[Audits across state borders for medical consulting agencies within the German healthcare insurance system].
The Medizinischer Dienst der Krankenversicherung (MDK) is a non-profit medical consulting organisation serving the German Healthcare Insurance System. Despite its uniform commission throughout Germany, organisation and structure differ considerably between Provincial States which is reflected by differing results. A common nationwide system of key figures and indicators aims at analysing results and learning from one another.


OBJECTIVE
Development of an audit concept for analysing key figures and indicators within the MDK aiming at quality improvement.


METHODS
Development of a system of key figures and indicators covering five spheres (products, staff, costs, data analysis, structure). Analysis by means of audits carried out across provincial state borders in five steps (audit manual, training of auditors, visitation, audit report, repetition audit).


RESULTS
The system of key figures and indicators assures relevant and comparable data. Audit manual, training of auditors, visitation, and audit report meet the needs of all people and institutions involved. Preparation of auditors as well as openness, and flow of information within audited organisations offer areas for improvement. There is as yet no assessment of the cost-benefit ratio of audits.


CONCLUSIONS
The concept presented in this article consists of two parts: A system of key figures and indicators as well as a concept for audits. The concept is suitable for a) generating and analysing relevant key figures and indicators for each MDK, and b) providing information for benchmarking between different MDK. Further development of the concept to a comprehensive management concept is necessary.
Schneider
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Medizinischer Dienst der Krankenversicherung Rheinland-Pfalz, Stabsstelle Qualitätsmanagement und Projektkoordintion, Alzey. Thomas.Schneider@mdk-rlp.de
Sommerfeld
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Möller
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D019985:Benchmarking / Q000379:methods; D005858:Germany; D006801:Humans; D007348:Insurance, Health / Q000592:standards*; D019984:Quality Indicators, Health Care; D011787:Quality of Health Care; D017749:Total Quality Management