Gesundheitswesen最新文献

{"title":"[Determinants of the utilization of general health check-up among older adults in Saxony-Anhalt: What is the influence of access to health services?]","authors":"Denise Kubat, Jelena Epping, Christoph Stallmann, Stefanie March, Enno Swart","doi":"10.1055/a-2446-6583","DOIUrl":"https://doi.org/10.1055/a-2446-6583","url":null,"abstract":"<p><p>Due to the nature of demographic developmens, there is an increasing need for prevention measures in healthcare. In Germany, people with statutory health insurance have a legal right to general health check-ups for early detection of diseases that are significant in terms of population medicine. However, the older population has thus far made inadequate use of these services, resulting in significant losses of prevention potential. This paper examines the impact of objective and subjectively perceived access to health services on the use of general health check-up among citizens aged 55 years and older in the state of Saxony-Anhalt, Germany.The study uses data from a written cross-sectional survey of residents from four major and minor cities in Saxony-Anhalt. Bivariate logistic regression models were used for the statistical analysis of data to evaluate the relation between access parameters to health services and utilization.In all, 953 questionnaires were included in the analyses; 59.7% of the respondents used the general health check-up in the recommended time interval. In the multivariate analyses, the study showed that neither subjective satisfaction with access nor self-reported travel times to family doctors were significant factors affecting the utilization. On the other hand, being a member of statutory health insurance funds and the use of a private car increased the likelihood of utilization. Other determinants that had an influence on the use of general health checks were net household income and need for long-term care.The results of this study indicate potential for increasing utilization of general health check-up among older people. However, increased use of free health check-ups by this section of the population cannot be achieved primarily by improving accessibility, but must be addressed by other factors, such as attitudes towards health checks, which requires further analysis.</p>","PeriodicalId":47653,"journal":{"name":"Gesundheitswesen","volume":" ","pages":""},"PeriodicalIF":0.7,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143371306","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":"[Mothers with migration background have significantly less knowledge of ante- and postnatal support services than mothers without migration background: cross-sectional survey in two maternity hospitals].","authors":"Benedikt Selbertinger, David Rothfuß, Maria Hatzipanagiotou, Angela Köninger, Christian Apfelbacher, Michael Kabesch, Susanne Brandstetter","doi":"10.1055/a-2486-6430","DOIUrl":"https://doi.org/10.1055/a-2486-6430","url":null,"abstract":"<p><p>The aim of this study was to describe and analyse knowledge of women in childbed with and without a migration background about ante- and postnatal support services.Questionnaires were provided in 26 languages. In a cross-sectional survey, 641 women answered questions about their knowledge of 11 different regional support services, and information sources for these and other support service providers. Median split was used to derive mothers with good and poor knowledge.German was not the mother tongue of 30% of the participants (n=194) and were therefore defined as \"mothers with migration background\". Of these, 83% (n=161) were aware of services offered by midwives and<40% knew of other support services. Women with migration background were significantly less likely to know the support services (OR 0.16, 95% CI 0.11 to 0.23), even after controlling for other sociodemographic variables. Furthermore, they obtained significantly less frequently information about relevant services from gynaecologists, midwives, relatives/acquaintances or by themselves.Especially for mothers with migration background, knowledge about ante- and postnatal support services must be made more accessible. In this, midwives could play a decisive role.</p>","PeriodicalId":47653,"journal":{"name":"Gesundheitswesen","volume":" ","pages":""},"PeriodicalIF":0.7,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143123753","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":"[Professional Health Literacy of General Practitioners - Results of the HLS-PROF].","authors":"Doris Schaeffer, Lennert Griese, Alexander Haarmann","doi":"10.1055/a-2350-6377","DOIUrl":"10.1055/a-2350-6377","url":null,"abstract":"<p><strong>Aim: </strong>To date, there are only a few studies analyzing health professionals' health literacy (HL). Mostly, the focus has been on personal rather than professional HL. To bridge this gap, a new concept and an associated survey instrument have been developed in a three-country consortium. The aim of this article was to examine the professional HL of general practitioners (GPs) in Germany.</p><p><strong>Method: </strong>The survey instrument used consists of 34 items and assesses subjective difficulties in four dimensions to be addressed in promoting patients' HL: \"information and knowledge management\", \"conveying information and knowledge\", \"patient-centred communication\", \"professional digital HL\". A total of 297 GPs and internists working in general practice were surveyed online over the summer of 2022. The professional HL (score from 0 to 100) was analyzed descriptively and examined in relation to gender, selected job-related, and organizational characteristics, using multiple linear regression.