Abstract:
BACKGROUND:The medical care of pediatric cancer patients in the German health care system relies on special structures. All children and adolescents with a diagnosis of cancer receive uniform treatment within clinical studies or registers and exclusively at centers which can ensure interdisciplinary care by a multiprofessional team. Reimbursement of outpatient services is highly heterogeneous among the centers, and the expenses are often not adequately compensated. METHOD:A nation-wide survey was performed among all centers of the German Society of Pediatric Hematology and Oncology, with a standardized questionnaire inquiring which reimbursement models are used to finance outpatient treatment and whether full coverage of the expenses is achieved. RESULTS:Of 58 Pediatric Oncology Centers in Germany 18 (33%) participated in the survey, including 8 (44%) University Hospitals. The use of available reimbursement tools was highly heterogeneous. Reimbursement for outpatient service was based on a mean of 3,33±1,49 individual components. Of the 18 responding centers, 17 indicated that the revenues do not fully cover the expenses. DISCUSSION AND CONCLUSION:Pediatric oncology centers in Germany can not achieve full coverage of expenses in the outpatient setting. Nationally uniform cost-covering remuneration strategies are needed. This article proposes three individual models for an adequate nationwide financial framework for the outpatient care of pediatric cancer patients. HINTERGRUND:Die pädiatrisch-onkologische Versorgungsstruktur nimmt in Deutschland eine Sonderrolle ein. An Krebs erkrankte Kinder und Jugendliche werden bundesweit einheitlich in Therapiestudien und Registern sektorenübergreifend an Zentren behandelt, die eine interdisziplinäre und multiprofessionelle Versorgung sicherstellen können. Für die Abrechnung der nicht-vollstationären Leistungen verwenden die Zentren heterogene Abrechnungsmodalitäten, die den erforderlichen Versorgungsaufwand monetär überwiegend nicht decken. METHODE:Es wurde deutschlandweit eine Umfrage aller Zentren der Gesellschaft für Pädiatrische Hämatologie und Onkologie (GPOH) durchgeführt. In der Umfrage wurde standardisiert abgefragt, über welche Versorgungsarten der nicht-vollstationäre Bereich in der Kinderonkologie finanziert wird und ob eine Kostendeckung erreicht werden kann. ERGEBNISSE:Von 58 kinderonkologischen Zentren beteiligten sich insgesamt 18 (33%) an der Umfrage, darunter 8 (44%) Universitätsklinika. Die Inanspruchnahme verfügbarer Abrechnungsarten erwies sich als sehr heterogen. Im Mittel werden 3,33±1,49 Abrechnungsarten pro Zentrum angewandt. 17 der 18 teilnehmenden Zentren gaben an, mit den Erlösen die Kosten für die nicht-vollstationäre Versorgung nicht decken zu können. DISKUSSION UND SCHLUSSFOLGERUNG:Kinderonkologische Zentren in Deutschland können eine kostendeckende Versorgung im nicht-vollstationären Setting nicht erreichen. Für die nicht-vollstationäre Versorgung an Krebs erkrankter Kinder und Jugendlicher wird eine bundeseinheitliche und leistungsgerechte Versorgungsform dringend benötigt. Drei verschiedene Modelle, die einen adäquaten Handlungsrahmen bieten, wurden erarbeitet und vorgestellt.
journal_name
Klin Padiatrjournal_title
Klinische Padiatrieauthors
Reinke E,Jürgens H,Haier J,Froehlich B,Kontny U,Rossig Cdoi
10.1055/a-1158-9341subject
Has Abstractpub_date
2020-11-01 00:00:00pages
289-293issue
6eissn
0300-8630issn
1439-3824journal_volume
232pub_type
杂志文章abstract:BACKGROUND:It has been shown that Interleukin 10 (IL-10) is able to inhibit alloreactivity in a mixed lymphocyte culture. Therefore, here IL-10 production in patients after allogeneic BMT was investigated and correlated with the incidence of acute GvHD. PATIENTS:14 patients after allogeneic BMT have been investigated....
journal_title:Klinische Padiatrie
pub_type: 杂志文章
doi:10.1055/s-2008-1046464
更新日期:1996-07-01 00:00:00
abstract:BACKGROUND:Peripheral schwannomas and pilomatrixoma are rare clinical features in childhood. The concomitant presence of these tumors in childhood are not described yet. PATIENTS:We describe the first case of a concomitant peripheral benign schwannoma and pilomatrixoma located at the head in a 10-year-old female patie...
