The German health care system is facing enormous challenges. Society is aging, chronic diseases are on the rise, and there are simultaneous problems of underuse, overuse and misuse in the population. For the regionally differentiated assessment of health care needs, the planning of health care structures and the correction of unfavorable patterns of utilization, population-based classification systems, are needed, similar to their use in numerous countries.
The aim of the project is to develop a population-based classification system, specific to the German health care system, for measuring morbidity-related regional health care needs (PopGrouper). This system is characterized by the fact that each insured person is assigned to exactly one group. This also takes into account the interaction of multimorbidity on the need for care. In previous German classifications, such as those used for the morbidity-oriented risk structure adjustment (Morbi-RSA) between the statutory health insurance funds, a person can fall into several categories if several illnesses are present. The project will contribute to the improvement of health care service delivery as well as to the further development of methods of health care services research.
Insured persons with similar health care needs will be assigned to a common group ("PopGroups"), taking into account all relevant diagnoses. The methodological grouping approach is to be chosen in such a way that medically meaningful and economically homogeneous groups are formed, which also take the impact of multimorbidity into account. The PopGrouper will then be tested with regard to the following areas of application:
The PopGrouper will be made publicly available together with a description of the data set and a catalog of the groups.
TU Berlin, Department of Healthcare Management (MiG)
BARMER Institute for Health Systems Research (bifg)
aQua Institute for Applied Quality Promotion and Research in Health Care
Central Institute for Health Care (Zi)
German Hospital Institute (DKI)
Association of the Scientific Medical Societies (AWMF),
Federal states (Baden-Württemberg, Berlin, Brandenburg, Hamburg, Rhineland-Palatinate),
Association of University Hospitals,
Protestant Hospital Association,
Robert Koch Institute (RKI),
as well as the experts Mr. P. Reschke, Mr. G. Mewis and Prof. A. Geissler (University of St. Gallen).
Grant number: 01VSF20027
Wilm Quentin, Reinhard Busse, Verena Vogt, Thomas Czihal, Matthias Offermanns, Thomas Grobe, Klaus Focke: Entwicklung eines Systems zur Klassifikation des morbiditätsbezogenen Versorgungsbedarfs (PopGroup), Seite 78–97, doi: 10.30433/GWA2020, https://www.bifg.de/media/dl/Gesundheitswesen%20aktuell/2020/GWA%202020-Kapitel%20Focke.pdf