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Reimbursement summary for angioplasty of arteries of lower extremities

This post presents an extract from our reimbursement analysis for angioplasty of arteries lower extremities using plain and drug-coated balloons (DCBs) for peripheral artery disease in England, France and Germany. Plain balloon angioplasty is reimbursement via DRG solely and DCBs are reimbursement via combination of DRG and add-on reimbursement.
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The G-BA Innovation Committee recommends transfer to standard care for two projects in Germany

On July 14, 2022, the Innovation Committee at the Federal Joint Committee (G-BA) published the decisions, recommending the transfer to standard care for two completed projects. The projects relate to preventing delirium, postoperative cognitive dysfunction, and back pain therapy using e-health.

A short overview of the projects is provided below:

  • OPTIMISE – Validation and optimization of the usability of routine data to improve the quality of hospital sepsis management" project researched how well sepsis and its risk factors are represented in hospital billing data. The results of the study demonstrated that billing data does not reflect the actual higher number of cases. In addition, differences in the frequency or mortality from sepsis were found between the participating hospitals;
  • Within the project "SEPFROK – Sepsis - secondary diseases, risk factors, healthcare and costs" insights into the spread and risk factors for sepsis-related diseases, as well as into existing healthcare offers and their costs were gained. The telephone interviews conducted as part of the project demonstrated that patients do not feel well informed and would like greater access to rehabilitation and structural support after sepsis. Due to the high social relevance of sepsis and its consequences, research questions are being pursued further in the currently ongoing AVENIR project, which the Innovation Fund also funds.

Innovation Fund is a vital instrument to propose and test a novel model of care (including the ones in the form of selective contracts). If the model proves valuable, it can be a subject for further dissemination in the country.

The detailed results of the projects are now being forwarded to the relevant organizations and institutions in the healthcare sector. In this regard, the respective stakeholders are requested to review the results and to consider them within their area of responsibility as far as possible.

The full details in German can be found here, here (decision for OPTIMISE project), and here (decision for SEPFROK project).

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