journal_title:Klinische Padiatrie
pub_type: 杂志文章
doi:10.1055/s-2004-816279
更新日期:2005-01-01 00:00:00
abstract::Severe combined immunodeficiency (SCID) is a heterogeneous group of congenital diseases characterized by their presentation with life threatening infections in the first months of life. The clinical presentation and the therapeutic outcome is influenced by multiple factors: the genetic defect, infectious complications...
journal_title:Klinische Padiatrie
pub_type: 杂志文章,评审
doi:10.1055/s-0031-1287826
更新日期:2011-11-01 00:00:00
abstract::The case is described of a 6 months old infant who developed purulent pericarditis during the course of pneumonia. Pericarditis probably developed in this condition by contiguous spread from the pleura. Diagnosis of impending cardiac tamponade was masked by the occurrence of massive unilateral empyema. The management ...
journal_title:Klinische Padiatrie
pub_type: 杂志文章
doi:10.1055/s-2008-1033831
更新日期:1982-09-01 00:00:00
abstract::The are various opinions about the optimal therapy of endemic goiter in adolescents. From 106 patients (75 girls) suffering from endemic goiter 50 patients (group A) were treated with 300 micrograms iodine per day and 56 patients (group B) with 100 micrograms iodine plus 100 micrograms levothyroxine per day. Before th...
journal_title:Klinische Padiatrie
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1055/s-2008-1046460
更新日期:1996-05-01 00:00:00
abstract::15 parameters of coagulation and fibrinolysis were investigated in 38 children with type I diabetes mellitus without clinical signs of diabetic angiopathy. Compared to an age matched non diabetic control group spontaneous platelet aggregation was enhanced, plasma levels for factor VIII C, von Willebrand factor, antith...
journal_title:Klinische Padiatrie
pub_type: 杂志文章
doi:10.1055/s-2007-1025468
更新日期:1991-11-01 00:00:00
abstract::Prognostic factors to estimate the risk of relapse are crucial for risk-adapted therapy in acute lymphoblastic leukemia (ALL). In a cooperative multicenter treatment study for childhood ALL (COALL-03-85) the prognostic relevance of the bone marrow (BM) blast count at day 28 was evaluated. Treatment was adjusted to the...
journal_title:Klinische Padiatrie
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1055/s-2007-1025434
更新日期:1991-07-01 00:00:00
abstract::The aetiology and pathogenesis of the Duchenne-type muscular dystrophy (pseudohypertrophic muscular dystrophy) are still largely unknown. The possibilities of treating the disease are rather limited. Treatment is the more successful, the earlier diagnosis was possible, and the earlier treatment is initiated. The CK-Sc...
journal_title:Klinische Padiatrie
pub_type: 杂志文章,评审
doi:
更新日期:1978-11-01 00:00:00
abstract::In case of painful scoliosis, a search for etiologic factors in the vertebral spinal canal and adjacent structures should be made. MRI with Gadolinium is useful to look for various pathology in and around the spine in particular of spinal cord. CT scanning is indispensible for bony details. Thus CT and MRI are complem...
journal_title:Klinische Padiatrie
pub_type: 杂志文章,评审
doi:10.1055/s-2008-1043932
更新日期:1997-03-01 00:00:00
abstract:BACKGROUND:Neurotrophins and their cognate receptors TrkA, TrkB and TrkC regulate proliferation, differentiation and death of neuronal progenitor cells and may be implicated in the progression of medulloblastoma and other primitive neuroectodermal brain tumors (PNET). These common childhood brain tumors are composed of...
journal_title:Klinische Padiatrie
pub_type: 杂志文章
doi:10.1055/s-2000-10044
更新日期:2000-07-01 00:00:00
abstract::The following paper is the manuscript of an oral presentation during the annual GPOH meeting on May 22nd, 2000 in Berlin. Following her experiences as a member of the psychosocial care team of a children's cancer unit the author discusses the emotional impact of stemcell or bone marrow transplantation in children. Psy...
