[Foreign dentures and dental tourism--willingness-to-pay and factors influencing the demand for foreign dental prosthesis in Germany]. / Auslandszahnersatz und Dentaltourismus--Zahlungsbereitschaft und Einflussfaktoren auf die Nachfrage nach ausländischem Zahnersatz in Deutschland.

With the progressive realisation of the single European market, public interest has been directed towards cross-border healthcare services to an increasing extent. More and more dentures are being imported into Germany from foreign countries. Furthermore, patients are becoming ever more mobile, travelling to other countries to receive prosthetic treatment from dentists. The objective of this evaluation was to determine by means of a dedicated questionnaire the patients' individual preferences for foreign dentures and the potential savings. 1 368 individuals between the ages of 30 and 75 years were interviewed within a representative omnibus survey. The evaluation of the individual willingness-to-pay included 4 treatment scenarios, which were assessed by the participants in a "bidding game". Participants could choose between a "crown scenario" and an "implant scenario", both with the subcategories "foreign dentures" and "dental tourism". The direct comparison revealed a preference for the "foreign dentures" option over "dental tourism". Average willingness-to-pay for the dental tourism option in the crown scenario was calculated as 80 Euro, and in the implant scenario as 280 Euro less in comparison with the willingness-to-pay for the foreign dentures option. The willingness to switch to a less expensive dentist was one of the main determinants in the causal explanation for the variance in willingness-to-pay. Quality proved to be the decisive criterion and was indicated by 92.4% participants. A lower price for dentures played a subordinate role and was only stated as the decisive factor by 31.1% participants. In conclusion, the results clearly indicate that the decision for or against foreign dentures and the extent of willingness-to-pay depends on a range of criteria, of which "price" is only one and not the decisive factor.

[Methods of health economic evaluation for health services research]. / Methoden der gesundheitsökonomischen Evaluation in der Versorgungsforschung.

On August 30, 2010, the German Network for Health Services Research [Deutsches Netzwerk Versorgungsforschung e. V. (DNVF e. V.)] approved the Memorandum III "Methods for Health Services Research", supported by the member societies mentioned as authors and published in this Journal [Gesundheitswesen 2010; 72: 739-748]. The present paper focuses on methodological issues of economic evaluation of health care technologies. It complements the Memorandum III "Methods for Health Services Research", part 2. First, general methodological principles of the economic evaluations of health care technologies are outlined. In order to adequately reflect costs and outcomes of health care interventions in the routine health care, data from different sources are required (e. g., comparative efficacy or effectiveness studies, registers, administrative data, etc.). Therefore, various data sources, which might be used for economic evaluations, are presented, and their strengths and limitations are stated. Finally, the need for methodological advancement with regard to data collection and analysis and issues pertaining to communication and dissemination of results of health economic evaluations are discussed.

[Effects of the new German quarterly practice fee on dental treatment -- cost-benefit analysis]. / Steuerungs- und Verteilungswirkungen der Praxisgebühr im Bereich der zahnmedizinischen Versorgung -- eine Kosten-Nutzen-Analyse.

BACKGROUND: In the German Law on the Modernization of the Statutory Healthcare System of 19 November 2003 the legislator enacted payment of a so-called quarterly practice fee for ambulant medical and dental care. The legislator hopes that by the introduction of this fee the central "steering" function of the family doctor is strengthened and that medically unnecessary treatment will be reduced, thus reducing cost and consolidating health insurance funds. In public, however, the introduction of the practice fee as a steering instrument is very controversially discussed. The aim of the analysis is to balance the cost-effectiveness of a quarterly practice fee with regard to the specific features of the dental care system. RESULTS: Analysis of the allocative and distributive effects shows that the practice fee does not adequately take into account the specific features of the dental care sector and that the adverse effects prevail if seen under the aspect of health economics and social medicine. Neither on the micro-economic nor on the macro-economic level a noticeable medicine-term or long-term cost containment effect may be expected.