Gesundheitswesen最新文献

{"title":"[Structural Barriers to Implementation: Clinic-Initiated Dissemination Activities and Awareness of a Family-Centered Care Model Among Outpatient Professionals].","authors":"Philip Martin Kaczmarek, Silke Wiegand-Grefe, Silke Pawils","doi":"10.1055/a-2935-5938","DOIUrl":"https://doi.org/10.1055/a-2935-5938","url":null,"abstract":"<p><strong>Introduction: </strong>Evidence-based care models frequently fail to reach outpatient professionals as potential referrers. Previous analyses of CHIMPS-NET, a new family-centered care model implemented in German psychiatric clinics, showed that centrally organized information campaigns had no measurable effect on awareness among this group. The present study examines whether decentralized, clinic-initiated public relations efforts are associated with greater awareness of the care model.</p><p><strong>Methods: </strong>Data are drawn from a postal and electronic survey of outpatient professionals across 18 psychiatric clinic sites in Germany at follow-up. Following Proctor et al.'s taxonomy of implementation outcomes, reach/penetration was operationalized as binary awareness of the care among outpatient professionals. Clinic-initiated activities were categorized into three intensity levels (low, medium, high) by two blinded raters based on internal project documentation. Associations were examined using binary logistic regression.</p><p><strong>Results: </strong>Of 2,828 professionals contacted, 203 returned evaluable questionnaires (response rate 7.2%). Only 9.4% of respondents (19/203) reported awareness of CHIMPS-NET. Logistic regression revealed no significant association between public relations intensity and awareness (χ²(2)=0.411; p=0.814; Nagelkerke R²=0.003).</p><p><strong>Conclusion: </strong>Neither centrally nor decentrally organized dissemination efforts measurably increased awareness of the care model among outpatient professionals. The findings suggest that sustainable implementation requires structural approaches, such as embedding relevant criteria in clinical guidelines or creating billing-relevant incentives within the statutory health insurance system.</p>","PeriodicalId":47653,"journal":{"name":"Gesundheitswesen","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149026212","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":"[Calculation of Standardised Unit Costs in the Health and Social Care Sector for the Economic Evaluation of Mental Disorders - Results of the PECUNIA Project for Germany].","authors":"Louisa Kristin Muntendorf, Hans-Helmut König, Susanne Mayer, Michael Berger, Claudia Fischer, Nataša Perić, Paul Hinck, Judit Simon, Alexander Konnopka","doi":"10.1055/a-2951-8273","DOIUrl":"https://doi.org/10.1055/a-2951-8273","url":null,"abstract":"<p><strong>Background: </strong>Current unit costs (UC) for mental health interventions in the German health and social care sector lack a harmonized methodology, making cross-country cost comparisons challenging.</p><p><strong>Methods: </strong>Twenty-three UCs were calculated based on the harmonized cost collection methods of the PECUNIA project. UC were calculated according to the pre-defined measurement parameters from the PECUNIA questionnaire by means of literature and internet research, or direct correspondence with stakeholders. If UC could not be identified, proxies were used. UCs were, if necessary, adjusted for inflation to 2025 using consumer price index.</p><p><strong>Results: </strong>UCs were calculated for hospital, general practitioner, specialist, diagnostic imaging, dentist, informal care, ambulance, medical on-call service, emergency room, holistic health care, hospice, nursing home, assisted living, therapeutic living group, social worker, therapeutic day center, worry phone, online psychological support, vocational training, day support centers / workshop, inclusion company and company integration measure.</p><p><strong>Discussion & conclusion: </strong>Calculated UCs using the PECUNIA methodology allow international comparison of resource use in health and social care sector. The UCs update and complement the UCs for mental health in Germany published in 2017.</p>","PeriodicalId":47653,"journal":{"name":"Gesundheitswesen","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149026230","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":"[Working group on hygiene in home-intensive care].","authors":"Patrick Ziech, Kirsten Bollongino, Josefine Haak, Susanne Harpel, Irena Harsch, Axel Hofmann, Jens Jakisch, Susanne Jäger, Ursula Kaspar, Anna Kern, Claudia Kohlstock, Dragisa Mitic, Christine Radke, Jana Rapp, Mathias Sager, Anja Susann Schinzel, Antje Schmidt, Nora-Lynn Schwerdtner, Shilpi Sharma, Kristin Tessarek, Helge Wilhelm Thies, Manfred Vogt, Hong Wang, Kerstin Zeiske","doi":"10.1055/a-2871-6109","DOIUrl":"https://doi.org/10.1055/a-2871-6109","url":null,"abstract":"<p><strong>Abstract: </strong>In response to the amendment to the Infection Protection Act (IfSG), a working group established in 2019 focused on hygiene in non-hospital intensive care and developed standardized documents for public health departments across the states to guide the conduct of inspections. These documents are primarily intended to provide practical support to the relevant public health departments. In the future, the checklist is to be structured in a modular format and expanded to include additional content. A module for assessing building structures is currently in the planning stages.