Gesundheitswesen最新文献

{"title":"[Profile of clients who attended the STI counseling services of the Ludwigsburg Health Department from 2019 to 2024: A retrospective cross-sectional study].","authors":"Paulo Roberto Sokoll, Christine Oexle, Dorothee Hoenes Duncan, Uschi Traub, Stephan Döring, Sonja Denjean, Karlin Stark","doi":"10.1055/a-2888-6360","DOIUrl":"10.1055/a-2888-6360","url":null,"abstract":"<p><strong>Introduction: </strong>Every day, more than one million people worldwide contract a sexually transmitted infection (STI). While most of these infections are asymptomatic, they can still cause long-term health issues. In 2024, approximately 3.259 new HIV cases were diagnosed in Germany alone. To detect new STI cases early and interrupt chains of infection, Germany's health departments offer anonymous STI counselling under Section 19 of the Infection Protection Act and state-specific health service laws.</p><p><strong>Objectives: </strong>This study aims to determine the profile of clients who have attended the Ludwigsburg Health Department's STI counselling services, as well as to analyse the proportion of STI diagnoses and the factors associated with them.</p><p><strong>Methods: </strong>This retrospective, cross-sectional study examined data from STI consultations at the Ludwigsburg Health Department between 2019 and 2024. First, a descriptive analysis was performed. The exact Fisher test was then used to examine associations between infections and sociodemographic and behavioural characteristics. Positivity rates for chlamydia and gonorrhoea were analysed across anatomical regions using a test for equality of proportions based on the chi-squared approximation. Paired comparisons of proportions with Bonferroni correction were then performed to investigate specific differences between affected anatomical regions. Temporal trends were analysed using the Cochran-Armitage test and the Mann-Kendall test. The significance level was set at p<0.05. All statistical analyses were performed using R software.</p><p><strong>Results and conclusion: </strong>A total of 9.440 tests were performed during 2.232 STI consultations, resulting in the diagnosis of 135 new infections. Chlamydia and gonorrhoea were the most prevalent infections, particularly among 18- to 29-year-olds and men who have sex with men (MSM). These findings underscore the need for targeted, low-threshold prevention strategies and sustained investment in STI prevention.</p>","PeriodicalId":47653,"journal":{"name":"Gesundheitswesen","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148151708","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":"Adaptations to Climate Change-Related Environmental Phenomena to Achieve Physical Activity Recommendations for Adults Aged 65 and Older.","authors":"Thomas Ernst Dorner, Christina Fastl, Sandra Haider, Matei Teodor Capatu, Kathrina Dankl, Verena Zeuschner, Maximilian Bastl, Sylvia Titze, Viktoria Stein","doi":"10.1055/a-2872-3795","DOIUrl":"https://doi.org/10.1055/a-2872-3795","url":null,"abstract":"<p><strong>Background: </strong>Regular physical activity promotes health, quality of life, and functional independence in older adults. However, climate change is leading to increasing environmental stressors such as heat, air pollution, and pollen exposure, which increase health risks and hinder adherence to physical activity recommendations. Older adults, particularly those with cardiovascular or respiratory conditions and pollen allergies, are especially affected. The aim of this project was to develop evidence-based recommendations to safely enable physical activity under climatically challenging conditions.</p><p><strong>Methods: </strong>The recommendations were developed through a three-step process: (1) a systematic online search of relevant guidelines, professional and governmental publications, and information from patient organisations; (2) an interdisciplinary expert workshop to refine and adapt recommendations for the target group; (3) a modified Delphi process with experts to finalise recommendations through multiple feedback rounds.</p><p><strong>Results: </strong>A total of 54 relevant articles published by 24 institutions were identified and compiled into a preliminary catalogue. The developed recommendations for heat, air pollution, and pollen exposure include: adaptation of activity according to timing and location (using climatically favourable time windows and indoor spaces), selection of appropriate intensity and types of exercise, breaks, hydration, sun protection, and self-monitoring of physiological warning signs. For individuals with pollen allergies, indoor activities, low-pollen locations, and the use of pollen forecasts are recommended. The recommendations provide practical guidance to maintain physical activity despite adverse environmental conditions.