Martin Roessler

• PhD
• BARMER Institut für Gesundheits­systemforschung

Background The low rate of organ donation in Germany has been linked to a deficit in the detection of patients with brain death (BD) in hospitals. It is unclear how crisis-related health system disruptions, such as the COVID-19 pandemic, affect this detection deficit. Methods Secondary data analysis of anonymized data from deceased patients with a...

Background Post-viral symptoms have long been known in the medical community but have received more public attention during the COVID-19 pandemic. Many post-viral symptoms were reported as particularly frequent after SARS-CoV-2 infection. However, there is still a lack of evidence regarding the specificity, frequency and persistence of these sympto...

Introduction Endometrial cancer is the most common malignant tumor of the female genital organs. In Germany, treatment is provided in both cancer centers certified by the German Cancer Society (Deutsche Krebsgesellschaft, DKG) and in non-certified hospitals. This study investigated whether treatment in DKG-certified centers leads to improved overal...

Background Little is known about regional differences regarding the utilization and costs of emergency medical services (EMS) in Germany. Evidence on characteristics of repeated use of EMS is also scarce. Objectives To compare German federal states regarding the utilization and costs of EMS and to analyze characteristics of repeated EMS use. Mate...

Purpose Evidence on the incidence and persistence of post-acute sequelae of COVID-19 (PASC) among children and adolescents is still limited. Methods In this retrospective cohort study, 59,339 children and adolescents with laboratory-confirmed COVID-19 in 2020 and 170,940 matched controls were followed until 2021-09-30 using German routine healthca...

Zusammenfassung Zertifizierte Brustkrebszentren bieten spezifische Qualitätsstandards für die Struktur, Diagnostik und Behandlungsverfahren, beispielsweise der Mammachirurgie, medikamentösen Tumortherapie, Strahlentherapie und psychosozialen Unterstützung, mit dem Ziel, die Behandlungsergebnisse für Brustkrebspatient*innen zu verbessern. Die Frage...

Zusammenfassung Zertifizierte Brustkrebszentren bieten spezifische Qualitätsstandards für die Struktur, Diagnostik und Behandlungsverfahren, beispielsweise der Mammachirurgie, medikamentösen Tumortherapie, Strahlentherapie und psychosozialen Unterstützung, mit dem Ziel, die Behandlungsergebnisse für Brustkrebspatient*innen zu verbessern. Die Frage...

Background The use of emergency medical services (EMS) in Germany has increased substantially over the last few decades. While current reform efforts aim to increase effectiveness and efficiency of the German hospital and EMS systems, there is lack of data on characteristics of hospital cases using EMS. Objectives To analyze and compare the charac...

Post-viral symptoms have long been known in the medical community but have received more public attention during the COVID-19 pandemic. Many post-viral symptoms were reported as particularly frequent after SARS-CoV-2 infection. However, there is still a lack of evidence regarding the specificity, frequency and persistence of these symptoms in compa...

Certified breast cancer centers offer specific quality standards in terms of their structure, diagnostic and treatment approaches with regards to breast surgery, drug-based cancer therapy, radiotherapy, and psychosocial support. Such centers aim to improve treatment outcomes of breast cancer patients. The question investigated here was whether pati...

Background Certified cancer centers aim to ensure high-quality care by establishing structural and procedural standards according to evidence-based guidelines. Despite the high clinical and health policy relevance, evidence from a nation-wide study for the effectiveness of care for colorectal cancer in certified centers vs. other hospitals in Germa...

Background Quality indicators are frequently used to assess the performance of health care providers, in particular hospitals. Established approaches to the design of such indicators are subject to distortions due to indirect standardization and high variance of estimators. Indicators for geographical regions are rarely considered. Objectives To d...

Background The direct thrombin inhibitor argatroban is indicated for the treatment of heparin-induced thrombocytopenia II, but it is also used off-label to treat critically ill patients presenting with heparin resistance, severe antithrombin deficiency or hypercoagulability. Direct drug monitoring is not routinely available and argatroban dosing is...

