:69 (IF 2.96)
    Link to the publication
  • Schaller S, Mauskopf J, Kriza C, Wahlster P, Kolominsky-Rabas PL
    The main cost drivers in dementia: a systematic review
    Int J Geriatr Psychiatry. 2015;30:111-129, Epub 2014 Oct 16 (IF 3.08)
    Link to the abstract