Routine skin cancer screening in Germany: First data on the impact on health care in dermatology.

ABSTRACT

BACKGROUND: On July 1st 2008, community skin cancer screening (cSCS) was established in routine care of the German statutory health insurances (SHI). This study aimed at gathering preliminary data on the impact of community SCS on health care provision in German dermatology practices. PATIENTS AND METHODS: Standardized questionnaires were sent to about 2,000 German dermatology practices. Data were analyzed descriptively and with bivariate tests. RESULTS: In total, 693 (34.7%) questionnaires were returned. Each practice performed an average of 354 SCS per quarter, the mean payment being euro 21.50. About 78% named an increase in SCS with an average increase of 36.7%. About 54% of practices performed SCS under SHI payment combined with individual health services paid by the patients ("IGeL"), 38% only as SHI and 8% exclusively as "IGeL". In 85% of practices, the number of surgical procedures had increased since the start of community SCS. 40% had an increase in drug prescriptions related to SCS. 32% were satisfied with SCS, while 40% were unsatisfied. 29 % would prefer SCS only as covered by SHI, 29% only as IGeL, and 42% in a combined fashion. 70% regarded the quality of health care of patients with skin cancer in Germany better since the introduction of cSCS. CONCLUSIONS: Dermatologists in Germany have mainly accepted their role in providing skin cancer as standard care covered by SCS. The regulatory and economic conditions for this need further improvement.