Background The optimal anesthetic management for endovascular therapy (EVT) in patients with posterior circulation stroke remains unclear. Our objective was to investigate the impact of early intubation in patients enrolled in the BASICS trial (Basilar Artery International Cooperation Study). Methods BASICS was a multicenter, randomized, controlle...

Simple Summary Certification in oncology aims to establish structural and procedural standards according to evidence-based guidelines. The WiZen study is the largest study so far to analyze the effect of the certification of designated cancer centers on survival in Germany. Based on clinical cancer registry data of 47.440 colorectal cancer patients...

Background An automated digital screening tool (DETECT) has been developed to aid in the early identification of patients who are at risk of developing brain death during critical care. Methods This prospective diagnostic accuracy study included consecutive patients ≥ 18 years admitted to neurocritical care for primary or secondary acute brain inj...

Background: According to the National Cancer Plan in Germany, all cancer patients should receive high-quality care in accordance with evidence-based treatment guidelines. Certification programs were established for this purpose but have not yet been comprehensively evaluated. Methods: In the WiZen project, which was supported by the Innovation F...

Objectives To investigate whether the risk of developing an incident autoimmune disease is increased in patients with prior COVID-19 disease compared to those without COVID-19, a large cohort study was conducted. Method A cohort was selected from German routine health care data. Based on documented diagnoses, we identified individuals with polymer...

Aim We aimed to develop a risk score to calculate a person’s individual risk for a severe COVID-19 course (POINTED score) to support prioritization of especially vulnerable patients for a (booster) vaccination. Subject and methods This cohort study was based on German claims data and included 623,363 individuals with a COVID-19 diagnosis in 2020....

Background: The aim of the project "Effectiveness of care in oncological centres" (WiZen), funded by the innovation fund of the federal joint committee, is to investigate the effectiveness of certification in oncology. The project uses nationwide data from the statuory health insurance AOK and data from clinical cancer registries from three differ...

Objectives: To investigate whether the risk of developing an incident autoimmune disease is increased in patients with previous COVID-19 disease compared to people without COVID-19. Method: A cohort was selected from German routine health care data covering 38.9 million individuals. Based on documented diagnoses, we identified individuals with poly...

The connection between Pediatric Inflammatory Multisystem Syndrome (PIMS) and Kawasaki Disease (KD) is not yet fully understood. Using the same national registry, clinical features and outcome of children hospitalized in Germany, and Innsbruck (Austria) were compared. Reported to the registry were 395 PIMS and 69 KD hospitalized patients. Patient a...

Effectiveness of care in German cancer centres – evidence from the WiZen study

Effectiveness of Care in Certified Cancer Centers (WiZen) - Success of Data Linkage between SHI and Clinical Cancer Registries

Background Long-term health sequelae of the Coronavirus Disease 2019 (COVID-19) are a major public health concern. However, evidence on post-acute COVID-19 syndrome (post-COVID-19) is still limited, particularly for children and adolescents. Utilizing comprehensive healthcare data on approximately 46% of the German population, we investigated post-...

Abstract Acute Respiratory Distress Syndrome (ARDS) is common in COVID-19 patients and is associated with high mortality. The aim of this observational study was to describe patients’ characteristics and outcome, identifying potential risk factors for in-hospital mortality and for developing Long-COVID symptoms. This retrospective study included al...

International werden Routinedaten zur Definition von Qualitätsindikatoren genutzt, um stationäre Behandlungsqualität zu erfassen. Fallübergreifende Routinedaten erlauben bei geringem administrativen Aufwand die sektorenübergreifende Longitudinalanalyse von Behandlungsfolgen inner- und außerhalb des initialen Klinikaufenthaltes. Aufgrund des Erhebun...

