Gesundheitswesen最新文献

{"title":"[Promoting cooperation between public health services and academic institutions in research: Experiences from the BMG-funded collaborative research project Infektionsschutz.Neu.Gestalten (I.N.Ge)].","authors":"Anja Herrmann, Emily Piontkowski, Gottfried Roller, Stefan Brockmann, Fabian Nill, Kersten Wolfers, Susanne Minkwitz, Jana Hailer, Uwe Stengele, Peter Schäfer, Pierre Braun, Nadja Oster, Stefanie Joos, David Häske, Brigitte Joggerst, Monika A Rieger","doi":"10.1055/a-2637-3372","DOIUrl":"https://doi.org/10.1055/a-2637-3372","url":null,"abstract":"<p><p>The 2018 mission statement of the ÖGD emphasises the importance of scientific research and cooperation with scientific institutions. In 2020, the Federal Ministry of Health (BMG) took up this aspect in a call for proposals to strengthen cooperation between the ÖGD and public health research. In the context of this call, the research network 'Infektionsschutz.Neu.Gestalten (I.N.Ge)' was established with four health authorities and one university (funding period: 09/2021-08/2024). The aim was to improve the evidence-based work of the ÖGD in the field of health and infection protection. Digitalisation, quality assurance, risk communication and special groups were examined using the example of infection control in the COVID-19 pandemic. A participatory, transformative approach with real-world laboratories and experiments was used. Lessons for successful cooperation between public health and university institutions were drawn from the intensive collaboration. Important were appropriate frameworks, targeted resource planning and clear role definitions. Issues were identified that could make future collaboration more effective and sustainable. The resulting recommendations for action are intended, among other things, to support the conception of joint research projects. I.N.Ge showed that improved framework conditions were necessary for increased cooperation. Funding projects should allow for flexible cooperation models that adapt to the specific resources and competencies of the partners. Forward-looking resource planning was determined to be essential - including job calculations, substitution arrangements and additional capacity for induction or methodological adaptation. Clear roles and responsibilities should be defined at the tendering stage to create transparency and optimise implementation. I.N.Ge emphasized the need to promote cooperation between the ÖGD and academic institutions in order to further develop and strengthen the public health service. I.N.Ge emphasises that cooperation between the ÖGD and academic institutions must be encouraged in order to further develop and strengthen the ÖGD.</p>","PeriodicalId":47653,"journal":{"name":"Gesundheitswesen","volume":" ","pages":""},"PeriodicalIF":0.7,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144668709","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Setting up of practices by general practitioners in Bavaria with a special focus on bureaucratic processes].","authors":"Fabian Walter, Katharina Maier, Marco Roos, Klara Lorenz-Dant","doi":"10.1055/a-2637-3305","DOIUrl":"https://doi.org/10.1055/a-2637-3305","url":null,"abstract":"<p><p>The demand for GP care is increasing while the number of GPs is decreasing. We investigated how GPs perceive bureaucracy during the process of establishing their own practice and how this perception changes with increasing establishment experience.Physicians who wished to set up a practice or who were in the process of setting up a practice and those who, up to two years and two to five years previously, had set up a GP practice were interviewed digitally following an interview guide. The recordings were transcribed verbatim and analysed using Braun & Clarkes Thematic Analysis.The 18 interviewees identified \"bureaucracy\" in various areas unrelated to patient care. A habituation effect occurs after the practice has been established. Resources for coping with bureaucratic challenges were mentioned.The participants define bureaucracy as any activity that is distant from the patient. Dealing with this should be made easier despite the habituation that occurs. Electronic processes and support through advice can help to overcome bureaucratic hurdles, and positive examples mentioned should be systematised. GPs view bureaucracy as a hurdle to setting up a practice, but it does not influence their decision to establish their own practice. Therefore, while still relevant, bureaucracy is found to be less important than previous research suggests.