Skip to main content

Zusammenfassung

Die Gesundheitsökonomie beschäftigt sich mit der Thematik der Knappheit von Ressourcen im Gesundheitswesen. Sie beschäftigt sich sowohl mit den Ursachen der Knappheit wie auch mit den Möglichkeiten, diese zu mildern. Dazu werden die Methoden der Ökonomie auf das Gesundheitswesen angewandt. Die Aussage, Gesundheit sei das höchste Gut, impliziert ökonomisch, dass die Gesundheitsgüter einen Grenznutzen aufweisen, der höher ist als alle anderen Güter. Erst wenn das Bedürfnis nach Gesundheitsgütern gedeckt ist, können andere Güter nachgefragt werden. Das zentrale Problem bleibt jedoch stets die Knappheit, die es erforderlich macht zu wirtschaften. Gegenstand der Gesundheitsökonomie ist infolgedessen das Wirtschaften, also die effiziente Wahl zwischen Alternativen. Hierzu werden verschiedene Annahmen zu Verhaltensweisen der Individuen gemacht. Die meisten gesundheitsökonomischen Theorien basieren auf der Annahme von nutzenmaximierenden Personen (Homo oeconomicus), die zum Wirtschaften das ökonomische Prinzip anwenden. Ein wichtiger Bestandteil der Gesundheitsökonomie ist daher die Planung von Gesundheitsleistungen in einem Umfeld der knappen Ressourcen.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 54.99
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

Literatur

  • Gold MR, Siegel JE, Russell LB, Weinstein MC (1996) Cost-effectiveness in Health and Medicine. Oxford University Press, New York

    Google Scholar 

  • Haddix A, Teutsch SM, Schaffer A, Dunet DO (1996) Prevention Effectiveness. A guide to decision analysis and economic evaluation. Oxford University Press, New York

    Google Scholar 

  • McDowell I, Newell C (1987) Measuring health: a guide to rating scales and questionnaires. Oxford University Press, New York

    Google Scholar 

  • Schöffski O, Schulenburg JM Graf von der (Hrsg) (2000) Gesundheitsökonomische Evaluationen. Springer, Berlin Heidelberg New York Tokyo

    Google Scholar 

  • Szucs T (1997) Medizinische Ökonomie. Eine Einführung. Urban & Vogel, München

    Google Scholar 

  • Valuing health care (1995) Costs, benefits, and effectiveness of pharmaceuticals and other medical technologies, Cambridge/ Melbourne; 207–232

    Google Scholar 

  • Weinstein MC, Stason WB (1977) Foundations of cost-effectiveness analysis for health and medical practices. N Engl J Med 296: 716–721

    Article  PubMed  CAS  Google Scholar 

  • Wennberg JE (1990) Outcomes research, cost containment, and the fear of health care rationing. N Engl J Med 323: 1202–1204

    Article  PubMed  CAS  Google Scholar 

  • AHRQ, US Agency for Health Care Research and Quality (1992) Acute pain management: operative or medical procedures and trauma. Clin Pract Guidel 1: 100–107

    Google Scholar 

  • Antes G, Bassler D (2000) Evidence-based medicine, Forschungstransfer and die Rolle der medizinischen Journale. Dtsch Med Wochenschr 125: 1119–1121

    Article  CAS  Google Scholar 

  • Antes G, Bassler D, Galandi D (1999) Systematische Obersichtsarbeiten. Ihre Rolle in einer Evidenz-basierten Gesundheitsversorgung. Dtsch Arztebl 96(10): A-616-A-622

    Google Scholar 

  • Antmann EM, Lau J, Kupelnick B, Mosteller F, Chalmers TC (1992) A comparison of results of meta-analyses of randomized control trials and recommendations of clinical experts. JAMA 268 (2): 240–248

    Article  Google Scholar 

  • Bero LA, Drummond R (1995) The Cochrane Collaboration. JAMA 274 (24): 1935–1938

    Article  PubMed  CAS  Google Scholar 

  • Crowley P, Chalmers I, Keirse MJNC (1990) The effects of corticosteroid administration before preterm delivery: An overview of the evidence from controlled trials. Br J Obstet Gynaecol 97 (1): 11–25

    Article  PubMed  CAS  Google Scholar 

  • Davidoff F, Haynes RB, Sackett DL, Smith R (1995) Evidence based medicine: a new journal to help doctors identify the information they need. BMJ 310: 1085–1086

    Article  PubMed  CAS  Google Scholar 

  • Gray MJA (1997) Evidence-based healthcare. How to make health policy and management decisions. Churchill Livingstone, Edinburgh London