</p>","PeriodicalId":47653,"journal":{"name":"Gesundheitswesen","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149002746","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":"Aerobic physical activity and chronic diseases in Austrian adults aged 65 years and older: a model-based population attributable fraction study.","authors":"Christina Fastl, K Viktoria Stein, Willi Haas, Thomas E Dorner","doi":"10.1055/a-2870-5575","DOIUrl":"https://doi.org/10.1055/a-2870-5575","url":null,"abstract":"<p><strong>Introduction: </strong>Physical activity (PA) plays an important role in maintaining health and preventing chronic diseases, particularly among older adults. This study aimed to estimate the proportions of four major chronic diseases that could potentially be avoided if all older adults in Austria engaged in sufficient aerobic PA.</p><p><strong>Methods: </strong>Data from the 3,995 participants of the representative Austrian Health Interview Survey 2019 (ATHIS) aged 65+ years was analysed. Sufficient aerobic PA (minimum of 150 minutes moderate aerobic PA per week) was assessed using the European Health Interview Survey Physical Activity Questionnaire (EHIS-PAQ). Self-reported myocardial infarction or related health issues, stroke or resulting health problems, diabetes mellitus, and cancer were investigated as outcomes. Observed and counterfactual risks were estimated using survey-weighted logistic regression models, adjusted for sex, age, education, income, smoking status, and daily portions of fruits or vegetables. Model-based population attributable fractions (PAFs) were calculated from these predictions.</p><p><strong>Results: </strong>The recommendations for aerobic PA were fulfilled by 29.6% of participants. Model-based PAFs indicated that up to 46.6% (95% confidence interval (CI): 21.0 to 67.5%) of strokes, 40.8% (95% CI: 15.5 to 62.1%) of myocardial infarctions, and 35.8% (95% CI: 23.8 to 47.4%) of diabetes mellitus cases could possibly have been prevented if all participants fulfilled the recommendations for aerobic PA. The PAF for cancers (21.3%; 95% CI: -1.6 to 42.7%) was not statistically significant.</p><p><strong>Conclusions: </strong>Insufficient aerobic PA may account for substantial proportions of several chronic diseases in older Austrians. Given the cross-sectional study design and the possibility of reverse causality, the estimates should be interpreted as hypothetical upper bounds. Nonetheless, they underscore the importance of aerobic PA for disease prevention in older adults.</p>","PeriodicalId":47653,"journal":{"name":"Gesundheitswesen","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149002743","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":"[What is needed to improve telemedicine in rural areas? Action required and research gaps from the perspective of experts].","authors":"Tobias Mettenberger","doi":"10.1055/a-2904-5209","DOIUrl":"10.1055/a-2904-5209","url":null,"abstract":"<p><strong>Background: </strong>Telemedicine is considered to have a great potential for maintaining or improving healthcare provision in rural areas of Germany. However, there are often significant obstacles to the effective and efficient implementation of digital solutions. Beyond project-specific evaluations, knowledge about the opportunities and challenges posed by telemedicine in rural regions of Germany is still thin and scattered across different disciplinary discourses.</p><p><strong>Methods: </strong>The aim of the present study was to reconstruct and to relate the perspectives of experts working at the interface between research and practice and to identify the necessary practical improvements and new pathways of research to better use the potential of telemedicine in rural areas.</p><p><strong>Results: </strong>A total of 27 interviews with 33 individuals were conducted and potential for improvement at various levels was articulated as follows: Operational improvements were needed in specific treatment situations and work processes. Organisational and professional needs were found to be related to broader organisational and knowledge-related prerequisites for certain groups of doctors that would enable them to use telemedicine solutions effectively and efficiently. Structural and systemic requirements addressed the cooperative healthcare system and the regional diversity of Germany as a whole, as well as the level of fundamentally negotiable norms and values.