Zusammenfassung In der COVID-19 Pandemie wurden zur Pandemiesteuerung und zur Evidenzgenerierung für die Beantwortung drängender Fragen empirische Datengrundlagen zu verschiedensten Fragestellungen benötigt, die mit Hilfe von GKV Routinedaten generiert werden können. Im Rahmen des Projektes egePan-Unimed des Netzwerk Universitätsmedizin (NUM) wurde...

This paper provides a theoretical rationale for the simultaneous use of repression and democratic institutions by a non-democratic government, as is often observed in reality. We find that economic development has different impacts on the levels of repression and democracy, depending on whether it appears in the form of rises in income or in educat...

The connection between Pediatric Inflammatory Multisystem Syndrome (PIMS) and Kawasaki Disease (KD) is not yet fully understood. Using the same national registry, clinical features and outcome of children hospitalized in Germany, and Innsbruck (Austria) were compared. Reported to the registry were 395 PIMS and 69 KD hospitalized patients. Patient a...

Objectives Studies analysing colorectal resections usually focus on a specific outcome (eg, mortality) and/or specific risk factors at the individual (eg, comorbidities) or hospital (eg, volume) level. Comprehensive evidence across different patient safety outcomes, risk factors and patient groups is still scarce. Therefore the aim of this analysis...

Background: Quality indicators are frequently used to assess the performance of healthcare providers, in particular hospitals. Established approaches to the design of such indicators are subject to distortions due to indirect standardization and high variance of estimators. Indicators for geographical regions are rarely considered. Objectives: To d...

Background Treatment of cancer patients in certified cancer centers, that meet specific quality standards in term of structures and procedures of medical care, is a national treatment goal in Germany. However, convincing evidence that treatment in certified cancer centers is associated with better outcomes in patients with pancreatic cancer is stil...

Background The aim of this study was to describe and compare clinical characteristics and outcomes in critically ill septic patients with and without COVID-19. Methods From February 2020 to March 2021, patients from surgical and medical ICUs at the University Hospital Dresden were screened for sepsis. Patient characteristics and outcomes were asse...

Background Although clinical peer review is a well-established instrument for improving quality of care, clinical effectiveness is unclear. Methods In a pragmatic cluster randomised controlled trial, we randomly assigned 60 German Initiative Qualitätsmedizin member hospitals with the highest mortality rates in ventilated patients in 2016 to interv...

Despite the relevance of pressure ulcers (PU) in inpatient care, the predictive power and role of care-related risk factors (e.g. anesthesia) remain unclear. We investigated the predictability of PU incidence and its association with multiple care variables. We included all somatic cases between 2014 and 2018 with length of stay ≥ 2d in a German un...

Background Relationships between in-hospital mortality and case volume were investigated for various patient groups in many empirical studies with mixed results. Typically, those studies relied on (semi-)parametric statistical models like logistic regression. Those models impose strong assumptions on the functional form of the relationship between...

Background: The aim of this study was to describe and compare clinical characteristics and outcomes in critically ill septic patients with and without COVID-19. Methods: From February 2020 to March 2021, patients from surgical and medical ICUs at the University Hospital Dresden were screened for sepsis. Patient characteristics and outcomes were ass...

(1) Background: Targeted (TT) and immune checkpoint inhibitor (ICI) therapies have become available in the routine care of metastatic melanoma in recent years. (2) Objective: We compared mortality in patients with metastatic melanoma and different systemic therapies. (3) Methods: A retrospective cohort study, based on pseudonymized health insurance...

Despite the relevance of pressure ulcers (PU) in inpatient care, the predictive power and role of care-related risk factors (e.g. surgical anesthesia) remain unclear. We investigated the predictability of PU incidence and its association with multiple care variables. We included all somatic cases between 2014 and 2018 with length of stay ≥2 days in...

(1) Background: Targeted (TT) and immune checkpoint inhibitor (ICI) therapies have become available in the routine care of metastatic melanoma in recent years. (2) Objective: We compared mortality in patients with metastatic melanoma and different systemic therapies. (3) Methods: A retrospective cohort study, based on pseudonymized health insurance...

Background Long-term health sequelae of the coronavirus disease 2019 (COVID-19) are a major public health concern. However, evidence on post-acute COVID-19 syndrome (post COVID-19) is still limited, particularly for children and adolescents. Utilizing comprehensive healthcare data on more than 45 percent of the German population from January 2019 t...

Purpose Multimorbidity leads to decreasing health-related quality of life (HRQoL). Telemedicine may help to improve HRQoL. The present study was conducted to show (I) differences in HRQoL and changes in HRQoL over time in elderly, multimorbid individuals with and without depression and/or mild cognitive impairment (MCI) using a telemonitoring appli...

Hintergrund und Stand (inter)nationaler Forschung: Die stationäre Dekubitusinzidenz ist als alters-, geschlechts- und komorbiditätsadjustierter Indikator fester Bestandteil der externen Qualitätssicherung. Fragestellung und Zielsetzung: In dieser Arbeit wurde zusätzlich zu den bekannten Risikofaktoren der Zusammenhang zwischen Versorgungscharakter...

Background Total knee replacement (TKR) is one of the most commonly performed routine procedures in the world. Prognostic studies indicate that the number of TKR will further increase constituting growing burden on healthcare systems. There is also substantial regional heterogeneity in TKR rates within and between countries. Despite the known thera...

Background The standardized mortality ratio (SMR) is often used to assess and compare hospital performance. While it has been recognized that hospitals may differ in their SMRs due to differences in patient composition, there is a lack of rigorous analysis of this and other—largely unrecognized—properties of the SMR. Methods This paper proposes fi...

Due to increasing demand and scarce financial resources for healthcare, health system efficiency has become a major topic in political and scientific debates. While previous studies investigating determinants of health system efficiency focused primarily on economic and social influence factors, the role of the political regime has been neglected....

Background Prolonged ventilation is associated with a high risk of death. This study investigated both patient-level and hospital-level risk factors for in-hospital mortality in patients ventilated for more than 24 hours. Methods The analyses were conducted in the framework of a German national multicenter retrospective cohort study. Patient and h...

Objective To characterize the clinical features of children and adolescents hospitalized with SARS-CoV-2 infections and to explore predictors for disease severity. Design Nationwide prospective observational cohort study. Setting Data collected from 169 out of 351 childrens hospitals in Germany between March 18, 2020 and April 30, 2021 and comparis...

This paper examines the transnational dimensions of low-level conflict and state repression. In this regard, special emphasis is placed on the role of political regimes. Drawing on a simple model, we argue that democracy has opposing effects on conflict intensity. On one hand, democracy satisfies demand for political participation and thus reduces...

Angesichts der derzeitigen Impfstoffknappheit geht mit den bundesweiten Schutzimpfungen gegen COVID-19 die Notwendigkeit einer Priorisierung bestimmter Bevölkerungsgruppen einher. Basierend auf den Empfehlungen der STIKO sollen zunächst Personen mit besonders hohem Risiko für schwere oder tödliche COVID-19-Verläufe oder beruflicher Exposition geimp...

Aim The primary objective of the IMPRESS study is to assess the causal effects of the IQM peer review on mortality in patients ventilated > 24 h. Secondary analyses are conducted for mortality in patients with myocardial infarction, stroke, COPD, pneumonia, and the procedural provision of a colorectal resection. This article provides a description...

Hintergrund: Vor dem Hintergrund des demographischen Wandels steht das deutsche Gesundheitssystem vor der Herausforderung, eine gute Versorgung für eine große und stetig wachsende Anzahl an Krebspatienten zu gewährleisten. Als ein Instrument zur Sicherstellung und Verbesserung der Versorgungsqualität sieht der Nationale Krebsplan die einheitliche Z...

