Mentoring system--performance optimization of treatment by formative case management
Johanns, A.; Grüber, J.
Versicherungsmedizin 61(3): 122-125
2009
ISSN/ISBN: 0933-4548 PMID: 19860170 Document Number: 629272
The efficiency of the German public health system and its principle of adequate treatment are not up to the standards required by accident insurance companies. These have to be interested in realising optimal treatment, because the amount of pecuniary reparation essentially depends on (the quality of) the state of health of the injured person. To accomplish these objectives, their case management departments have to find a way to use the resources of the public health system and to improve considerably the quality of process und structure of the treatment. This is why case management is becoming increasingly important for insurance companies. Against this background, this case report describes the process of rehabilitation of a 72-year-old woman who had an accident and suffered a traumatic brain injury. This process was managed by AMB Generali Schadenmanagement GmbH in cooperation with the consulting firm Haase & Johanns Consulting, to develop approaches to rehabilitation management. It describes the mutual benefit for the injured person and of the insurer, which is defined by the success of treatment and saving of costs (care home, damages for pain and suffering) amounting to about 700,000 Euros.