</p>","PeriodicalId":47653,"journal":{"name":"Gesundheitswesen","volume":" ","pages":""},"PeriodicalIF":0.7,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144668710","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Anonymization of general practitioners' electronic medical records in two research datasets].","authors":"Johannes Hauswaldt, Roland Groh, Knut Kaulke, Falk Schlegelmilch, Alireza Zarei, Eva Hummers","doi":"10.1055/a-2624-0084","DOIUrl":"https://doi.org/10.1055/a-2624-0084","url":null,"abstract":"<p><p>A dataset can be called \"anonymous\" only if its content cannot be related to a person, not by any means and not even <i>ex post</i> or by combination with other information. Free text entries highly impede \"factual anonymization\" for secondary research. Using two source datasets from GPs' electronic medical records (EMR), we aimed at de-identification in an iterative and systematic search for potentially identifying field content (PIF).EMR data of 14,285 to 100 GP patients with 40 variables (parameters, fields) in 5,918,321 resp. 363,084 data lines were analyzed at four levels: field labels, their combination, field content, dataset as a whole. Field labels were arranged into eleven semantic groups according to field type, their frequencies examined and their combination evaluated by GP experts rating the re-identification risk. Iteratively we searched for free text PIFs and masked them for the subsequent steps. The ratio of PIF data lines' number over total number yielded final probability estimators. In addition, we processed a whole dataset using ARX open source software for anonymizing sensitive personal data. Results were evaluated in a data protection impact assessment according to article 35 GDPR, with respect to the severity of privacy breach and to its estimated probability.We found a high risk of re-identification with free text entries into \"history\", \"current diagnosis\", \"medication\" and \"findings\" even after repeated algorithmic text-mining and natural language processing. Scrupulous pre-selection of variables, data parsimony, privacy by design in data processing and measures described here may reduce the risk considerably, but will not result in a \"factually anonymized\" research dataset.To identify and assess re-identifying field content is mandatory for privacy protection but anonymization can be reached only partly by reasonable efforts. Semantic structuring of data is pre-conditional but does not help with erroneous entries.</p>","PeriodicalId":47653,"journal":{"name":"Gesundheitswesen","volume":" ","pages":""},"PeriodicalIF":0.7,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144638436","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Health security, politics and responsibility. Acceptance speech by the award winner and laudatory speech for the award of the Johann Peter Frank Medal 2025].","authors":"Johannes Donhauser","doi":"10.1055/a-2652-1101","DOIUrl":"https://doi.org/10.1055/a-2652-1101","url":null,"abstract":"","PeriodicalId":47653,"journal":{"name":"Gesundheitswesen","volume":" ","pages":""},"PeriodicalIF":0.7,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144601946","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-term survival after treatment in certified lung cancer centers and not certified hospitals: Results of a large German cohort study using clinical routine data.","authors":"Vinzenz Völkel, Michael Gerken, Kees Kleihues-van Tol, Olaf Schoffer, Veronika Bierbaum, Christoph Bobeth, Martin Roessler, Torsten Blum, Frank Griesinger, Christian Günster, Judith Hansinger, Jochen Schmitt, Monika Klinkhammer-Schalke","doi":"10.1055/a-2624-0160","DOIUrl":"https://doi.org/10.1055/a-2624-0160","url":null,"abstract":"<p><p>Lung cancer represents the second most frequent tumor entity worldwide with an increasing number of patients treated in specialized centers. The aim of the WiZen study was to find out whether treatment at hospitals certified by the German Cancer Society (GCS) was associated with long-term survival benefits.Data for this cohort study was derived from the largest German statutory health insurance (SHI) AOK, four regional population-based clinical cancer registries (CCR), and standardized hospital quality reports. The analyses were based on 173,999 incident lung cancer patients in the SHI dataset and 35,702 patients in the CCR dataset who received primary treatment for lung cancer (ICD-10-GM C33, C34, D38.1) between 2009 and 2017.Distributions of age, sex, comorbidities, and most tumor characteristics were similar among patients treated in certified and non-certified hospitals. The Kaplan-Meier estimator for 5-year overall survival was 28.0% for patients from certified and 16.9% from non-certified hospitals (SHI data; CCR data: 21.4% vs. 13.6%). Cox-regression adjusting for relevant confounders yielded hazard ratios of 0.97 (SHI data; 95%CI 0.94, 1.00) and 0.85 (CCR data; 95%CI 0.82, 0.88) for all-cause mortality. The adjusted hazard ratio for recurrence-free survival (CCR data, UICC stage I-III, R0 only) was 0.82 (95%CI 0.75, 0.90).The presented analyses show that treatment in certified lung cancer centers is associated with relevant survival benefits and should therefore be supported.