Centre for General Medicine and Geriatrics, University Medical Center of the Johannes Gutenberg University Mainz, Am Pulverturm 13, 55131, Mainz, Germany.
Wien Med Wochenschr. 2024 Mar;174(3-4):53-60. doi: 10.1007/s10354-022-00935-0. Epub 2022 May 3.
The Innovation Fund was set up in 2015 with the aim of improving medical care in the German statutory health insurance system. Primary care needs to be involved in testing interventions and new forms of care for effectiveness and inclusion in standard care. There has so far been hardly any research on how far Innovation Fund models accommodate the primary care setting, or on the experience general practitioners have had with these models. Between September 2021 and January 2022, 36 semi-standardized individual interviews were performed with general practitioners who had already participated in Innovation Fund projects. Eleven regional physician networks in Rhineland-Palatinate, Hesse, North Rhine-Westphalia, and Schleswig-Holstein were involved in the recruitment process. Most of the interviewees associated the Innovation Fund with potential and opportunity including intensification of application-oriented healthcare research, independent financing, and general healthcare involvement. Even so, many general practitioners were unsure as to how far primary care in particular would stand to benefit from the Innovation Fund in the long term. A mostly positive balance was drawn from participation in care models-benefit of intervention as well as cost-benefit ratio. However, some also reported hurdles and stress factors such as documentation requirements and disruption in everyday office routine. Innovation Fund projects will need to be suitable for general practitioners especially regarding medical decision-making leeway, limits to documentation requirements, preserving established office routine, greater involvement in research planning, and improvements to the primary care setting to encourage willingness to participate in Innovation Fund projects amongst general practitioners.
创新基金成立于 2015 年,旨在改善德国法定健康保险制度中的医疗服务。初级保健需要参与干预措施和新的护理形式的有效性测试,并将其纳入标准护理。迄今为止,几乎没有研究探讨创新基金模式在多大程度上适应初级保健环境,也没有研究一般从业者在这些模式方面的经验。2021 年 9 月至 2022 年 1 月,对已经参与创新基金项目的全科医生进行了 36 次半标准化的个体访谈。莱茵兰-普法尔茨州、黑森州、北莱茵-威斯特法伦州和石勒苏益格-荷尔斯泰因州的 11 个区域医生网络参与了招聘过程。大多数受访者认为创新基金具有潜力和机会,包括加强面向应用的医疗保健研究、独立融资和普通医疗保健的参与。即便如此,许多全科医生仍不确定从长远来看,初级保健特别是能从创新基金中获益多少。参与护理模式的人对干预措施的好处和成本效益比进行了评估,得出的结论是基本平衡。然而,一些人也报告了障碍和压力因素,如文件要求和日常办公流程中断。创新基金项目需要特别适合全科医生,尤其是在医疗决策回旋余地、文件要求限制、维护既定办公流程、更多地参与研究规划以及改善初级保健环境方面,以鼓励全科医生参与创新基金项目的意愿。