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Chancen und Barrieren des IPReG für die außerklinische Intensivpflege: eine explorative Interviewstudie mit Kostenträgern und gesundheitspolitischen Akteuren im Rahmen der „PRiVENT“-Studie

Background The number of long-term ventilated patients in out-of-hospital intensive care (OIC) in Germany has risen sharply in recent years. Due to financial disincentives, structural care deficits and resource bottlenecks, there is an increasing risk of inadequate care. In 2020, the Intensive Care...

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Main Authors: Biehler, Elena (Author) , Fleischhauer, Thomas (Author) , Fuchs, Gerhard (Author) , Forstner, Johanna (Author) , Weis, Aline (Author) , Schumann, Selina von (Author) , Michels-Zetsche, Julia D. (Author) , Trudzinski, Franziska (Author) , Herth, Felix (Author) , Szecsenyi, Joachim (Author) , Wensing, Michel (Author)
Format: Article (Journal)
Language:German
Published: 10 February 2025
In: Medizinische Klinik, Intensivmedizin und Notfallmedizin
Year: 2025, Pages: 1-8
ISSN:2193-6226
DOI:10.1007/s00063-025-01247-y
Online Access:Verlag, lizenzpflichtig, Volltext: https://doi.org/10.1007/s00063-025-01247-y
Verlag, lizenzpflichtig, Volltext: http://link.springer.com/article/10.1007/s00063-025-01247-y
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Author Notes:Elena Biehler, Thomas Fleischhauer, Gerhard E. Fuchs, Johanna Forstner, Aline Weis, Selina von Schumann, Julia D. Michels-Zetsche, Franziska C. Trudzinski, Felix J.F. Herth, Joachim Szecsenyi, Michel Wensing
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Summary:Background The number of long-term ventilated patients in out-of-hospital intensive care (OIC) in Germany has risen sharply in recent years. Due to financial disincentives, structural care deficits and resource bottlenecks, there is an increasing risk of inadequate care. In 2020, the Intensive Care and Rehabilitation Strengthening Act (IPReG) was therefore passed by legislators with the aim of improving OIC. This study examines the opportunities and challenges of the IPReG with regard to the care of long-term ventilated patients in OIC from the perspective of payers and healthcare policy. Materials and methods A qualitative interview study was conducted as part of the process evaluation of the multicenter study PRiVENT (Prevention of invasive Ventilation). Using semi-structured, guideline-based individual interviews, health policy actors and representatives of statutory health insurers were asked about the IPReG. Results In all, 11 health policymakers and 12 representatives of statutory health insurance companies took part in the interviews. Both interview groups showed a positive attitude towards the IPReG and expressed the expectation of added value for the outpatient care of long-term ventilated patients. The current remuneration regulations for weaning and the assessment of weaning potential in the OIC were criticized, among other things. Conclusion The IPReG provides a legal basis for improving OIC, but there is still room for improvement in its current version. The evaluation planned by legislators should be used to identify potential weaknesses and make appropriate adjustments.
Item Description:Gesehen am 08.07.2025
Physical Description:Online Resource
ISSN:2193-6226
DOI:10.1007/s00063-025-01247-y

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