</p>","PeriodicalId":47653,"journal":{"name":"Gesundheitswesen","volume":" ","pages":""},"PeriodicalIF":0.7,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144592672","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[UV protection in climate change: health policy relevance and necessary framework conditions].","authors":"Yvonne de Buhr, Inga-Marie Hübner, Eckhard Wilhelm Breitbart","doi":"10.1055/a-2623-3832","DOIUrl":"10.1055/a-2623-3832","url":null,"abstract":"<p><p>Skin cancer is the most common type of cancer in Germany. Over 330,000 new cases are diagnosed every year and the trend is rising. The main risk factor for the development of skin cancer is UV radiation. Higher temperatures, more hot days, more extreme weather events as well as increase in UV radiation are expected throughout Germany in the future. The federal government has therefore passed the Federal Climate Adaptation Act, which obliges the federation, federal states and local authorities to deal with the consequences of climate change and to plan adaptation measures. Particular attention is paid to human health, with the reduction of heat stress and UV-related diseases such as skin cancer being prioritized. Priming the population should be prepared for heat and UV radiation by 2030. In order to develop effective strategies, cooperation between science, politics and practice is necessary. The UV-protection colloquium brought together various stakeholders to exchange current findings and define strategies. It was concluded that a joint commitment at all levels is necessary in order to integrate UV protection into climate adaptation strategies. Concrete suggestions for municipal UV protection included making the UV index visible, creating shaded areas, adapting daily routines to avoid UV exposure at peak times and comprehensive information campaigns. These measures can help to significantly reduce UV exposure among the public. For successful implementation, various stakeholders must cooperate to raise awareness of UV protection and protect the health of the population. It is crucial that UV protection is considered indispensable in the development of heat protection measures and is incorporated into all municipal climate adaptation strategies. An integrated approach should be developed to replace existing individual measures where appropriate.</p>","PeriodicalId":47653,"journal":{"name":"Gesundheitswesen","volume":" ","pages":""},"PeriodicalIF":0.7,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144162910","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Increasing the efficiency of remote delegated home visits in a rural region of Bavaria: interim results of the VERSORGT am ORT study].","authors":"Reiner Hofmann, Romina Lörzing, Martin Emmert, Julia Bräuer","doi":"10.1055/a-2620-5842","DOIUrl":"https://doi.org/10.1055/a-2620-5842","url":null,"abstract":"<p><p>Against the background of increasing problems in the provision of medival care in rural regions, the further development of outpatient medical concepts focussing on the imperative of economic efficiency and economy is essential. The delegation of medical tasks to medical assistants (MFA) offers a promising approach to relieve the burden on GPs and to support the provision of sustainable care. The 'VERSORGT am ORT' (VaO) project develops this principle and aims to reduce working hours away from patients by partially shifting delegated home visits to specialised care rooms without compromising the quality of care.Parameters for evaluating the VaO concept were quality of life (LQ) and satisfaction (PZ) of patients through standardized questionnaires, time spent away from patients and distance travelled. An initial data analysis from May 2024 to May 2025 compared the standard in the form of home visits (home visit /HB scenario) with partial transfer to VaO rooms according to the VaO model (VaO scenario) using paired t-tests over two survey time points.The n=134 data sets analysed showed significant differences in favour of the VaO model in the scenario comparison. The mean differences for travel time were MW=1.89 [min], travel time MW=2.79 [min], set-up time MW=0.63 [min], total time MW=5.32 [min] and kilometres travelled MW=1.89 [km] with p-values<0.001. Overall, a 20.9% reduction in working time away from the patient from 25.32 to 20.01 min and a 7.8% reduction in kilometres travelled from 13.34 to 12.30 km were achieved. The psychological component of the patients' LQ improved significantly from MW=52.94 to MW=57.27. The physical sum scale increased slightly from MW=41.01 to MW=43.94. Satisfaction remained almost unchanged.These results indicate that the VaO system can significantly increase the efficiency of GP care in rural areas. Despite a small absolute difference in the figures, the relative comparison already shows the potential and the increased efficiency of this innovative form of care. In addition, the interim evaluation shows that the concept does not lead to negative effects on QoL and patient satisfaction. An expansion to other regions and an in-depth analysis of the outcome parameters in further studies are recommended.