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Health Care System

Healthcare comprises all organisations, structures and processes that serve purposes of health promotion, prevention of illness, medical and therapeutic treatment, rehabilitation and nursing care.

The description and analysis of important indicators of the health system are essential when it comes to ensuring appropriate and high-quality healthcare. These indicators form the basis for the evaluation of quality and cost aspects, requirements planning and formulation of recommendations for action for the health system and health policy.

Within the framework of the health monitoring programme at Robert Koch Institute (RKI), representative data on the utilisation of medical and therapeutic services is regularly collected and analysed.

Studies Supplement Invoice Data

The RKI collects data on doctor's visits, hospital stays and use of medicine, among other aspects. The data gained in the surveys depicts the healthcare utilisation patterns from the perspective of patients. This data is an important supplement to the data of service providers (including the invoice data of the statutory health insurance companies).

One of the reasons for this is that only limited statements on the use of medication can be made from prescription data. For one thing, not all prescribed medicines are actually taken. In addition, the invoice data does not include medication that was taken without a medical prescription.

The wide range of topics covered by the RKI surveys makes it possible to establish links between diseases, risk factors, protective factors and psychosocial characteristics. Moreover, social and structural inequalities in utilisation behaviour can be recognised. These may be differences according to social and migration status, region or health insurance status. It is thus possible to identify typical healthcare utilisation patterns and derive management approaches for health policy.


Socioeconomic status and use of outpatient medical care: the case of Germany

Hoebel J, Rattay P, Prütz F, Rommel A, Lampert T (2016) PLoS One 11(5): e0155982 DOI: 10.1371/journal.pone.0155982

‘We can do only what we have the means for’
general practitioners’ views of primary care for older people with complex health problems

Herzog A, Gaertner B, Scheidt-Nave C, Holzhausen M (2015) BMC Family Practice 16:35 doi: 10.1186/s12875-015-0249-2

Somatic and mental health service use of children and adolescents in Germany (KiGGS-study) (Abstract)

Wölfle S, Jost D, Oades R, Schlack R, Hölling H, Hebebrand J (2014) European Child & Adolescent Psychiatry. Epub 2014 Mar. doi: 10.1007/s00787-014-0525-z

Direct costs of inequalities in health care utilization in Germany 1994 to 2009: a top-down projection

Kroll LE, Lampert T (2013) BMC Health Services Research 2013(13):271 doi: 10.1186/1472-6963-13-271

A clinical trial alert tool to recruit large patient samples and assess selection bias in general practice research

Heinemann S, Thüring S, Wedeken S, Schäfer T, Scheidt-Nave C, Ketterer M, Himmel W (2011) BMC Med Res Methodol 11:16

Changes of menopausal hormone therapy use pattern since 2000: results of the Berlin Spandau Longitudinal Health Study

Du Y, Scheidt-Nave C, Schaffrath-Rosario A, Ellert U, Dören M, Knopf H. (2009) CLIMACTERIC 12:329–340

Simply no time? Barriers to GPs’ participation in primary health care research.

Hummers-Pradier E, Scheidt-Nave C, Martin H, Heinemann S, Kochen MM, Himmel W (2008) Family Practice 25(2):105-112

Differences in Menopausal Hormone Therapy Use among Women in Germany between 1998 and 2003

Du Y, Dören M, Melchert HU, Scheidt-Nave C, Knopf H (2007) BMC Women's Health 7:19

Primary care doctors’ awareness of osteoporosis and knowledge about guidelines – results of a representative survey of German family physicians

Chenot R, Scheidt-Nave C, Gabler S, Kochen MM, Himmel W (2007) Exp Clin Endocrinol Diabetes 115: 584 – 589