Prescribing behavior of Bavarian general practitioners at the inpatient-outpatient interface within the context of the Bavarian active substance agreement-qualitative results of the WirtMed Study
Zeschick N, Gollnick J, Muth J, Hoerbrand F, Killian P, Krombholz W, Donner-Banzhoff N, Kühlein T, Sebastiao M (2022)
Publication Type: Journal article
Publication year: 2022
Journal
DOI: 10.1007/s00103-022-03563-6
Abstract
Background and objectives In 2014, the Association of Statutory Health Insurance Physicians of Bavaria introduced the active substance agreement (WSV) for the transparent control of pharmaceutical expenditure within the framework of the efficiency principle ( 12 of the Fifth Book of the German Social Code [SGB V]). It replaced the prescribing target scheme. Regarding the role of the WSV, the article presents the reasons of the general practitioners (GPs) for or against a further prescription of drugs from the hospital. Materials and methods In a qualitative study design, individual interviews (n = 18) and two focus groups (n = 10) were conducted with Bavarian GPs between November 2019 and March 2020 and evaluated according to qualitative content analysis. Results With the introduction of the WSV, recourse concerns decreased for GPs overall. Patient-oriented care and the professional correctness of therapy decisions are of great importance in prescribing, ahead of cost-effectiveness. Economic challenges arise with discharge medication, especially with the lead substance target of oral anticoagulants, the generic targets for antidiabetics, and for therapeutics for the cardiovascular system. Generally criticized are drug discount contracts, which often lead to drug changes after hospital discharge. There are individual reports of a "predominance" of hospital physicians when prescribing, which is contrary to their own economic actions as GPs. According to the GPs, there is a lack of cross-sectoral cost responsibility. Conclusions In the view of GPs, a smooth interface transition is not yet available in the outpatient sector despite a framework agreement on discharge management and the new control system of the WSV. An economical supply of drugs continues to require political discussion across sectors, but also across federal states.
Authors with CRIS profile
Nikoletta Lippert
Institute of General Practice
Thomas Kühlein
Lehrstuhl für Allgemeinmedizin
Maria Sebastiao
Institute of General Practice
Related research project(s)
Involved external institutions
Germany (DE)How to cite
APA:
Zeschick, N., Gollnick, J., Muth, J., Hoerbrand, F., Killian, P., Krombholz, W.,... Sebastiao, M. (2022). Prescribing behavior of Bavarian general practitioners at the inpatient-outpatient interface within the context of the Bavarian active substance agreement-qualitative results of the WirtMed Study. Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz. https://doi.org/10.1007/s00103-022-03563-6
MLA:
Zeschick, Nikoletta, et al. "Prescribing behavior of Bavarian general practitioners at the inpatient-outpatient interface within the context of the Bavarian active substance agreement-qualitative results of the WirtMed Study." Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz (2022).
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