</p><p><strong>Discussion: </strong>Key conclusions aim to embed needs-based telemedicine approaches into larger, integrated healthcare concepts, develop digital solutions together with users, and not lose sight of the limitations of digitalisation.</p>","PeriodicalId":47653,"journal":{"name":"Gesundheitswesen","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148907601","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":"Opportunities and Challenges of Routine Healthcare Data in Oncological Health Services Research in Germany.","authors":"Anika Kästner, Simone Gloystein, Kilson Moon, Kerstin Weitmann, Semaw Ferede Abera, Alexandra Stein, Fabian Kleinke, Anna Krauß, Neeltje van den Berg, Wolfgang Hoffmann","doi":"10.1055/a-2935-7861","DOIUrl":"https://doi.org/10.1055/a-2935-7861","url":null,"abstract":"<p><strong>Abstract: </strong>Routine healthcare data are becoming increasingly important for oncological health services research, as they enable population-based analyses based on routinely collected data. In particular, the combined use of different routine healthcare data sources, such as data from cancer registries in accordance with § 65c of the German Social Code, Book V, and claims data from statutory health insurance funds, offer significant potential for generating reliable evidence. The aim of this article is to describe practical experience related to data application, case selection, data preparation and analysis, and challenges and potential associated with the use of these routine healthcare data sources. To illustrate these insights, a research project funded by the Innovation Fund of the Joint Federal Committee is used as an example. As part of this intervention study evaluating a new model of care, an external routine healthcare data control arm was established based on cancer registry data and linked with claims data from statutory health insurance funds. Cancer registry data include valid information on diagnoses, tumor characteristics, treatment courses, and vital status and thus enable precise case selection; however, data completeness varies across regions. Claims data allow for the longitudinal and cross-sectoral analysis of treatment courses, but are limited in terms of clinical details, diagnostic accuracy, and therapy assignment. In particular, record linkage projects involving multiple routine healthcare data sources require time-consuming coordination and approval processes. Data preparation and analysis require detailed knowledge of the respective data structures and their limitations, as well as expertise in oncology and statistical methodology. The use of cancer registry and claims data linked at the person level enables comprehensive analyses of oncological long-term outcomes, care structures, and health economic aspects. At the same time, legal frameworks, data quality, and methodological complexity remain key challenges. With the introduction of the Health Data Utilization Act and the establishment of the Research Data Centre for Health, new opportunities are emerging for the use of routine healthcare data. The development of competencies among future users is a key prerequisite for generating valid and reliable research results.</p>","PeriodicalId":47653,"journal":{"name":"Gesundheitswesen","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148978421","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":"Community health research in the new German center for child and adolescent health.","authors":"Neeltje van den Berg, Samuel Tomczyk, Matthias Heckmann, Astrid Bertsche, Anna Lene Seidler, Corinna Bergelt, Julika Loss, Kirsten Minden, Julia Hauer, Volker Mall, Marc-André Weber, Almut Meyer-Bahlburg, Daniel Troitzsch, Ulrike Ravens-Sieberer, Holger N Lode, Jan Däbritz, Wolfram Mittelmeier, Martin Wabitsch, Reinhard Berner, Michael Kölch, Silke Schmidt","doi":"10.1055/a-2945-6211","DOIUrl":"10.1055/a-2945-6211","url":null,"abstract":"<p><strong>Abstract: </strong>The newly established German Center for Child and Adolescent Health has made Community Health Research one core focus area. It aims to understand and address the health-related needs and resources of children and adolescents within relevant developmental, regional, social and societal contexts. In the following, we will discuss the role of Community Health Research in addressing child and adolescent health. Additionally, we would like to shed light on how it adds to basic and applied research focused on specific conditions, describe the establishment and operational framework of this research area within the German Center for Child and Adolescent Health, and present a roadmap for the way ahead.