The shaded side of the UHC cube: a systematic review of human resources for health management and administration in social health protection schemes.

Managers and administrators in charge of social protection and health financing, service purchasing and provision play a crucial role in harnessing the potential advantage of prudent organization, management and purchasing of health services, thereby supporting the attainment of Universal Health Coverage. However, very little is known about the needed quantity and quality of such staff, in particular when it comes to those institutions managing mandatory health insurance schemes and purchasing services. As many health care systems in low- and middle-income countries move towards independent institutions (both purchasers and providers) there is a clear need to have good data on staff and administrative cost in different social health protection schemes as a basis for investing in the development of a cadre of health managers and administrators for such schemes. We report on a systematic literature review of human resources in health management and administration in social protection schemes and suggest some aspects in moving research, practical applications and the policy debate forward.

[Malpractice Claims Against Pediatricians - Analysis of Expert Testimonies from the Medical Service of Health Insurance Companies Between 2000 and 2014]. / Behandlungsfehlervorwürfe gegen Pädiater ­ eine Analyse von Gutachten des Medizinischen Dienstes der Krankenversicherung der Jahre 2000 bis 2014.

Background In Germany, few data are available on medical malpractice claims against pediatricians. On behalf of Statutory Health Insurance Companies their Medical Service (MDK) regularly offers expert testimony in case of allegations during pediatric treatment. Methods Analysis of 374 written pediatric testimonies, documented between September 1st, 2000 and August 31st, 2014. Results 193 allegations against pediatricians were analysed separately for each sector of care (35% concerning outpatients, 28% normal inpatients, and 37% patients treated in an intensive care unit, ICU). Outpatient care led more frequently to malpractice claims regarding diagnosis, most often in the case of dysplasia of the hip (n=6), meningitis (n=5), and pneumonia (n=4). In inpatients, allegations regarding treatment errors were more common and frequently associated with extravasation injury (n=7), as well as periventricular leukomalacia (n=7), sepsis (=6), and intraventricular haemorrhage (n=4) in newborn infants on ICUs. Expert testimony confirmed allegations in 43% of the outpatients, 22% of the normal inpatients and 38% of the ICU patients. Discussion and conclusion The frequency of pediatric malpractice claims seems to depend primarily on the pattern of utilization of pediatric care services. Diagnosis-related constellations leading to malpractice claims in Germany are well-known internationally. Case analysis according to medical care sectors allows comprehensible conclusions for risk management.