    Google Scholar 

  • Guyatt GH, Sackett DL, Cook DJ (1993) Users’ guides to the medical literature. II. How to use an article about therapy or prevention. A. Are the results of the study valid? Evidence-Based Medicine Working Group. JAMA 270 (21): 2598–2601

    Article  PubMed  CAS  Google Scholar 

  • Guyatt GH, Sackett DL, Cook DJ (1994) Users’ guides to the medical literature. II. How to use an article about therapy or prevention. B. What were the results and will they help me in caring for my patients? Evidence-Based Medicine Working Group. JAMA 271 (1): 59–63

    Article  PubMed  CAS  Google Scholar 

  • Jadad AR (1999) Bias in randomized controlled trials. BMJ Publishing Group, London

    Google Scholar 

  • Jadad AR, Moore RA, Carroll D, Jenkinson C, Reynolds DJM, Gavaghan DJ, McQuay HJ (1996) Assessing the quality of reports of randomized clinical trials: Is blinding necessary? Control Clin Trials 17: 1–12

    Article  PubMed  CAS  Google Scholar 

  • Kunz R, Ollenschläger G, Raspe H, Jonitz G, Kolkmann FW (2000) Lehrbuch Evidenz-basierte Medizin in Klinik and Praxis. Deutscher Ärzte-Verlag, Köln

    Google Scholar 

  • Olkin I (1995) Statistical and theoretical considerations in meta-analysis. J Clin Epidemiol 48 (1): 133–146

    Article  PubMed  CAS  Google Scholar 

  • Pulmonary Embolism Prevention (PEP) Trial Collaborative Group (2000) Prevention of pulmonary embolism and deep vein thrombosis with low dose aspirin: Pulmonary Embolism Prevention (PEP) trial. Lancet 355: 1295–1302

    Google Scholar 

  • Sackett DL, Richardson WS, Rosenberg WMC, Haynes RB (1997) Evidence-based medicine. How to practice and teach EBM. Churchill Livingstone, Edinburgh London [dt. Ausgabe: Kunz R, Fritsche L ( 1999 ) Evidenzbasierte Medizin. Zuckschwerdt, München]

    Google Scholar 

  • Schulz KF, Chalmers I, Hayes RJ, Altman DG (1995) Empirical evidence of bias. JAMA 273 (5): 408–412

    Article  PubMed  CAS  Google Scholar 

  • Woolf SH (1992) Practice guidelines: a new reality in medicine, II: methods of developing guidelines. Arch Int Med 152: 946–952

    Article  CAS  Google Scholar 

  • Brockmöller J, Kirchheiner J, Meisel C, Roots I (2000) Pharmacogenetic diagnostics of cytochrome P450 polymorphisms in clinical drug development and in drug treatment. Pharmacogenomics 1: 125–151

    Article  PubMed  Google Scholar 

  • Evans WE, Relling MV (1999) Pharmacogenomics: translating functional genomics into rational therapeutics. Science 286: 487–491

    Article  PubMed  CAS  Google Scholar 

  • Hoffmeyer S, Burk O, von Richter O et al. (2000) Functional polymorphisms of the human multidrug-resistance gene: multiple sequence variations and correlation of one allele with P-glycoprotein expression and activity in vivo. Proc Natl Acad Sci U S A 97: 3473–3478

    Article  PubMed  CAS  Google Scholar 

  • Kirchheiner J, Brosen K, Dahl M et al. (2001) CYP2D6 and CYP2C19 genotype-based dose recommendations for antidepressants: a first step towards subpopulation-specific dosages. Acta Psychiatr Scand Suppl 104: 173–192

    Article  CAS  Google Scholar 

  • McLeod HL, Evans WE (2001) Pharmacogenomics: unlocking the human genome for better drug therapy. Annu Rev Pharmacol Toxico141: 101–21

    Google Scholar 

  • Meisel C, Roots I, Cascorbi I, Brinkmann U, Brockmöller J (2000) How to manage individualized drug therapy: application of pharmacogenetic knowledge of drug metabolism and transport. Clin Chem Lab Med 38: 869–876

    Article  PubMed  CAS  Google Scholar 

  • Roses AD (2000) Pharmacogenetics and the practice of medicine. Nature 405: 857–865

    Article  PubMed  CAS  Google Scholar 

  • Brynne L, Karlsson MO, Paalzow LK (1998) Concentration-effect relationship of 1-propranolol and metoprolol in spontaneous hypertensive rats after exercise-induced tachycardia. J Pharmacol Exp Ther 286 (3): 1152–1158