</p><p><strong>Conclusions: </strong>An evidence-based, systematic approach to complement physical activity recommendations with climate-change-related environmental stressors is feasible and necessary. Older adults can remain active, reduce health risks, and preserve independence. Tailored presentation and practical implementation of the recommendations represent the next crucial step.</p>","PeriodicalId":47653,"journal":{"name":"Gesundheitswesen","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148406282","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":"[\"Strong together\": Preparedness in German ports from the perspective of the stakeholders involved in the context of infection events].","authors":"Marie Frese, Julian Bäßler, Matthias Boldt, Martin Dirksen-Fischer, Lena Ehlers, Sarah Nikola Gueye, Volker Harth, Jan Heidrich","doi":"10.1055/a-2735-5866","DOIUrl":"10.1055/a-2735-5866","url":null,"abstract":"<p><strong>Background: </strong>Ports are the first interface with the local population in the event of infections on board ships. In addition to the health authorities, other stakeholders are also involved in the management of disease outbreaks or are affected by them through their activities at the port. An effective approach to outbreak prevention and management that takes all stakeholders into account is therefore crucial. This qualitative sub-study of the 'GESA - Healthy Ports, Strong Together' project analyses the needs of the stakeholders involved.</p><p><strong>Methods: </strong>As part of the GESA study, qualitative interviews were conducted with port medical services, port authorities, fire services, terminal operators, pilots and other relevant stakeholders in order to record structures and processes in five major German ports. Among other things, optimisation opportunities and fields of action were identified. The interviews were analyzed using a qualitative content analysis according to Mayring.</p><p><strong>Results: </strong>A total of 34 interviews were conducted, covering 13 different stakeholders. The needs were primarily expressed in the areas of emergency planning, interdisciplinary exchange, digitalisation, interfaces and information requirements in operations as well as training and further education.</p><p><strong>Conclusion: </strong>The GESA project makes an important contribution to disease prevention and management at ports, as the needs identified are directly incorporated into the development of an idealised process for infection management in German ports. The results will also be taken into account in the development of a training concept for the public health service.</p>","PeriodicalId":47653,"journal":{"name":"Gesundheitswesen","volume":" ","pages":"475-480"},"PeriodicalIF":1.1,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13345682/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145410452","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Mobility services in primary care: An overview of existing types of services and potentials for the German healthcare system].","authors":"Oliver Legler, Nina Ratschker, Verena Maier, Jule Hofmann, Thomas Ewert, Gunnar Geuter","doi":"10.1055/a-2800-6420","DOIUrl":"10.1055/a-2800-6420","url":null,"abstract":"<p><strong>Background: </strong>Current developments in Germany are leading to concentration processes of primary care services, which can result in longer distances or travel times, especially in rural areas. So far, there are only recommendations regarding the reasonableness of the effort to reach them. Nevertheless, there are increasing calls for efforts, for example, for people with limited mobility and chronic illnesses, to reduce potential access barriers. One discussion thread in recent years has been the further development of proactive and outreach primary care services. This includes discussions about mobile GP practices as well as specific transportation offers for patients to complement public transport and individual travel. However, the needs and significance of such offerings in the German healthcare system have hardly been investigated so far. The aim of this paper was to provide an overview of existing types of offerings, discuss them and highlight their potential for the German healthcare system.</p><p><strong>Methods: </strong>In addition to searching data banks to identify scientific publications, an internet search was conducted. Both national and international results were taken into consideration.