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Drei Thesen für ein attraktives Gesundheitssystem Wie muss Ökonomie ausgerichtet sein, um sinnvolle Impulse für eine bessere Versorgung zu liefern? 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In Kürze

Das Dilemma leistungsfähiger Gesundheitssysteme

Berlin (pag) – Die Ökonomie sollte nicht als Ökonomisierung verteufelt werden, sondern als Impulsgeber für eine bessere Versorgung genutzt werden. So lautet die Botschaft eines zwölfseitigen Strategiepapiers des Bundesverbandes Managed Care (BMC).

Das Papier mit dem Titel „Mehr Ökonomie wagen“ beschreibt das Dilemma leistungsfähiger Gesundheitssysteme: Je mehr aufgrund von medizinischem und technischem Fortschritt möglich sei, desto stärker werde der Finanzierungsdruck und desto bedeutender eine effiziente Ressourcenallokation. Die Pandemie habe das Potenzial, die Akteure aus tradierten Strukturen und Denkmustern zu lösen. Angesichts der sich abzeichnenden Verknappung finanzieller Ressourcen im Gesundheitswesen und dem daraus resultierenden Handlungsdruck wird eine sinnvoll ausgerichtete Ökonomie empfohlen, um Herausforderungen zu bewältigen und Impulse für eine Versorgung zu liefern, die sich tatsächlich am Outcome Gesundheit orientiere. „Lediglich eher ‘einfältige‘ Leistungskürzungen werden nicht genügen, es sind politische Reformen gefragt, die eine sinnvolle Allokation von Ressourcen in den Vordergrund stellen“, konstatieren die Autoren.

Teil des Solidarprinzips

Als zukunftsorientierte ökonomische Ansätze werden Value-based Health Care und Population Care in dem Papier genannt. Bei letzterem kann die Verantwortung für die Gesundheit bestimmter Populationen auf unterschiedliche Akteure übertragen werden. Value-based Health Care wird der Ansatz genannt, die Vergütung der Leistungserbringer nicht an der Menge der erbrachten Leistungen, sondern an den Behandlungsergebnissen auszurichten. Als leitendes Prinzip wird die Qualitätsverbesserung empfohlen; dieses sollte auch als ethisches Gebot und Teil des Solidarprinzips verstanden werden. Den Autoren zufolge kann ein solcher Kulturwandel nicht nur top-down gesteuert werden. Alle Akteure sollten sich auf die Suche nach zukunftsfähigen Versorgungsansätzen begeben.

 

Hinweis: Die Illustrationen der drei Thesen sind dem BMC-Papier entnommen.

Das Strategiepapier enthält neben diesen Appellen drei Thesen:

 

1. Messen, Vergleichen und Nutzen von Daten fördert die Qualität
Ökonomie schaffe Transparenz und befähige zu informierten Wahlentscheidungen, etwa durch Erhebung und Veröffentlichung aufbereiteter Versorgungsdaten zu Leistungserbringern und sektorenübergreifenden Behandlungsverläufen. Erwähnt wird auch der Einsatz von Real World Evidenz sowie Kennzahlen über Krankenkassen und -versicherungen.

2. Innovationen brauchen Handlungsspielräume und Leitplanken
Ökonomie setze auf den Abbau von Barrieren und Spielräume als Stimuli. Angemahnt werden verlässliche Leitplanken, die Förderung von unternehmerischem Handeln sowie eine kontinuierliche Strukturbereinigung mit Markt-
zugang und -austritt.

3. Veränderungen müssen vom Menschen her gedacht werden
Verhaltensökonomische Ansätze erzielten große Wirkungen durch Versorgungsmodelle, die sich an Lebenswelten orientieren. Das Honorieren von Qualität wird in diesem Zusammenhang ebenso genannt wie die Übernahme von Verantwortung für die Gesundheit von Patienten zu fördern.

 

Weiterführender Link:

Strategiepapier des BMC: https://www.bmcev.de/mehr-oekonomie-wagen/