</p><p><strong>Results: </strong>Depending on the four areas, GPs achieved approximately half to almost three-quarters of the highest possible score. The dimension \"patient-centred communication\" was perceived as the easiest, followed by \"information and knowledge management\", and \"conveying information and knowledge\". The most challenging dimension was \"professional digital HL\". According to the multivariate analysis, professional HL shows a relation to gender, organizational framework and training conditions, job duration, and coping with the diversity of digital information. The strength of correlation varies by area and is rather weak in some instances.</p><p><strong>Conclusions: </strong>The results demonstrate the importance of promoting professional HL of GPs and provide numerous indications of where to start. They also indicate that the regression models should be extended by additional determinants, since the included variables can explain only a small amount of variance.</p>","PeriodicalId":47653,"journal":{"name":"Gesundheitswesen","volume":" ","pages":"109-118"},"PeriodicalIF":0.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11849789/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142082142","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":"[Community-based Disease Prevention and Health Promotion: Promoting Digital Health Literacy among People in Precarious Living Conditions].","authors":"Kamil J Wrona, Kolja Heckes, Leona Aschentrup, Florian Fischer","doi":"10.1055/a-2283-4440","DOIUrl":"10.1055/a-2283-4440","url":null,"abstract":"<p><p>The rapidly advancing digital transformation is opening up innovative opportunities for disease prevention and health promotion, particularly through sociotechnical innovations. Digitally-enabled interventions serve as augmentative tools for disseminating health-related information and promoting individual empowerment and self-efficacy. Despite their potential, digital media in community-based disease prevention and health promotion face challenges, such as the need for low-threshold design and consideration of technological acceptance factors. People in precarious life situations, who often face limited access and lower literacy towards digital technologies, could benefit from targeted measures geared to their specific needs. At the same time, it is important to highlight the risks of insufficient digital health literacy, which can have a negative impact on health. Promoting digital health literacy therefore appears to be an essential tool for improving the health situation of people in precarious living circumstances. This article argues for evidence-based and targeted further development of digital interventions for health promotion that are tailored to the needs of people in precarious living conditions and emphasizes the central role of digital health literacy in this process. In this contribution, the area of early childhood intervention is considered for exemplification.</p>","PeriodicalId":47653,"journal":{"name":"Gesundheitswesen","volume":" ","pages":"131-135"},"PeriodicalIF":0.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11849785/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140060855","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":"[The Struggle for Human Resources in the Reforming Public Health Service].","authors":"Ulrike Junius-Walker, Fabian Feil","doi":"10.1055/a-2449-3214","DOIUrl":"10.1055/a-2449-3214","url":null,"abstract":"","PeriodicalId":47653,"journal":{"name":"Gesundheitswesen","volume":"87 2","pages":"93-95"},"PeriodicalIF":0.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11849788/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143426479","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":"[Economic Relevance of Preventable Prohibitions of Employment in Bavarian Schools].","authors":"Anna Wolfschmidt-Fietkau, Uta Ochmann, Julia Hiller, Dennis Nowak, Oliver Schöffski, Hans Drexler","doi":"10.1055/a-2251-5727","DOIUrl":"10.1055/a-2251-5727","url":null,"abstract":"<p><strong>Introduction: </strong>According to the Maternity Protection Act, an occupational risk of infection (e. g. in childcare) - combined with individual immunity gaps - can result in an irresponsible risk for pregnant women in the workplace. If this risk cannot be eliminated by any other means, the employer must impose a prohibition of employment (PE) for the pregnant woman concerned. We classified PE as preventable if the underlying immunity gaps could have been closed by immunisation prior to pregnancy.</p><p><strong>Methods: </strong>From 01.09.2016 to 25.03.2020, 1922 pregnant employees of Bavarian state schools obtained medical counselling on their occupational risk of infection as part of a research project. If the individual combination of occupational-risk profile and immunity status resulted in an irresponsible risk for the pregnancy, a PE was recommended by the attending physician. We determined the proportion of PE that would have theoretically been preventable by full immunisation prior to pregnancy and approximated the resulting - theoretically preventable - loss of working hours and personnel costs.