    PubMed  CAS  Google Scholar 

  • Dirig DM, Yaksh TL (1995) Differential right shifts in the dose-response curve for intrathecal morphine and sufentanil as a function of stimulus intensity. Pain 62 (3): 321–328

    Article  PubMed  CAS  Google Scholar 

  • Garg V, Jusko WJ (1994) Pharmacodynamic modeling of nonsteroidal anti-inflammatory drugs: antipyretic effect of ibuprofen [letter]. Clin Pharmacol Ther 55 (1): 87–88

    Article  PubMed  CAS  Google Scholar 

  • Hill AV (1910) The possible effects of the aggregation of the molecules of haemoglobin on its dissociation curves. Journal J Physiol 40: iv-vii

    Google Scholar 

  • Holford NH, Sheiner LB (1982) Kinetics of pharmacologic response. Pharmacol Ther 16 (2): 143–166

    Article  PubMed  CAS  Google Scholar 

  • Holford NH (1990) Concepts and usefulness of pharmacokineticpharmacodynamic modelling. Fundam Clin Pharmacol 4 (Suppl 2): 93s - 101s

    Article  PubMed  Google Scholar 

  • Hull CJ, Van Beem HB, McLeod K, Sibbald A, Watson MJ (1978) A pharmacodynamic model for pancuronium. Br J Anaesth 50: 1113–1123

    Article  PubMed  CAS  Google Scholar 

  • Kong AN, Ludwig EA, Slaughter RL, DiStefano PM, DeMasi J, Middleton E Jr et al (1989) Pharmacokinetics and pharmacodynamic modeling of direct suppression effects of methylprednisolone on serum cortisol and blood histamine in human subjects. Clin Pharmacol Ther 46 (6): 616–628

    Article  PubMed  CAS  Google Scholar 

  • Lew KH, Ludwig EA, Milad MA, Donovan K, Middleton E Jr, Ferry JJ et al (1993) Gender-based effects on methylprednisolone pharmacokinetics and pharmacodynamics. Clin Pharmacol Ther 54 (4): 402–414

    Article  PubMed  CAS  Google Scholar 

  • Lu W, Bailey JM (2000) Reliability of pharmacodynamic analysis by logistic regression: a computer simulation study. Anesthesiology 92 (4): 985–992

    Article  PubMed  CAS  Google Scholar 

  • Mandema JW, Danhof M (1992) Electroencephalogram effect measures and relationships between pharmacokinetics and pharmacodynamics of centrally acting drugs. Clin Pharmacokinet 23: 191–215

    Article  PubMed  CAS  Google Scholar 

  • Mandema JW (1995) Population Pharmacokinetics and Pharmacodynamics. In: Welling PG, Tse FLS (eds) Pharmacokinetics. Marcel Dekker, New York, pp 411–450

    Google Scholar 

  • Minto CF, Howe C, Wishart S, Conway AJ, Handelsman DJ (1997) Pharmacokinetics and pharmacodynamics of nandrolone esters in oil vehicle: effects of ester, injection site and injection volume. J Pharmacol Exp Ther 281 (1): 93–102

    PubMed  CAS  Google Scholar 

  • Schnider TW, Minto CF, Stanski DR (1994) The effect compartment concept in pharmacodynamic modelling. Anaesth Pharmacol Rev 2: 204–213

    CAS  Google Scholar 

  • Scott JC, Ponganis KV, Stanski DR (1985) EEG quantitation of narcotic effect: the comparative pharmacodynamics of fentanyl and alfentanil. Anesthesiology 62: 234–241

    Article  PubMed  CAS  Google Scholar 

  • Sheiner LB, Stanski DR, Vozeh S, Miller RD, Ham J (1979) Simultaneous modeling of pharmacokinetics and pharmacodynamics: application to d-tubocurarine. Clin Pharmacol Ther 25: 358–371

    PubMed  CAS  Google Scholar 

  • Sheiner LB (1969) Computer-aided long-term anticoagulation therapy. Comput Biomed Res 2 (6): 507–518

    Article  PubMed  CAS  Google Scholar 

  • Shi J, Benowitz NL, Denaro CP, Sheiner LB (1993) Pharmacokinetic-pharmacodynamic modeling of caffeine: tolerance to pressor effects. Clin Pharmacol Ther 53: 6–14

    Article  PubMed  CAS  Google Scholar 

  • Aronoff GR, Berns JS, Brier ME et al. (1999) Drug prescribing in renal failure, 4th edn. American College of Physicians, Philadelphia New York

    Google Scholar 

  • Bailey DG, Malcolm J, Arnold O, Spence JD (1998) Grapefruit juice-drug interactions. Br J Clin Pharmacol 46: 101–110

