National health fund and morbidity-based risk structure equalization with focus on haemophilia

The Gesundheitsfonds (national health fund) was established in Germany on January 1st, 2009, in combination with the morbidity-based risk structure equalization (RSA) in order to manage the cash flow between the statutory health insurances. The RSA equalizes income differences due to the varying lev...

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Bibliographic Details
Published inHämostaseologie Vol. 30 Suppl 1; p. S70
Main Author König, T
Format Journal Article
LanguageGerman
Published Germany 01.11.2010
Subjects
Age Distribution
Female
Germany - epidemiology
Hemophilia A - drug therapy
Hemophilia A - economics
Hemophilia A - epidemiology
Humans
Income
Insurance, Health - economics
Male
Morbidity
Prescription Drugs - economics
Risk Assessment
Germany
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Summary:The Gesundheitsfonds (national health fund) was established in Germany on January 1st, 2009, in combination with the morbidity-based risk structure equalization (RSA) in order to manage the cash flow between the statutory health insurances. The RSA equalizes income differences due to the varying levels of contributory income of the members of a health insurance (basic wage totals) and expenditure differences due to varying distribution of morbidity risks across different health insurances, as well as the varying numbers of non-contributing insured family members. Additionally, insured persons are allocated to morbidity groups according to a classification model based upon diagnoses and prescriptions anticipating medical expenses in the subsequent year. Haemophilia falls, among 80 disease entities, in the morbidity group which generates the highest risk supplement. Matching of prescribed drugs with disease entities facilitates disease grading and improves the accuracy of risk supplements.
ISSN:0720-9355