</p><p><strong>Results: </strong>In 425 cases (22%), a PE was deemed necessary by the attending physician, whereby 193 (45%) were retrospectively classified as theoretically preventable. Of these cases, 53 PE (27%) were temporary (valid until the 20th week of pregnancy) and 140 were long-term (valid for the complete duration of the pregnancy). Based on these results, we approximated a loss of 2,746 working weeks for our collective, which entails theoretically preventable personnel costs totalling 5,763,305 € for the observation period of our study (3.6 years). We then extrapolated estimates for all employees of Bavarian state schools and found a loss of 4,260 working weeks and theoretically preventable personnel costs amounting to almost 8,941,000 € per year during our observation period.</p><p><strong>Conclusion: </strong>Theoretically preventable PE caused by immunity gaps can entail a considerable loss of working hours and high personnel costs. Therefore, we should step up measures aimed at improving vaccination rates in women and increasing their willingness to be vaccinated. In view of the changes in legal and regulatory conditions in Germany since 2020, new investigations should be made as soon as there is sufficient data after the general employment prohibitions due to the SARS-CoV-2-pandemic have been lifted.</p>","PeriodicalId":47653,"journal":{"name":"Gesundheitswesen","volume":" ","pages":"103-108"},"PeriodicalIF":0.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11849782/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140102651","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":"[How effective are non-pharmacological interventions for family caregivers? A systematic review with meta-analyses].","authors":"Patrick Janson, Chu-Wei Hung, Kristina Willeke, Dieter Frisch, Anne Berghöfer, Peter Heuschmann, Andreas Zapf, Manfred Wildner, Carolin Stupp, Thomas Keil","doi":"10.1055/a-2340-1560","DOIUrl":"10.1055/a-2340-1560","url":null,"abstract":"<p><strong>Introduction: </strong>Informal caregiving is associated with mental disorders and reduced quality of life. The aim of this systematic review was to summarize the results of methodologically high-quality intervention studies on the effectiveness of non-pharmacological interventions on patient-relevant outcomes for family caregivers in Germany.</p><p><strong>Method: </strong>We searched three large scientific literature databases for intervention studies with a control group and a low or moderate risk of bias on the effectiveness of non-pharmacological interventions for family caregivers in Germany.</p><p><strong>Result: </strong>Among 4,376 publications reviewed, 10 intervention studies with good methodological quality were identified. These investigated multi-component interventions or cognitive behavioral therapy for family caregivers of people with dementia (8 studies), stroke (1 study) and with general care dependency (1 study). The control groups received information material as a minimal intervention or usual standard care. Meta-analyses showed a statistically significant slight reduction in depressive symptoms 3-6 months after the start of the study as a result of cognitive behavioral therapy (standardized mean difference -0.27; 95% confidence interval -0.44 - -0.10), but this no longer reached statistical significance after 9-12 months (-0.21; -0.51 - 0.09). Multi-component interventions showed no changes in depressive symptoms either after 3-6 or after 9-12 months (-0.18; -0.40 - 0.03 and -0.14; -0.47 - 0.14, respectively). In contrast, the mental component of quality of life of family caregivers improved statistically significantly in the multi-component intervention groups compared to the control groups: slightly after 3-6 months (0.28; 0.01 - 0.56) and moderately after 9-12 months (0.45; 0.09 - 0.82). The interventions had no effect on the physical component of quality of life.</p><p><strong>Conclusion: </strong>The reduction of depressive symptoms by behavioral therapy interventions for family caregivers appears to be only slight and not sustainable. The mental component of quality of life of people affected may be improved in the longer term by multi-component interventions. Current scientifically examined interventions for informal caregivers do not appear to have a sufficient and sustainable effect. Greater effects could possibly be achieved through more elaborate behavioral approaches, but also structural preventive measures.</p>","PeriodicalId":47653,"journal":{"name":"Gesundheitswesen","volume":" ","pages":"145-160"},"PeriodicalIF":0.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11849791/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141989134","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":"[Tuberculosis among Ukrainian Refugees in Germany - A Comparison of Screening and Reporting Data].","authors":"Vanessa Igbokwe, Ralf Otto-Knapp, Cornelia Breuer, Martin Priwitzer, Torsten Bauer, Brit Häcker","doi":"10.1055/a-2312-6270","DOIUrl":"10.1055/a-2312-6270","url":null,"abstract":"<p><p>Since the onset of the war in Ukraine until November 2022, nearly 1 million people sought refuge in Germany. Despite efforts to reduce tuberculosis (TB) cases, Ukraine had a high TB incidence in 2020, with increased rates of multidrug-resistant TB. Conflict and war have historically been associated with TB spread due to delays in diagnosis, treatment interruptions, and increased transmission risks. The World Health Organization (WHO) estimated a rise in TB cases in the EU region due to refugee movements. In Germany, screening methods used in testing individuals in communal housing involving chest X-rays or immunological tests were variable. A survey conducted by the DZK within the nationwide TB working group evaluated TB screening methods and results for Ukrainian refugees. Out of 26,196 individuals aged over 15, 48 TB cases were detected, with a higher-than-expected incidence. About 42% of cases were multidrug-resistant TB. The screening findings differed from both the WHO's estimates as well as TB cases reported to the Robert Koch Institut (RKI) in 2022. A preliminary comparison of the numbers is presented here. The differing results emphasize the need for ongoing data collection and analysis to adapt resources and interventions to the evolving TB situation among Ukrainian refugees in Germany, especially considering the ongoing conflict and potential for increased TB cases in the future.