Society is aging and more and more people are developing chronic illnesses. At the same time, we are seeing an increase in the problems caused by underuse, overuse and misuse of health care. The German health system faces enormous challenges. The lack of tools available to assess the regional needs of hospitals and outpatient care makes it harder to plan more effective health care reflecting the actual needs of the population. To address these problems, researchers at TU Berlin have now joined forces with other partners, including the BARMER Institut für Gesundheitsystemforschung (bifg), to set up the PopGroup project.
The aim is to develop a classification system of patient groups to help plan tailored and intersectoral health care for the population. The project is being funded by the Federal Joint Committee over a period of three years with approximately 1.8 million euros and will commence 1 April 2021. Consortium speaker is Professor Dr. med. Reinhard Busse, head of the Department of Health Care Management at TU Berlin.
“To understand the different medical care requirements of the regions and plan effective care structures as well as improve patterns of health care usage, we require population classification systems,” explains Reinhard Busse. Dr. Wilm Quentin, head researcher of PopGroup adds: “A number of different methods are already in use around the world and it is high time to introduce something similar in Germany.”
This was also the conclusion of a report on the development of health care published by an expert advisory council as early as 2018. The report recommended a cross-sectoral health care structure to assess the needs of both outpatient care and hospital care. A further important factor is morbidity, in other words the types of illnesses and the number of people affected by them in a region.
Researchers in the PopGroup project are now looking to use empirical data to develop a classification system which will enable medical care to be planned according to both intersectoral needs and morbidity. The funding organization focuses on improving the health care provided via statutory health insurance. The information required for the project will therefore be gathered from health insurers’ routine data, that is data regarding outpatient care, hospital care and other forms of treatment.
“The goal of our project is to develop a ‘PopGrouper’ based on comprehensive treatment, billing and insurance data covering all relevant diagnoses for a patient. The term PopGroup refers to the practice of grouping together sections of the population with similar health care requirements,” explains Wilm Quentin. The use of the term reflects international language practice. According to Quentin, the term “grouper” is often used internationally to reflect the fact that each individual person within the entire population can be effectively assigned to a group on the basis of their clinical history and needs. These groups can then serve as a basis for planning effective and efficient health care. The researchers are also examining whether this method makes it possible to identify patients who would benefit from individual case management.
“Our classification system is intended to identify a broad spectrum of potential uses within the health care system,” Quentin explains. As such, the PopGrouper approach should also enable better planning for building and equipping new hospitals and for the requirements of outpatient care as well as improved cooperation between all relevant stakeholders. A further aim is to be able to compare regions in terms of the quality and efficiency of health care. “These improved measurement and assessment techniques will also provide an insight into the impacts of health care reforms and new methods of treatment,” explains Quentin. The algorithms developed within the project will later be made available to health services (open source).
In the new PopGroup project, TU Berlin’s Department of Health Care Management (MiG) will work together with the BARMER Institut für Gesundheitssystemforschung (bifg), the aQua Institute for Quality in Health Care as well as the Central Institute of Ambulatory Health Care in Germany and the Deutsches Krankenhaus Institut (DKI). The consortium is led by Professor Dr. Reinhard Busse, head of the Department of Health Care Management at TU Berlin. The Department is also home to one of the Federal Ministry of Education and Research’s four centers of health economics research and one of the three research centers operated by the World Health Organization’s European Observatory on Health Systems and Policies. Both centers are closely involved in policy advising.