</p>","PeriodicalId":47653,"journal":{"name":"Gesundheitswesen","volume":" ","pages":""},"PeriodicalIF":0.7,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144592671","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Patient and population participation in the healthcare system: On the (im)possibility of a comprehensive survey].","authors":"Daniela Rojatz, Anna-Kristina Wahl","doi":"10.1055/a-2606-2053","DOIUrl":"https://doi.org/10.1055/a-2606-2053","url":null,"abstract":"<p><p>In its resolution on social participation, the World Health Assembly called on member states to involve patients and the population in decision-making processes in the healthcare system. Furthermore, the resolution calls for the monitoring of participation processes. The survey of examples of participation in the context of health, which was carried out in 2023, comes closest to such monitoring for Austria. The article summarises lessons learned from the survey.The learning experiences are based on the analysis of process-produced data from a questionnaire survey on examples of patient and population participation in the healthcare system commissioned by the Federal Ministry of Social Affairs, Health, Care and Consumer Protection in Austria. Data included were pretest results, workshop protocols to reflect on the survey instrument and results as well as limitations in the survey report. The contents of the documents included were paraphrased and analysed thematically.The results of the questionnaire survey showed that central to the planning and implementation of a survey were (1) the objective of the survey, including clarification of the objective and the areas to be covered, (2) the target group, including clarification of the target group and requirements adapted to it, and (3) reaching the target group, including motivators, choice of words and dissemination channels. The learning experiences were summarised in ten key questions for the development of similar survey instruments.A survey of examples of participation is possible and provides an overview of which groups are involved in which areas and how. Without concrete specifications as to which groups should be involved, the survey remains exploratory and does not allow any conclusions to be drawn about representativeness. The design of the survey is also caught between breadth (short questionnaire with potentially high response rate) and depth (long questionnaire with lower response rate). The checklist presented here is intended to support similar surveys. Without an orientation framework as to where participation should take place and who acts as the contact person for these processes, such surveys remain exploratory.</p>","PeriodicalId":47653,"journal":{"name":"Gesundheitswesen","volume":" ","pages":""},"PeriodicalIF":0.7,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144555306","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mentor, driving force and companion for healthcare research.","authors":"Thomas Bierbaum, Martin Härter, Wolfgang Hoffmann, Jochen Schmitt","doi":"10.1055/a-2597-5739","DOIUrl":"https://doi.org/10.1055/a-2597-5739","url":null,"abstract":"","PeriodicalId":47653,"journal":{"name":"Gesundheitswesen","volume":" ","pages":""},"PeriodicalIF":0.7,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144555307","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[WHO clinical practice guidelines for influenza: an update].","authors":"Jana Meixner, Barbara Nußbaumer-Streit, Isolde Sommer","doi":"10.1055/a-2571-3357","DOIUrl":"10.1055/a-2571-3357","url":null,"abstract":"<p><p>Every year, more than one billion people around the world are infected with influenza, an acute infection of the respiratory tract. Influenza spreads from person to person through air, contaminated hands or objects. Antiviral and immunomodulatory drugs are available for treatment of patients and prophylaxis of exposed persons. Reverse transcription polymerase chain reaction (RT-PCR), nucleic acid amplification tests (NAATs) and rapid tests are available for the diagnosis of influenza. Objective The aim of this World Health Organization (WHO) guideline is to provide recommendations for the diagnosis, drug treatment and prophylaxis of influenza.This updated guideline has been developed in accordance with standards for trustworthy guidelines. The recommendations are based on systematic reviews on safety and effectiveness. They take into account the magnitude of benefits and harms of treatments, the reliability of the evidence, and the needs of patients and healthcare professionals.For non-severe influenza, there is a conditional recommendation to use baloxavir if the risk of severe illness is high. Antivirals are not recommended if the risk is low. There is also a strong recommendation against the use of antibiotics if bacterial co-infection is unlikely. Oseltamivir is conditionally recommended for severe influenza. Not recommended are peramivir and zanamivir, as well as macrolide antibiotics (in the absence of co-infection), mTOR inhibitors and plasma therapy, and corticosteroids. Baloxavir and oseltamivir are conditionally recommended for prophylaxis in asymptomatic persons who have been exposed to seasonal influenza viruses and would be at very high risk of becoming hospitalised. For zoonotic influenza, laninamivir and zanamivir are also conditionally recommended in addition to baloxavir and oseltamivir, regardless of individual risk. For diagnosis, the use of NAAT or digital immunoassay (DIA) for suspected non-severe influenza and nucleic acid amplification test (NAAT) for suspected severe influenza is recommended.</p>","PeriodicalId":47653,"journal":{"name":"Gesundheitswesen","volume":" ","pages":"484-486"},"PeriodicalIF":0.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143765393","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}