Die bedeutung ausgewählter präventiver, therapeutischer und rehabilitativer leistungen im spiegel eines bevölkerungssurveys

Background: Statutory health insurance bodies in Germany are experiencing increasing deficits, which raises the demand for rationalising health benefits. This, however, requires the establishment of priorities unless absolutely necessary benefits have to be cut. In other words, we must examine the preferences, expectations and experiences of the insured population. Within the framework of this study, we tried to find out the preferences and assessment of health services by the German population in the Lübeck region. Design: Mail survey (questionnaire and two reminders) to register the preferences and attitudes to guaranteed medical services in the light of threatening deficits. The random sample was drawn by the residents' registration office in Lübeck, the criteria being an age of between 25 and 64 years, German nationality and principle domicile in Lübeck. Instrument: Postal questionnaire with 7 pages including 9 question complexes on the importance of preventive, curative and rehabilitative health services with 88 items and personal data. Results: We succeeded in contacting 992 persons and achieved a response rate of 64.1%-67% of the participants (n=634) conveyed about their opinion on economic decisions in health care. 12% refused any involvement. In respect of importance and the cost of medical interventions, preventive, curative and rehabilitative interventions for children have highest priority. In the curative and rehabilitative sphere the emphasis lies on the severity of the illness. Interventions with controversial effectiveness were rated less important by the respondents and hence these should not be financed by the health insurance companies in every case, in the opinion of the persons who had been questioned. Conclusions: The evaluation shows that most participants could cope quite well with this questionnaire and were ready to be involved in decisions concerning health care. Like the participants of Ann Bowling's survey about the investigation of preferences in the UK, our respondents give medical interventions for children (independent from the medical sector) a higher priority. Mit vorang. Satz weicht die engl. Zusammenfassung von der dt. Zusammenfassung ab Apart from this it is obvious that interventions with controversial effectivity should not be covered by the health insurance companies to the same extent as those with established effectivity, which is, in a way, in contrast to valid German legal regulations.