journal_title:Klinische Padiatrie
pub_type: 杂志文章,评审
doi:10.1055/s-2001-16857
更新日期:2001-07-01 00:00:00
abstract::In a retrospective study we evaluated clinical features and diagnostic impact of sonography, white blood cell count, C-reactive protein as well as bacterial etiology of children treated surgically for bacterial cervical lymphadenitis. We report on 38 children at the age between 2.5 months and 14 years who were admitte...
journal_title:Klinische Padiatrie
pub_type: 杂志文章
doi:10.1055/s-2003-41403
更新日期:2003-07-01 00:00:00
abstract::The aims of trial NHL-BFM 90 for patients (pts) suffering from B-cell neoplasms are to prove whether: 1. Treatment for pts with complete resection can be reduced from 3 to 2 therapy courses; 2. Results for pts of stage III with large abdominal tumors can be improved by high dose (HD) chemotherapy; 3. Survival for pts ...
journal_title:Klinische Padiatrie
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1055/s-2008-1046610
更新日期:1994-07-01 00:00:00
abstract:BACKGROUND:Children suffering from life limiting diseases are frequently cared for by adult palliative care teams due to missing paediatric structures in that field. However it is questionable whether palliative care curricula for physicians comprehensively cover issues of paediatric palliative care (PaedPC). AIM:To i...
journal_title:Klinische Padiatrie
pub_type: 杂志文章
doi:10.1055/s-0035-1569266
更新日期:2016-01-01 00:00:00
abstract::Several randomized controlled trials (RCTs) have investigated the prophylactic use of probiotics in preterm infants aimed at reducing the rate of necrotising enterocolitis (NEC). There are 4 meta-analyses on this subject. 2 more RCTs have been published since these meta-analyses were completed. Each meta-analysis, as ...
journal_title:Klinische Padiatrie
pub_type: 杂志文章,meta分析
doi:10.1055/s-0030-1254113
更新日期:2010-09-01 00:00:00
abstract:BACKGROUND:The survival of infants born with esophageal atresia (EA) is > 90% at present. The purpose of this study was to evaluate early complications and long term outcome in children with EA treated at our institution. METHODS AND PATIENTS:Retrospective analysis of 111 children with EA undergoing repair of EA or tr...
journal_title:Klinische Padiatrie
pub_type: 杂志文章
doi:10.1055/s-0030-1249610
更新日期:2010-09-01 00:00:00
abstract::The phagocytic and NBT reduction indices of 94 preterm and underweight babies, divided into 7 groups and two weight classes, were observed over a period of six weeks while they were observed over a period of six weeks while they were given four commercial baby foods (Humana 0, Meb, Multival, Pomil). In all groups the ...
journal_title:Klinische Padiatrie
pub_type: 杂志文章
doi:
更新日期:1978-03-01 00:00:00
abstract::Low birth weight babies and sick full-term babies, who require total parenteral nutrition and repeated intravenous applications of drugs, which irritate peripheral veins, very often need a reliable central venous catheter. The aim of our paper was to study prospectively the efficiency and the complications of peripher...
journal_title:Klinische Padiatrie
pub_type: 杂志文章
doi:10.1055/s-2008-1046574
更新日期:1994-01-01 00:00:00
abstract::The investigation of Immunoglobulins-and Total protein concentrations in saliva of healthy children shows an agreement with literature, a maturation in individual development of the saliva-producing organs in the mouth. ...
journal_title:Klinische Padiatrie
pub_type: 杂志文章
doi:10.1055/s-2008-1035623
更新日期:1980-09-01 00:00:00
abstract:OBJECTIVES:Despite about 3 decades of clinical experience with the therapy of inherited thrombocytopathies (HTP) with desmopressin (DDAVP) the mechanisms of haemostatic effects of DDAVP in these diseases remain unclear. Therefore platelet function diagnostics was carried out in whole blood (WB) from children with aspir...
journal_title:Klinische Padiatrie
pub_type: 杂志文章
doi:10.1055/s-0031-1275347
更新日期:2011-05-01 00:00:00
abstract::The psychosocial and intellectual development of 4 boys with nephropathic cystinosis and brain atrophy documented by cranial computerized tomography was investigated by use of biographical data and psychological tests (HAWIK, Deutscher Rechtschreibtest). Inspite of the brain atrophy the patients showed low-normal inte...
