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  1. Beeinflusst eine Budgetierung Qualität und Wirtschaftlichkeit der ambulanten Arzneimitteltherapie ? Anwendung von Indikatoren am Beispiel des Verordnungsverhaltens niedergelassener Arzte einer norddeutschen Region mit festgestellten Qualitätsdefiziten von der Einführung des GSG.

    Article - En allemand

    Traduction en anglais : Will a predetermined budget influence the quality and efficiency of ambulatory drug therapy ?

    Application of indicators exemplified by the prescribing conduct of physicians in a specific region of northern Germany showing deficits before implementation of the new GSG (Health Structure Law).

    The prescriptions of physicians in a specific region of northern Germany were examined to see whether the quality of drug therapy in this region, which showed deficits before the implementation of the GSG, had been influenced by this law.

    After encoding the prescription data the 100 most often prescribed drugs were identified as physician-related the resulting costs determined and arranged in order of precedence ( « medicine charts »). The indicators were defined as to which « medicine-chart » drug they related, to facilitate a qualitative analysis of the prescriptions.

    The indicators were :

    • drugs, whose therapeutic advantage is not proven ;

    • drugs based on obsolete therapeutic concepts ;

    • drugs with lower-priced and/or therapeutic equal alternatives Standard-Therapeutics.

    The qualitative analysis of the prescriptions from the 4th quarter of 1991 and the 1st quarter of 1993 shows a reduction in the number of prescriptions and prescription costs corresponding with the overall Federal German trend due to the GSG and the fixed budget.

    It was however observed in qualitative analysis that the 33% portion of drugs with dubious efficacy or obsolescence, remained constant.

    Mots-clés Pascal : Chimiothérapie, Traitement, Assurance qualité, Indicateur, Prescription médicale, Législation, Budget, Allemagne, Nord, Coût, Economie santé, Europe

    Mots-clés Pascal anglais : Chemotherapy, Treatment, Quality assurance, Indicator, Medical prescription, Legislation, Budget, Germany, North, Costs, Health economy, Europe

    Logo du centre Notice produite par :
    Inist-CNRS - Institut de l'Information Scientifique et Technique

    Cote : 95-0364538

    Code Inist : 002B30A01B. Création : 01/03/1996.