</p>","PeriodicalId":47653,"journal":{"name":"Gesundheitswesen","volume":" ","pages":"99-102"},"PeriodicalIF":0.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11849790/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141471591","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":"[Effects of a One-Week Inpatient Health Programme for Family Caregivers and Persons in Need of Care (SVLFG Care Tandem) - A Quasi-Experimental Study].","authors":"Christian Hetzel, Julia Schaller, Wolfgang Michel, Ingo Froböse","doi":"10.1055/a-2305-0146","DOIUrl":"10.1055/a-2305-0146","url":null,"abstract":"<p><strong>Aim: </strong>The aim of this study was to assess the effect of a one-week inpatient health programme for family carers together with the persons in need of care (care tandem) on the well-being of family carers. Acceptance and subjective benefits were also assessed. The intervention was funded by the Social Insurance for Agriculture, Forestry and Horticulture (SVLFG).</p><p><strong>Methodology: </strong>Central to the intervention are (1) the home care counselling before the seminar, (2) the one-week seminar in the setting of a rehabilitation clinic at a health resort, in particular with a care course, exercise and relaxation units and the use of local remedies, (3) the substitute care of the person in need of care in close proximity to the seminar location and (4) the low-threshold telephone aftercare by SVLFG specialists. In a controlled prospective panel study (IG n=35, VG n=67, allocation not randomised), well-being (WHO-5, range 0-100) was measured at several points in time (IG: 0, 1, 9, 17, 28 and 43 weeks after the start of the seminar; VG 0, 17, 28 and 43 weeks). Statistical analyses were performed using fixed-effects panel regression, controlling for time-varying covariates (period effects, external stress).</p><p><strong>Results: </strong>In the IG (80% women, mean age 66.5 years), 69% of family carers showed evidence of clinically relevant depression at baseline. All care levels were represented among the people in need of care, predominantly 2 and 3, with medically diagnosed dementia in 37% of the cases. The VG was similarly structured. Under the condition of stable external stress, the initial effect was very clear (delta=+19 points). The effect then flattened out, but remained fairly stable at around 10 points above the initial level. Although the last measurement (43 weeks) was no longer statistically significantly higher, it was independent of the development of external stress. Acceptance and subjective benefit were very high.</p><p><strong>Conclusions: </strong>The strength of the intervention is the dyadic approach. The intervention promotes well-being and is highly accepted. The design allows at least cautious causal conclusions. For the remaining limitations, larger case numbers and a randomised controlled trial would be necessary.</p>","PeriodicalId":47653,"journal":{"name":"Gesundheitswesen","volume":" ","pages":"136-144"},"PeriodicalIF":0.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11849786/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140855609","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":"[The Effect of Service Concentration on Outcome Quality in Obstetrics Departments - An Empirical Analysis of Newborn Mortality in German Hospitals].","authors":"Fabian Kianpour","doi":"10.1055/a-2373-6769","DOIUrl":"10.1055/a-2373-6769","url":null,"abstract":"<p><p>The effect of service concentration on outcome quality of inpatient services in the hospital sector is debated, and is particularly important in the field of obstetrics. The aim of this article was to investigate the influence of volume-outcome factors and competitive economic parameters on the quality of outcomes in obstetric departments of German hospitals. In this study, structural and performance data on 412 German hospitals in 2021 were analyzed with a quantitative research approach. To test the hypotheses, a polynomial multiple regression model with a total of eleven independent variables was estimated. Newborn mortality was used as an indicator of outcome quality in obstetrics departments. Contrary to expectations, the competitive economic parameters that are important for births play a rather subordinate role, while strong empirical evidence was found for volume-outcome relationships. The results of this study suggest that positive quality effects of service concentrations also predominate in the field of obstetrics and thus provide evidence in support of the forthcoming hospital reform in Germany.</p>","PeriodicalId":47653,"journal":{"name":"Gesundheitswesen","volume":" ","pages":"119-130"},"PeriodicalIF":0.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11849792/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141761681","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}