    Article  PubMed  CAS  Google Scholar 

  • Beers MH, Ouslander JG (1989) Risk factors in geriatric drug prescribing. A practical guide to avoiding problems. Drugs 37: 105–112

    Article  PubMed  CAS  Google Scholar 

  • Caregaro L, Menon F, Angeli P et al. (1994) Limitations of serum creatinine level and creatinine clearance as filtration markers in cirrhosis. Arch Intern Med 154: 201–205

    Article  PubMed  CAS  Google Scholar 

  • Dettli L (1976) Drug dosage in renal disease. Clin Pharmacokinet 1: 126–134

    Article  PubMed  CAS  Google Scholar 

  • Dettli L (1996) Pharmakokinetische Daten für die Dosisanpassung. In: Grundlagen der Arzneimitteltherapie. Documed, Basel, S 13–21

    Google Scholar 

  • Gubbins PO, Bertch KE (1991) Drug absorption in gastrointestinal disease and surgery. Clinical pharmacokinetic and therapeutic implications. Clin Pharmacokinet 21: 431–447

    Article  PubMed  CAS  Google Scholar 

  • Hardman JG, Limbird LE, Molinoff PB, Ruddon RW, Goodman A (1996) The pharmacological basis of therapeutics, 9th edn. McGraw-Hill, New York St. Louis San Francisco

    Google Scholar 

  • Luke DR, Halstenson CE, Opsahl JA, Matzke GR (1990) Validity of creatinine clearance estimates in the assessment of renal function. Clin Pharmacol Ther 48: 503–508

    Article  PubMed  CAS  Google Scholar 

  • Morgan DJ, McLean AJ (1995) Clinical pharmacokinetic and pharmacodynamic considerations in patients with liver disease. Clin Pharmacokinet 29: 370–391

    Article  PubMed  CAS  Google Scholar 

  • Pirlich M, Selberg 0, Boker K, Schwarze M, Muller MJ (1996) The creatinine approach to estimate skeletal muscle mass in patients with cirrhosis. Hepatology 24: 1422–1427

    Article  PubMed  CAS  Google Scholar 

  • Pond SM, Tozer TN (1984) First-pass elimination. Basic concepts and clinical consequences. Clin Pharmacokinet 9: 1–25

    Article  PubMed  CAS  Google Scholar 

  • Diener W, Gundert-Remy U (1999) Challenge for the successful prediction of drug metabolism in vivo from studies in vitro: simulation of variability. In: Boobis AR, Kremers P, Pelkonen O, Pithan K (eds) European symposium on the prediction of drug metabolism in man: progress and problems. Science, Research and Development EC, DG XII: 247–264

    Google Scholar 

  • Gleiter CH, Gundert-Remy U (1996) Gender differences in pharmacokinetics. Eur J Drug Metab Pharmacokinet 21: 123–128

    Article  PubMed  CAS  Google Scholar 

  • Gundert-Remy U (1999) Pharmakologische Grundlagen von UAWs. In: Müller-Oerlinghausen B, Lasek R, Düppenbecker H, Munter KH (Hrsg.) Handbuch der unerwünschten Arzneimittelwirkungen. Urban & Fischer, München Jena, S 620–626

    Google Scholar 

  • Gundert-Remy U (1995) Medikamente im Alter. In: Schwandt P, Richer WO (Hrsg) Handbuch der Fettstoffwechselstörungen. Schattauer, Stuttgart New York, pp 468–475

    Google Scholar 

  • Müller HJ, Gundert-Remy U (1994) Regulatory view on drug interactions. In: Kuhlmann JW (ed) Drug interaction studies during drug development. Zuckschwerdt, München Bern Wien New York, pp 69–73

    Google Scholar 

  • Schneeweis S, Hasford J (1999) Pharmakoepidemiologische Methoden bei der Erfassung von UAWs. In: Müller-Oerlinghausen B, Lasek R, Düppenbecker H, Munter KH (Hrsg) Handbuch der unerwünschten Arzneimittelwirkungen. Urban & Fischer, München Jena, S 600–611

    Google Scholar 

Download references

Authors

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2003 Springer-Verlag Berlin Heidelberg

About this chapter

Cite this chapter

Reichen, J. et al. (2003). Prinzipien der Therapie. In: Schölmerich, J., et al. Medizinische Therapie in Klinik und Praxis. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-12451-2_1

Download citation

  • DOI: https://doi.org/10.1007/978-3-662-12451-2_1

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-662-12452-9

  • Online ISBN: 978-3-662-12451-2

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics