Steffen Flessa
Biographic Data
| ID | 6330779 |
|---|---|
| NAME | Steffen Flessa |
| GIVEN NAMES | Steffen |
| FAMILY NAME | Flessa |
| SIGNATURE | FLESSA S |
| AFFILIATIONS | Universität Greifswald |
| ORCID | 0000-0002-4068-1539 |
| VERIFIED | Yes |
| TOTAL WORKS | 21 |
| TOTAL CITATIONS | 10 |
| AUTHOR COUNT | 21 |
| EDITOR COUNT | 0 |
| FIRST PUBLICATION YEAR | 1998 |
| LATEST PUBLICATION YEAR | 2025 |
| H-INDEX | 2 |
Toward a One Health Region
To establish a One Health Region, where human, animal, and environmental health are integrated into all decision-making processes, input from local stakeholders is essential. Their insights help identify the key transformation processes required for systemic change. Findings from Western Pomerania highlight the need to clarify the concept’s scope and enhance its relevance across various sectors.The One Health approach is crucial for addressing co…
Exploring health insurance as a financial buffer in Maternal and Child Health in the Democratic Republic of Congo
Digital-Health-Innovation im Ostseeraum
Sector-Wide Approach (SWAp) in Healthcare—A Mixed-Methods Assessment of Health SWAps in Nepal and Bangladesh
SWAps were an appropriate instrument of cooperation between the respective governments and EDPs for almost two decades. However, as the share of government budgets in the sector finance has strongly increased and the management capacity of the respective ministries has gone up, there will come a point in time where EDPs can focus more on financing and implementing innovations instead of standard care
Revisiting a decade of inequality in healthcare financial burden in Cambodia, 2009–19
Background Out-of-pocket healthcare expenditure (OOPHE) without adequate social protection often translates to inequitable financial burden and utilization of services. Recent publications highlighted Cambodia’s progress towards Universal Health Coverage (UHC) with reduced incidence of catastrophic health expenditure (CHE) and improvements in its distribution. However, departing from standard CHE measurement methods suggests a different storyline…
The impact of the health microinsurance M-Fund on the utilization of health services among migrant workers and their dependents in Thailand
The M-FUND health microinsurance was positively associated with the utilization of all major types of health services among migrant workers and their dependents in Thailand. For migrants, particularly vulnerable migrant workers and their dependents, the M-FUND appears to be a good approach to reducing barriers to health care. This study of the impact of health microinsurance for migrants provides important information for policy and program plann…
Viruses don't need a passport to affect labor markets – findings from a Polish-German study on combating unemployment during the Covid-19 pandemic
Labor markets have been strongly affected by the COVID-19 crisis. Much empirical evidence exists on how they operated since the COVID-19 outbreak, illustrated predominantly by public statistics. However, there is limited primary research on labor market stakeholders who experienced significant changes in border regions. The aim of this study is to explore the perceptions and experiences of labor market experts, especially entrepreneurs, regarding…
Health insurance uptake, poverty and financial inclusion in the Democratic Republic of Congo
This study estimates the prevalence of health insurance coverage and associated socioeconomic factors in the Democratic Republic of Congo (DRC). Using the nationally representative household survey of the 2017/2018 DRC Multiple Indicator Cluster Survey (MICS), we applied weighted logistic regression models to identify regions and subgroups with low health insurance coverage. The study's findings revealed a low insurance coverage of less than 5%, …
Sensitivity analysis and methodological choices on health-related impoverishment estimates in Cambodia, 2009–17
The measurement of health expenditure–related impoverishment as a proxy of financial risk protection is regularly used as an indicator of progress towards universal health coverage. However, the use of this indicator is greatly sensitive to analysts’ choices and data sources, making comparisons across time and countries challenging. We report the results of a sensitivity analysis of critical methodological choices in estimating health-related fin…
Strategic Management in Healthcare
Strategic management is becoming increasingly important for sustainable management in healthcare. The reasons for this can be seen in the increasing complexity, dynamics and uncertainty of the system's regimes and the resulting need for strategic thinking in a long-term period. The scientific discussion of this issue is the aim of the present analytical framework. The starting point is the definition of the term strategic management itself, follo…
Innovations in Health Care—A Conceptual Framework
Innovations are the source of all human development and improvement of quality of life. At the same time, they challenge existing standards, solutions and societal patterns. In health care in particular, innovations enable us to treat previously incurable diseases or to make better use of scarce resources. However, they also make existing health care technologies obsolete, force specialists to learn completely new methods and require high investm…
Costing of Cesarean Sections in a Government and a Non-Governmental Hospital in Cambodia—A Prerequisite for Efficient and Fair Comprehensive Obstetric Care
Knowing the cost of health care services is a prerequisite for evidence-based management and decision making. However, only limited costing data is available in many low- and middle-income countries. With a substantially increasing number of facility-based births in Cambodia, costing data for efficient and fair resource allocation is required. This paper evaluates the costs for cesarean section (CS) at a public and a Non-Governmental (NGO) hospit…
Sustainability of health systems research – a conceptional framework based on two projects
Background: Projects of health systems research frequently suffer from poor sustainability, i.e., the innovations generated in the project are not adopted as standards. As soon as project funding ends, the interest of researchers declines and the innovations will not make their way in the routine health care system. This failure is partly due to the fact that key partners of the project are very good researchers, but sustainability is not in the …
Making free public healthcare attractive
The findings suggest that HEF encompassing health centre and hospital services and complemented by additional interventions are better than stand-alone HEF in attracting sick HEFB to public health facilities and lowering out-of-pocket expenses associated with healthcare seeking
Equality in financial access to healthcare in Cambodia from 2004 to 2014
Since the end of its internal conflict in 1998, Cambodia has experienced tremendous developments in the social, economic and health sectors, with the government embarking on substantial reforms in health financing. Health equity funds that have improved access to public health services for poor people have gradually been extended to the entire country. Using the World Health Organization's methods for the analysis of healthcare expenditure and ho…
Economic Analysis of Perioperative Surgical Processes
Background: Improving clinical pathways, especially in operating rooms (OR), is important for the success of a hospital. Objectives: (a) To analyze time-related perioperative pathways; (b) to identify delays focusing on (i) anaesthesiological process-times, (ii) vacancy of the OR and (iii) the validity of the surgery-planning. Methods: A time study was conducted to assess perioperative processes. Accurateness, variation and duration of surgeries …
Reimbursement for Hospital-acquired Infections with Multidrug Resistant Organisms in German DRG System
Hospital-acquired infections (HAIs), especially caused by multidrug resistant organisms (MDROs) are one of significant cost drivers for healthcare systems worldwide, associated, inter alia, with additional costs for hospitals. An empirical study was conducted to analyse whether changes in German DRG system led to a better coverage of increased expenditure due to HAIs and the related prevention procedures. 784 patient records from six hospitals in…
Inpatient Dialysis in Germany – Financing and Economic Challenges
This paper shows the financing situation of inpatient dialysis in the German healthcare system from the providers' perspective. Due to two predominant financing options -Diagnosis Related Groups (DRGs) and additional charges -decision makers need knowledge on the revenue per treatment as well as arising economic challenges. The analysis explains the financing options, compares the revenue per treatment of both options and explains advantages, dis…
Determining the impacts of hospital cost-sharing on the uninsured near-poor households in Vietnam
Around 45% of hospital AFC was paid by DGS, the larger rest by UF. UF have become a great financial burden on the uninsured near-poor households, who have to pay for these out-of-pocket and therefore may not utilize even necessary services. If the rate of DGS were reduced, this would have the effect of increasing UF, but the savings to Government could be spent on subsidizing insurance to ensure that a larger part of the population can cover UF t…
Comparative cost analysis of insecticide-treated net delivery strategies
Insecticide-treated nets (ITNs) are effective in substantially reducing malaria transmission. Still, ITN coverage in sub-Saharan Africa (SSA) remains extremely low. Policy makers are concerned with identifying the most suitable delivery mechanism to achieve rapid yet sustainable increases in ITN coverage. Little is known, however, on the comparative costs of alternative ITN distribution strategies. This paper aimed to fill this gap in knowledge b…
The Costs of Hospital Services
The health care systems of many developing countries are facing a severe crisis. Problems of financing services leads to high patient fees which make institutions of Western health care unaffordable for the majority of the rural poor. The conflict between sustainability and affordability of the official health care system challenges both local decision-makers and health management consultants. Decisions must be made soon so that the existing heal…
Equality in financial access to healthcare in Cambodia from 2004 to 2014
Since the end of its internal conflict in 1998, Cambodia has experienced tremendous developments in the social, economic and health sectors, with the government embarking on substantial reforms in health financing. Health equity funds that have improved access to public health services for poor people have gradually been extended to the entire country. Using the World Health Organization's methods for the analysis of healthcare expenditure and ho…
Health insurance uptake, poverty and financial inclusion in the Democratic Republic of Congo
This study estimates the prevalence of health insurance coverage and associated socioeconomic factors in the Democratic Republic of Congo (DRC). Using the nationally representative household survey of the 2017/2018 DRC Multiple Indicator Cluster Survey (MICS), we applied weighted logistic regression models to identify regions and subgroups with low health insurance coverage. The study's findings revealed a low insurance coverage of less than 5%, …
Viruses don't need a passport to affect labor markets – findings from a Polish-German study on combating unemployment during the Covid-19 pandemic
Labor markets have been strongly affected by the COVID-19 crisis. Much empirical evidence exists on how they operated since the COVID-19 outbreak, illustrated predominantly by public statistics. However, there is limited primary research on labor market stakeholders who experienced significant changes in border regions. The aim of this study is to explore the perceptions and experiences of labor market experts, especially entrepreneurs, regarding…
Comparative cost analysis of insecticide-treated net delivery strategies
Insecticide-treated nets (ITNs) are effective in substantially reducing malaria transmission. Still, ITN coverage in sub-Saharan Africa (SSA) remains extremely low. Policy makers are concerned with identifying the most suitable delivery mechanism to achieve rapid yet sustainable increases in ITN coverage. Little is known, however, on the comparative costs of alternative ITN distribution strategies. This paper aimed to fill this gap in knowledge b…
The Costs of Hospital Services
The health care systems of many developing countries are facing a severe crisis. Problems of financing services leads to high patient fees which make institutions of Western health care unaffordable for the majority of the rural poor. The conflict between sustainability and affordability of the official health care system challenges both local decision-makers and health management consultants. Decisions must be made soon so that the existing heal…
The Costs of Hospital Services
The health care systems of many developing countries are facing a severe crisis. Problems of financing services leads to high patient fees which make institutions of Western health care unaffordable for the majority of the rural poor. The conflict between sustainability and affordability of the official health care system challenges both local decision-makers and health management consultants. Decisions must be made soon so that the existing heal…
Comparative cost analysis of insecticide-treated net delivery strategies
Insecticide-treated nets (ITNs) are effective in substantially reducing malaria transmission. Still, ITN coverage in sub-Saharan Africa (SSA) remains extremely low. Policy makers are concerned with identifying the most suitable delivery mechanism to achieve rapid yet sustainable increases in ITN coverage. Little is known, however, on the comparative costs of alternative ITN distribution strategies. This paper aimed to fill this gap in knowledge b…
Determining the impacts of hospital cost-sharing on the uninsured near-poor households in Vietnam
Around 45% of hospital AFC was paid by DGS, the larger rest by UF. UF have become a great financial burden on the uninsured near-poor households, who have to pay for these out-of-pocket and therefore may not utilize even necessary services. If the rate of DGS were reduced, this would have the effect of increasing UF, but the savings to Government could be spent on subsidizing insurance to ensure that a larger part of the population can cover UF t…
Economic Analysis of Perioperative Surgical Processes
Background: Improving clinical pathways, especially in operating rooms (OR), is important for the success of a hospital. Objectives: (a) To analyze time-related perioperative pathways; (b) to identify delays focusing on (i) anaesthesiological process-times, (ii) vacancy of the OR and (iii) the validity of the surgery-planning. Methods: A time study was conducted to assess perioperative processes. Accurateness, variation and duration of surgeries …
Reimbursement for Hospital-acquired Infections with Multidrug Resistant Organisms in German DRG System
Hospital-acquired infections (HAIs), especially caused by multidrug resistant organisms (MDROs) are one of significant cost drivers for healthcare systems worldwide, associated, inter alia, with additional costs for hospitals. An empirical study was conducted to analyse whether changes in German DRG system led to a better coverage of increased expenditure due to HAIs and the related prevention procedures. 784 patient records from six hospitals in…
Inpatient Dialysis in Germany – Financing and Economic Challenges
This paper shows the financing situation of inpatient dialysis in the German healthcare system from the providers' perspective. Due to two predominant financing options -Diagnosis Related Groups (DRGs) and additional charges -decision makers need knowledge on the revenue per treatment as well as arising economic challenges. The analysis explains the financing options, compares the revenue per treatment of both options and explains advantages, dis…
Making free public healthcare attractive
The findings suggest that HEF encompassing health centre and hospital services and complemented by additional interventions are better than stand-alone HEF in attracting sick HEFB to public health facilities and lowering out-of-pocket expenses associated with healthcare seeking
Equality in financial access to healthcare in Cambodia from 2004 to 2014
Since the end of its internal conflict in 1998, Cambodia has experienced tremendous developments in the social, economic and health sectors, with the government embarking on substantial reforms in health financing. Health equity funds that have improved access to public health services for poor people have gradually been extended to the entire country. Using the World Health Organization's methods for the analysis of healthcare expenditure and ho…
Sustainability of health systems research – a conceptional framework based on two projects
Background: Projects of health systems research frequently suffer from poor sustainability, i.e., the innovations generated in the project are not adopted as standards. As soon as project funding ends, the interest of researchers declines and the innovations will not make their way in the routine health care system. This failure is partly due to the fact that key partners of the project are very good researchers, but sustainability is not in the …
Costing of Cesarean Sections in a Government and a Non-Governmental Hospital in Cambodia—A Prerequisite for Efficient and Fair Comprehensive Obstetric Care
Knowing the cost of health care services is a prerequisite for evidence-based management and decision making. However, only limited costing data is available in many low- and middle-income countries. With a substantially increasing number of facility-based births in Cambodia, costing data for efficient and fair resource allocation is required. This paper evaluates the costs for cesarean section (CS) at a public and a Non-Governmental (NGO) hospit…
Innovations in Health Care—A Conceptual Framework
Innovations are the source of all human development and improvement of quality of life. At the same time, they challenge existing standards, solutions and societal patterns. In health care in particular, innovations enable us to treat previously incurable diseases or to make better use of scarce resources. However, they also make existing health care technologies obsolete, force specialists to learn completely new methods and require high investm…
Sensitivity analysis and methodological choices on health-related impoverishment estimates in Cambodia, 2009–17
The measurement of health expenditure–related impoverishment as a proxy of financial risk protection is regularly used as an indicator of progress towards universal health coverage. However, the use of this indicator is greatly sensitive to analysts’ choices and data sources, making comparisons across time and countries challenging. We report the results of a sensitivity analysis of critical methodological choices in estimating health-related fin…
Strategic Management in Healthcare
Strategic management is becoming increasingly important for sustainable management in healthcare. The reasons for this can be seen in the increasing complexity, dynamics and uncertainty of the system's regimes and the resulting need for strategic thinking in a long-term period. The scientific discussion of this issue is the aim of the present analytical framework. The starting point is the definition of the term strategic management itself, follo…
Viruses don't need a passport to affect labor markets – findings from a Polish-German study on combating unemployment during the Covid-19 pandemic
Labor markets have been strongly affected by the COVID-19 crisis. Much empirical evidence exists on how they operated since the COVID-19 outbreak, illustrated predominantly by public statistics. However, there is limited primary research on labor market stakeholders who experienced significant changes in border regions. The aim of this study is to explore the perceptions and experiences of labor market experts, especially entrepreneurs, regarding…
Health insurance uptake, poverty and financial inclusion in the Democratic Republic of Congo
This study estimates the prevalence of health insurance coverage and associated socioeconomic factors in the Democratic Republic of Congo (DRC). Using the nationally representative household survey of the 2017/2018 DRC Multiple Indicator Cluster Survey (MICS), we applied weighted logistic regression models to identify regions and subgroups with low health insurance coverage. The study's findings revealed a low insurance coverage of less than 5%, …
Digital-Health-Innovation im Ostseeraum
Sector-Wide Approach (SWAp) in Healthcare—A Mixed-Methods Assessment of Health SWAps in Nepal and Bangladesh
SWAps were an appropriate instrument of cooperation between the respective governments and EDPs for almost two decades. However, as the share of government budgets in the sector finance has strongly increased and the management capacity of the respective ministries has gone up, there will come a point in time where EDPs can focus more on financing and implementing innovations instead of standard care
Revisiting a decade of inequality in healthcare financial burden in Cambodia, 2009–19
Background Out-of-pocket healthcare expenditure (OOPHE) without adequate social protection often translates to inequitable financial burden and utilization of services. Recent publications highlighted Cambodia’s progress towards Universal Health Coverage (UHC) with reduced incidence of catastrophic health expenditure (CHE) and improvements in its distribution. However, departing from standard CHE measurement methods suggests a different storyline…
The impact of the health microinsurance M-Fund on the utilization of health services among migrant workers and their dependents in Thailand
The M-FUND health microinsurance was positively associated with the utilization of all major types of health services among migrant workers and their dependents in Thailand. For migrants, particularly vulnerable migrant workers and their dependents, the M-FUND appears to be a good approach to reducing barriers to health care. This study of the impact of health microinsurance for migrants provides important information for policy and program plann…
Toward a One Health Region
To establish a One Health Region, where human, animal, and environmental health are integrated into all decision-making processes, input from local stakeholders is essential. Their insights help identify the key transformation processes required for systemic change. Findings from Western Pomerania highlight the need to clarify the concept’s scope and enhance its relevance across various sectors.The One Health approach is crucial for addressing co…
Exploring health insurance as a financial buffer in Maternal and Child Health in the Democratic Republic of Congo
Business (17 works) · Medicine (15 works) · Economics (14 works) · Economic growth (12 works) · Global Maternal and Child Health (11 works) · Health care (11 works) · Healthcare Systems and Reforms (9 works) · Environmental health (8 works) · Global Health Care Issues (6 works) · Demographic economics (4 works)