journal_title:Klinische Padiatrie
pub_type: 杂志文章
doi:
更新日期:1979-09-01 00:00:00
abstract::Report about cyclic agranulocytosis in a 10 1/2 years old girls, having stomatitis, sore throat and fever up to 39 degrees C in the interval of approximately 3 weeks since the age of 6 months. By the prophylactic treatment with pulverized tetracyclin, which is already given 2 days prior to the expected decrease of the...
journal_title:Klinische Padiatrie
pub_type: 杂志文章
doi:
更新日期:1975-03-01 00:00:00
abstract::The therapy of complicated Kaposiform hemangioendothelioma (KHE) is still difficult. We present the first case of laryngomalacia with simultaneous mammalian target of Rapamycin (mTOR)-positive KHE of the neck and thoracic inlet and concurrent Kasabach-Meritt Phenomenon (KMP) in an 11-month-old boy suffering life-threa...
journal_title:Klinische Padiatrie
pub_type: 杂志文章
doi:10.1055/s-0034-1372587
更新日期:2014-11-01 00:00:00
abstract::While leadpoisoning has been with mankind since the dawn of civilization, only in recent years this disease was recognized as a serious public health problem. It has been estimated that more than half a million children are suffering from lead intoxication in the U.S.A. In most instances this disease is caused by eati...
journal_title:Klinische Padiatrie
pub_type: 杂志文章
doi:
更新日期:1975-09-01 00:00:00
abstract::In a prospective investigation, a rapid latex test for Helicobacter pylori in the serum (Pyloriset) was carried out in 39 patients with recurrent abdominal pain aged from six to 15 years. The test was positive in 19 patients. All of these children were subjected to gastroduodenoscopy. Seven cases showed a Helicobacter...
journal_title:Klinische Padiatrie
pub_type: 杂志文章
doi:10.1055/s-2008-1046500
更新日期:1995-01-01 00:00:00
abstract::Since reliable diagnosis of cystic fibrosis (CF) is still difficult, the occurrence of serum markers CA 19-9, CA 50 and elastase 1 was analysed. Serum levels of CA 19-9, CA 50, CA 125 and elastase 1 were estimated in 54 CF patients as well as in a control group of 66 children of similar age suffering from various othe...
journal_title:Klinische Padiatrie
pub_type: 杂志文章
doi:10.1055/s-2008-1033692
更新日期:1988-03-01 00:00:00
abstract::Screening for Hypothyroidism is part of the Austrian Newborn Screening for Inborn Errors and centralized (ca. 85.000 births/year). It began 1976 in 2 provinces and covers the whole country since 7.6.1978. Primary T4 and selective TSH on 3 mm discs is used. Control frequency is 0.14%, the frequency of permanent primary...
journal_title:Klinische Padiatrie
pub_type: 杂志文章
doi:10.1055/s-2008-1034501
更新日期:1981-09-01 00:00:00
abstract:BACKGROUND:Up to now, no German language test for children has been controlled for diagnostic accuracy. Therefore the application of language tests in clinical diagnostics is limited. The aim of the study was to determine the diagnostic validity of the SBE-3-KT, a parent questionnaire for identification of children wit...
journal_title:Klinische Padiatrie
pub_type: 杂志文章
doi:10.1055/s-0030-1267156
更新日期:2010-12-01 00:00:00
abstract::The GPOH-MAHO trials designed in 3/82 and 7/88 for treatment of childhood testicular germ cell tumors registered 3/92 105 pts. In MAHO 82 study 57 pts. and in MAHO 88 study 48 pts. were treated. Histologically 60% of the tumors revealed yolk sac tumors (YST), 22% teratomas (TD) and 18% malignant teratomas (MTI, MTU, M...
journal_title:Klinische Padiatrie
pub_type: 杂志文章
doi:10.1055/s-2007-1025231
更新日期:1993-07-01 00:00:00
abstract::On our opinion one important indication for sonographic diagnosis in future are masses in the larynx area: in infancy or childhood mainly laryngeal papillomatosis. In one of our boy patients with massive laryngeal papillomatosis laser surgery was first performed at 15 months of age. After a second and third procedure ...
journal_title:Klinische Padiatrie
pub_type: 杂志文章
doi:10.1055/s-2007-1025304
更新日期:1989-05-01 00:00:00