</p><p><strong>Results: </strong>The identified approaches from the 21 included publications were clustered according to their types of offerings. The four clusters \"Independent mobile doctor's practice\", \"Mobile branch practice\", \"Specific transportation offers for patients as a complement to local transport\" and \"Brokerage services for patient transportation\" were identified. A closely coordinated approach of relevant actors with a participatory approach to consider different perspectives was proved to be beneficial in conception and implementation. In addition to legal hurdles, non-cost-covering economic aspects, often associated with the rather low use of the offers, proved to be inhibiting.</p><p><strong>Conclusion: </strong>Mobile doctor's offices and offers to supplement existing mobility options for patients can potentially reduce access barriers to local primary care, especially if they are part of an overall concept for multidisciplinary primary care and take into account the respective needs. To concretize the potential, scientific evaluation of pilot projects is recommended. Regional needs and requirements should be consistently taken into account.</p>","PeriodicalId":47653,"journal":{"name":"Gesundheitswesen","volume":" ","pages":"422-429"},"PeriodicalIF":1.1,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13345684/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146107791","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","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":"10.1055/a-2606-2053","url":null,"abstract":"<p><strong>Background: </strong>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.</p><p><strong>Methodology: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Discussion and conlcusion: </strong>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":"470-474"},"PeriodicalIF":1.1,"publicationDate":"2026-07-01","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":"[Extremism in medical treatment: Results of an e-learning training course for prevention].","authors":"Thea Rau, Sophia Mayer, Marius Stickel, Jörg M Fegert, Marc Allroggen","doi":"10.1055/a-2701-3883","DOIUrl":"10.1055/a-2701-3883","url":null,"abstract":"<p><strong>Background: </strong>Initial studies showed that healthcare professionals are confronted with patients with extremist attitudes and do not feel safe when dealing with these patients. With this in mind, an e-learning training programme on extremism was designed for healthcare professionals. The paper deals with the results of the accompanying research on this training programme.</p><p><strong>Methods: </strong>The data comes from a pre- and post-survey to evaluate the e-learning training course entitled 'Extremist attitudes in medical and psychotherapeutic treatment', which was designed for physicians and psychological psychotherapists. The data analyses include questions on knowledge and skills.</p><p><strong>Result: </strong>A total of 2,971 professionals took part in the pre- and post-survey. The findings showed a significant increase in learning among participants in the training programme in all eight areas of competence (confidentiality, areas of phenomena, legal principles, etc.). In addition, concerns and worries about dealing with potential threats were reduced and the participants felt more confident in dealing with potential patients from the extremist milieu after the training programme. However, there were still uncertainties, especially in dealing with dangerous situations.</p><p><strong>Conclusion: </strong>Training on the topic of extremism is effective in ensuring greater safety for medical professionals in dealing with these issues. Networking with experts in the field is recommended for certain issues.</p>","PeriodicalId":47653,"journal":{"name":"Gesundheitswesen","volume":" ","pages":"448-454"},"PeriodicalIF":1.1,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145439746","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":"[Gender-Specific Lethality in Myocardial Infarction: A Regional and Temporal Analysis].","authors":"Tatjana Dunkel, Ute Seeland","doi":"10.1055/a-2796-4998","DOIUrl":"10.1055/a-2796-4998","url":null,"abstract":"<p><strong>Background: </strong>Epidemiological indicators form the statistical basis for medical research questions and influence how the relevance of a research topic is perceived. Temporal, financial, and human resources are invested to improve healthcare based on empirical evidence. While indicators such as morbidity and mortality are widely reported and describe the number of disease and death cases in relation to the total population, lethality - defined as the proportion of deaths among those actually affected - receives far less attention. From a gender-sensitive perspective, knowledge of the 30-day lethality rate is essential to assess treatment outcomes in women and men. This raises the question of whether current data in Germany are sufficient to enable regional and temporal analyses of lethality among women and men following myocardial infarction.