Introduction: Medical care of soft-tissue sarcoma (STS) and bone sarcoma (BS) patients in Germany has rarely been investigated. The objectives of this article were (1) to investigate medical care and survival in STS and BS patients, and (2) to examine methodological aspects of corresponding analyses based on administrative healthcare data. Method...

Background: The standardized mortality ratio (SMR) is often used to assess and compare hospital performance. While it has been recognized that hospitals may differ in their SMRs due to differences in patient composition, there is a lack of rigorous analysis of this and other - largely unrecognized - properties of the SMR. Methods: This paper propos...

Targeted therapies (TT) and immune checkpoint inhibitors (ICI) have become increasingly important in the treatment of metastatic malignant melanoma in recent years. We examined implementation and effectiveness of these new therapies over time in Germany with a focus on regional differences. We analyzed data from 12 clinical cancer registries in 8 f...

Kommunale Investitions­rückstände haben verschiedene Ursachen. Die zu Grunde liegenden Zusammen­hänge können dabei sehr komplex sein. Deshalb werden in der Analyse erstmalig Daten der amtlichen Statistik mit den Ergebnissen des KfW-Kommunal­panels kombiniert und anhand von Methoden maschinellen Lernens analysiert. Die ersten Ergebnisse zeigen, dass...

Background The conceptualization of hospital quality indicators usually includes some form of risk adjustment to account for hospital differences in case mix. For binary outcome variables like in-hospital mortality, frequently utilized risk adjusted measures include the standardized mortality ratio (SMR), the risk standardized mortality rate (RSMR)...

While most of the theoretical literature suggests that democracy promotes the provision of public goods, the findings of empirical studies are inconclusive. Drawing on a simple model, this paper aims at reconciling theory and evidence. We argue that the stronger dependence of more democratic governments upon public support has two opposing effects:...

Despite extensive research, there is no agreement on the value of the elasticity of substitution between capital and labour at the aggregate or the industrial level. Utilizing 2,419 estimates from 77 studies published between 1961 and 2017, this paper provides the first meta‐regression analysis for the US economy. We show that the heterogeneity in...

The present study determines removal rates (RR) of 56 pharmaceuticals and metabolites, respectively, in an urban sewage treatment plant using mass flow analysis by comparing influent and effluent loads over a consecutive ten-day monitoring period. Besides well investigated compounds like carbamazepine and metoprolol, less researched targets, such a...

Aim Nosocomial infections are an increasing risk worldwide, including in German hospitals. Methicillin-resistant Staphylococcus aureus (MRSA) infections are difficult to treat because of antibiotic resistances. The aim of this study is to gain insights into the relationship between MRSA and several characteristics of patients (individual level) and...

Based on regional prescription data several pharmaceuticals with variable amounts of prescription and corresponding metabolites were selected and analyzed in influent and effluent samples of the sewage treatment plant (STP) in Dresden, Germany. Pharmaceuticals of the following most prescribed therapeutic groups were chosen: antibiotics, antifungals...

Background The care of elderly people in need of maintenance and care is affected by demographic changes and therefore will increasingly gain importance. It will be a challenge to provide tailored and versatile care services for the respective target groups. In addition to the various burdens of inpatient geriatric care, nursing staff is faced with...

Hintergrund Neben den Belastungen, denen Pflegekräfte in der stationären Altenpflege ausgesetzt sind, kommen im Umgang mit dementen Menschen zusätzliche Herausforderungen auf die Pflegekräfte zu. Ziel der Arbeit Untersucht wurden die Unterschiede und Einflussfaktoren hinsichtlich der Angebote des betrieblichen Gesundheitsmanagements sowie deren Nut...

On the whole GDP growth is usually considered robust in the CIS-8. However, there are remarkable differences in the quality of growth performances between the countries in the region. These differences cast doubts on the sustainability of the recent growth performance in some Caspian/Caucasian countries. This paper tries to develop a basic understa...