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Diagnosebasierte Risikoadjustierungsverfahren in wettbewerblichen Krankenversicherungssystemen

Diagnosebasierte Risikoadjustierungsverfahren in wettbewerblichen Krankenversicherungssystemen


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About the Book

Studienarbeit aus dem Jahr 2004 im Fachbereich BWL - Unternehmensführung, Management, Organisation, Note: 2,0, Universität Duisburg-Essen, Veranstaltung: Medizinmanagement, Sprache: Deutsch, Abstract: In wettbewerblichen Krankenversicherungssystemen gibt es für die dort beteiligten Akteure grundsätzlich Anreize, ihre Wettbewerbsposition zu verbessern oder finanzielle Vorteile zu erlangen. Weitestgehend basieren solche Anreize auf den individuellen Risiken der einzelnen Versicherten eines Krankenversicherungssystems und den daraus resultierenden höheren oder niedrigeren Gesundheitsausgaben, woraus Wettbewerbsverzerrung resultiert. Dieses Buch befasst sich mit diagnose-basierten Risikoadjustierungsverfahren, die zum Zweck einer genaueren Abbildung der individuellen Risiken sowie der Ermittlung und Vergleichbarkeit der Gesundheitsausgaben die Versicherten, hauptsächlich aufgrund von Diagnosen, in bestimmte Gruppen zuordnen. In diesem Buch wird darauf eingegangen, was ein wettbewerbliches Krankenversicherungssystem ausmacht, wie das rationale Verhalten der darin beteiligten Akteure unter den dort vorliegenden Umständen aussieht und wie sich daraus die Motivation bzw. die Gründe für den Einsatz von diagnose-basierten Risikoadjustierungsverfahren ableiten lassen. Hierbei werden neben der eigentlichen Motivation für den Einsatz auch die Anwendungsfelder von diagnose-basierten Risikoadjustierungsverfahren auf nationaler und internationaler Ebene angesprochen. Anschließend erfolgt eine allgemeine Betrachtung der diagnose-basierten Risikoadjustierungsverfahren, wobei auf die grundsätzlich angewendete Methodik sowie auf die verschiedenen Daten, mithilfe derer eine Klassifizierung oder Gruppierung von Versicherten vorgenommen werden kann, eingegangen wird. Nach der Beschreibung des methodischen und zeitlichen Bezugs der Verfahren werden drei diagnose-basierte Risikoadjustierungsverfahren vorgestellt und hinsichtlich ihrer Vorgehensweise erläutert. Zur Wahrung der Übersichtlichk


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Product Details
  • ISBN-13: 9783638650205
  • Publisher: Grin Publishing
  • Binding: Paperback
  • Language: German
  • Returnable: N
  • Spine Width: 4 mm
  • Width: 148 mm
  • ISBN-10: 3638650200
  • Publisher Date: 16 Jul 2007
  • Height: 210 mm
  • No of Pages: 68
  • Series Title: German
  • Weight: 154 gr


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