</p><p><strong>Methods: </strong>A systematic PubMed search (PRISMA, 28 January 2025) identified publications (2017-2025) reporting sex-specific 28-day lethality after acute myocardial infarction (AMI). Evidence was assessed using the GRADE system. In addition, a secondary analysis of publicly available datasets (Destatis, MONICA/KORA, RHESA, GBE-Bund) was conducted. AMI cases were defined via ICD-10 I21.0-I21.9 (first infarctions). Results The search identified 18 relevant publications. Three studies of high methodological quality (AOK, MONICA/KORA, GBE-Bund) consistently showed higher 28-day lethality in women (RR 1.12-1.30), especially in individuals under 60 years; in older age groups, differences diminished. Marked regional disparities were observed, with higher lethality rates in eastern German states (e. g., Brandenburg 19%, Berlin 12%).</p><p><strong>Conclusion: </strong>These findings reveal a rudimentary data landscape regarding 30-day mortality after acute coronary syndrome or myocardial infarction. Known factors, such as earlier diagnosis in men, differences in risk profiles, and treatment disparities, can partly explain the observed trends. However, robust, evidence-based analyses and datasets enabling sex- and age-specific evaluations are lacking. Consistent inclusion of post-discharge follow-up data is essential to fully capture care quality and to develop targeted, gender-sensitive prevention and treatment strategies.</p>","PeriodicalId":47653,"journal":{"name":"Gesundheitswesen","volume":" ","pages":"430-440"},"PeriodicalIF":1.1,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146114512","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":"[Access to Digital Health Applications - Prescription by Physicians vs Patient Requests Made Directly to Health Insurance Companies: Interviews with Experts].","authors":"Godwin Giebel, Klemens Höfer, Pascal Raszke, Jürgen Wasem, Anna Bußmann, Sarah Schlierenkamp, Michael Minor, Carsten Volland, Udo Schneider, Enno Maaß, Josepha Katzmann, Carina Abels","doi":"10.1055/a-2800-1191","DOIUrl":"10.1055/a-2800-1191","url":null,"abstract":"<p><strong>Introduction: </strong>In Germany, Digital Health Applications (DiGA) can be prescribed for mental illnesses since 2020. Patients with statutory health insurance can access DiGA in two different ways. They can either be prescribed by a physician or psychotherapist or patients can request them directly from their health insurance company. The aim of the present study was to shed light on the different ways of access especially with regard to their actual implementation.</p><p><strong>Methods: </strong>Semistructured interviews were conducted with experts to investigate the current care situation with DiGA in the context of mental illnesses. The experts were representatives of patients, physicians and psychotherapists, statutory health insurance companies and DiGA manufacturers. The interviews were conducted online, recorded and transcribed. A qualitative content analysis according to Kuckartz was performed with MAXQDA.</p><p><strong>Results: </strong>A total of 13 expert interviews were conducted. Content analysis revealed three main topics: 1) relevance of direct authorization by the health insurance company, 2) implementation of direct authorization by the health insurance company, and 3) advantages and disadvantages of direct access. While direct access via the health insurance company played a minor role quantitatively, it has potential advantages such as a low threshold access or a greater patient autonomy. Disadvantages were seen in the transfer of therapeutic sovereignty from physicians and psychotherapists towards the health insurance companies. Problems were also seen in the lack of comprehensive therapy monitoring, inadequate diagnosis without or with inadequate consideration of contraindications, and additional effort on the part of health insurance companies.</p><p><strong>Conclusion: </strong>The direct application for statutory health insurance-funded services from health insurance companies marks a new approach in the German health care system. While there are good arguments for and against patient self-referral, the current implementation needs to be scrutinized. Because of the need for a current indication and the possible exclusion of contraindications, patients usually have to visit a doctor or psychotherapist anyway, which significantly limits the benefits. Under the current conditions, the way of prescription is usually associated with fewer problems.