[Health economic impact of heart failure: An analysis of the nationwide German database]. / Gesundheitsökonomische Bedeutung der Herzinsuffizienz: Analyse bundesweiter Daten.

BACKGROUND AND AIMS: Patients with congestive heart failure represent a significant amount of the total annual cost of the health care system. Because of a lack of studies on the economic health cost of the related health care, including all cost generating factors, we analysed in detail characteristics of these patients and the costs created by their care. METHOD: Data were retrieved from the German Bureau of Health Statistics for the year 2002 relating to congestive heart failure (Code I50) including other factors (e. g. co-morbidities, ambulatory and hospital care and choice of the doctor). The data were from more than 2 million patients, from 350 insurance companies, the Federal Employees Insurance and the German Institute for Medical Informatics and Documentation. A total of 86 193 patients with congestive heart failure had been recorded. RESULTS: More women than men were recorded as having congestive heart failure (66 vs. 34 %). The various health insurance companies paid 2.3 times more for patients with than without congestive heart failure. Nearly three quarters of the cost for these patients (72 %) resulted from in-patient care. Moreover, costs for drugs were three times higher (1073 Euro vs. 366 Euro). CONCLUSIONS: This analysis clearly demonstrates the increased costs incurred for patients with congestive heart failure. It should serve as a reference base for better assessing future innovations, such as telemedicine, for their effects in different sectors of health care.

Medical devices in Germany.

Pressure from health-insurance companies, difficulties in getting innovative products to market and a new breed of purchasing associations are threatening the future livelihood of manufacturers in Germany. This article puts forward a cooperative concept that may suit every player's needs.