</p>","PeriodicalId":47653,"journal":{"name":"Gesundheitswesen","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148841573","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":"[Discussion Paper DNVF-Forum 2025 - Approaches to a Good Last Year of Life Beyond Overuse, Underuse, and Misuse of Care - Ideas for Health Services Research, Policy, and Practice].","authors":"Kerstin Kremeike, Christoph Kowalski, Claudia Bausewein, Wolfgang Hoffmann, Rika Lützow, Ute Lewitzka, Kathleen Nducha-Lauer, Raymond Voltz, Birgit Weihrauch, Eva Winkler, Sylke Ruth Zeißig, Ulrich Wedding","doi":"10.1055/a-2918-6521","DOIUrl":"https://doi.org/10.1055/a-2918-6521","url":null,"abstract":"","PeriodicalId":47653,"journal":{"name":"Gesundheitswesen","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148971594","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":"Developing regional tailored health care targets on a federal level - a multi stage delphi process.","authors":"Julia Hoffmann, Andrea Feldhus, Dennis Häckl, Lorenz Harst, Ivonne Panchyrz, Leonie Sundmacher, Josephine Thiesen, Felix Walther, Ines Weinhold, Felix Wittmann, Jochen Schmitt","doi":"10.1055/a-2904-3017","DOIUrl":"https://doi.org/10.1055/a-2904-3017","url":null,"abstract":"<p><strong>Abstract: </strong>The development of regionally tailored healthcare goals and targets shared by all stakeholders is essential for a high-quality healthcare system. This study outlines the development of a generic framework for creating patient-centered, cross-sectoral healthcare targets, applying a multi-stage, hybrid Delphi process and using Saxony, Germany as an example. The process involved key stakeholders, including policymakers, healthcare providers, and patient representatives, and focused on two use cases: child and adolescent health and dementia. Through expert interviews, online surveys, and workshops, five thematic domains were identified: digitalization, patient orientation, cross-sectoral care, securing skilled workers, and health(-system) competence. A total of 15 healthcare targets were developed, addressing structural and process improvements at macro, meso, and micro levels. While digitalization targets were rated highest in alignment with SMART criteria, patient orientation targets showed room for improvement. The study highlights the importance of stakeholder consensus, measurable indicators, and iterative adjustments to ensure effective implementation. Despite challenges such as limited measurability and tight timelines, the results provide a transferable framework for developing healthcare targets that can guide strategic planning and resource allocation. This approach contributes to optimizing healthcare delivery and achieving equitable, needs-based care in Saxony and beyond.</p>","PeriodicalId":47653,"journal":{"name":"Gesundheitswesen","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148971697","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":"[The GP-arranged referral in outpatient care practice - between coordination, tensions, and improvement of patient care: findings from qualitative focus groups].","authors":"Laura Rink, Tina Mallon, Heike Hansen, Sandra Mangiapane, Thomas Czihal, Yannick Weber, Martin Scherer, Thomas Kühlein, Lisette Warkentin, Maria Sebastião","doi":"10.1055/a-2924-0374","DOIUrl":"10.1055/a-2924-0374","url":null,"abstract":"<p><strong>Background: </strong>The GP-arranged referral was introduced in 2019 to accelerate the transfer of medically urgent cases from GPs to specialist care. Following the 2023 reform, the system became more important in terms of health policy and care provision. This study aimed to examine physicians' perceptions of the system, how it was being implemented, its effects on care, interdisciplinary cooperation, and the physician-patient relationship.</p><p><strong>Methods: </strong>Eight qualitative focus groups were conducted with 40 physicians from various disciplines. The analysis followed a qualitative content analysis according to Kuckartz.</p><p><strong>Results: </strong>It was emphasised that patients with a GP-arranged referral obtained appointments more quickly in underserved specialist fields. GPs perceived the additional organisational effort involved as a burden. The regulation changed the dynamic between GPs and specialists, both positively and negatively. Additionally, undesirable effects such as misuse were becoming apparent.</p><p><strong>Conclusion: </strong>While the GP-arranged referral ensures faster and more reliable appointment scheduling, it also reveals structural tensions. To prevent uncertainties and misuse, further development with clearer criteria and unambiguous control mechanisms is required.</p>","PeriodicalId":47653,"journal":{"name":"Gesundheitswesen","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148585591","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}