</p>","PeriodicalId":47653,"journal":{"name":"Gesundheitswesen","volume":" ","pages":"455-461"},"PeriodicalIF":1.1,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13345681/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148158655","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Pharmacists' use of embryotox.de in routine healthcare].","authors":"Ariane Wahliß, Anne Müller, Evelin Beck, Elisa Harms, Martina Breuning, Christine Holmberg, Christof Schaefer, Marlies Onken, Katarina Dathe","doi":"10.1055/a-2715-1040","DOIUrl":"10.1055/a-2715-1040","url":null,"abstract":"<p><strong>Background: </strong>Embryotox.de offers evidence-based information on drug safety during pregnancy and lactation free of charge and independent from pharmaceutical industry. There are more than five million users per year. Utilization of embryotox.de in routine healthcare was investigated in a mixed-methods study funded by the G-BA Innovation Fund. The following sub-analysis focuses on the use by pharmacists.</p><p><strong>Methods: </strong>User feedback was obtained by two different online questionnaires (multiple choice options or ratings on a Likert Scale ranging from 0 \"not at all\" to 10 \"completely\"). Questionnaire 1 included questions on user characteristics, clinical circumstances, comprehensibility and consequences of use, while questionnaire 2 asked about typical situations of use and applications of retrieved information. For this analysis, all questionnaires answered by pharmacists were evaluated using descriptive statistics.</p><p><strong>Results: </strong>A total of 550 pharmacists completed online questionnaire 1, 87.3% of whom (n=480/550) worked in community pharmacies. Medication for cough and cold symptoms (19.3%, n=106/550) and non-opioid analgesics (16.9%, n=93/550) were most frequently inquired. 57.1% (n=314/550) reported that their risk perception of a given drug had changed after reading the respective fact sheet. Pharmacists' mean rating of fact sheet comprehensibility was 9.25 (Likert scale from 0 to 10). 79 pharmacists completed online questionnaire 2. 93.7% (n=74/79) considered embryotox.de helpful for informing and, if necessary, reassuring worried patients. They also used embryotox.de to pass on selected information to patients (79.7%, n=63/79), to check prescription drugs before dispensing (57.0%, n=45/79) and to consult with prescribing doctors in cases of critical medications (58.2%, n=46/79).</p><p><strong>Conclusion: </strong>Community pharmacists obtain relevant information from embryotox.de on risk and safety of OTC and prescription drugs in pregnancy and lactation. Embryotox.de thus supports pharmacists in counselling pregnant and breastfeeding patients and ensuring safe and rational drug treatment.</p>","PeriodicalId":47653,"journal":{"name":"Gesundheitswesen","volume":" ","pages":"462-469"},"PeriodicalIF":1.1,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145558006","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":"[Outpatient intensive care - relevant aspects of care following personal on-site assessments by the Medical Service: A practical report].","authors":"Thomas Gaertner, Andreas Mappes, Moritz Rau, Ulfert Grimm, Annette Hoffmann-Götz, Patrick Schunda","doi":"10.1055/a-2711-1073","DOIUrl":"10.1055/a-2711-1073","url":null,"abstract":"<p><strong>Abstract: </strong>The new out-of-hospital intensive care (AKI) law, which is now included in social law, allows critically ill patients, most of whom are tracheostomy patients or require ventilation, to live a participatory life in a home environment as far as possible. As a service provided by statutory health insurance companies, it requires a special prescription from a statutory health insurance provider and, in the case of ventilated or tracheotomized patients, a qualified potential assessment for weaning and/or decannulation (removal of the tracheostomy tube). A mandatory assessment by the Medical Advisory Service (MAS) at the place of care is the basis for the health insurance company's decision for benefit approval. A secondary data analysis was carried out consisting of 1615 initial reports from the Hessian MAS of the first 17 months after the new regulations and requirements for AKI were implemented. Of the high proportion of tracheotomized patients (72.6%) of the total population, 27.7% received continuous or intermittent invasive ventilation. In 46.5% of cases, a potential assessment, which was mandatory at the time, was still pending. From a socio-medical perspective, in around 8.2% of all assessed cases, the AKI requirements were not met. The MAS assessment enables a more individual and differentiated picture of the special constellation according to ICF criteria with a view to the socio-medical necessity of AKI care. Furthermore, it helps to ensure adequate medical and nursing care on site and reviews any weaning potential that may have not been sufficiently exploited to this point.</p>","PeriodicalId":47653,"journal":{"name":"Gesundheitswesen","volume":" ","pages":"441-447"},"PeriodicalIF":1.1,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13345683/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145716257","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}