Gesundheitswesen最新文献

{"title":"[Rehabilitation Recommendations According to § 31 SGB XI: Empiricism, Discussion and Health Policy Implications].","authors":"Stephan Herberg, Juergen Zerth, Jonas Hammer, Frank Teuteberg","doi":"10.1055/a-2369-1175","DOIUrl":"10.1055/a-2369-1175","url":null,"abstract":"<p><strong>Background: </strong>The principle of \"rehabilitation before care\" is a principle of social law. The recommendation of the Medical Service (MD) as part of the assessment (§ 31 SGB XI) plays an important role in rehabilitation recommendations. In around 3% of its assessments, the MD recommends implementation of rehabilitation. Only every fourth to fifth recommendation is actually carried out. The aim of the study was to find out if rehabilitation recommendations are utilized and exploited.</p><p><strong>Materials and methods: </strong>This study aimed to examine the perspective of insured persons whose recommended rehabilitation was actually carried out. After evaluating 586,228 routine data records with care assessments by the MD, 1,972 survey questionnaires were sent out in March 2023, and 1,116 analyzable questionnaires were included in the data analysis. In seven questions, the respondents were asked to retrospectively assess the overall success and satisfaction with rehabilitation procedures carried out.</p><p><strong>Results: </strong>The evaluation of the results showed that 87% of the study participants would be ready to undergo repeat rehabilitation. The assessment of the success of rehabilitation in terms of remaining at home for a longer period of time also carried weight. On the other hand, only around 10% of rehabilitation was carried out on an outpatient basis.</p><p><strong>Conclusions: </strong>One previously assumed reason for the low rate of patients taking advantage of recommended rehabilitation was that those in need of care had already received rehabilitation in the previous year. In this study focussing on whether recommended rehabilitation is taken advantage of, this assumption was found not to be correct. The question needs to be raised whether the strong focus in Germany on inpatient rehabilitation is up-to-date, both medically and with regard to the preferences of those entitled to rehabilitation. In contrast to inpatient rehabilitation, individual, outpatient and, if necessary, mobile rehabilitation offers might be more suitable, and these would also take into consideration issues of individual mobility and patient autonomy. The offer of different modes of rehabilitation also enables meeting the wish of those patients who prefer to have rehabilitation carried out in a home environment.</p>","PeriodicalId":47653,"journal":{"name":"Gesundheitswesen","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2024-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141724754","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":"[Subjective Health Impairment And Associated Factors In The Heatwave Of Summer 2022: An Online Survey].","authors":"Christian Buhtz, Thomas Frese, Patrick Jahn, Eva Kantelhardt, Alexander Kuhlmann, Sara Lena Lückmann, Gabriele Meyer, Thorsten Meyer-Feil, Jan Schildmann, Anke Steckelberg, Anja Knöchelmann","doi":"10.1055/a-2332-0059","DOIUrl":"https://doi.org/10.1055/a-2332-0059","url":null,"abstract":"<p><strong>Background: </strong>Heatwaves might diminish the sense of well-being and are associated with increased mortality. Individual measures to protect against heat are often insufficient, with the perception of one's own risk playing a crucial role. Due to varying levels of vulnerability, it is expected that the perception differs among populations. Presumably, symptom awareness is higher when people are concerned with and inform themselves about the topic of heat. Our study examined subjective health impairment during the heatwave in 2022, its association with socio-demographic and economic factors, as well as perceived heat stress and individual engagement with the issue.</p><p><strong>Method: </strong>An online survey of a population-based sample from five federal states of Germany was carried out. Multivariable regression analyses were conducted to explore the relationship between subjective health impairment due to heat and potential risk indicators.</p><p><strong>Results: </strong>Out of 3,111 people contacted, 1,522 responded, with 649 (20.9%) included in the analysis as they were affected by heat in their region of residence during the summer of 2022. The average subjective health impairment was 9.29 (SD: 5.25) out of 29 possible points. Higher age was associated with lower impairment; -1.36 points (95%-CI: -4.10; 1.38) in the group of those aged 80 and compared with the reference group of 60 to 69-year-old people. Furthermore, higher impairment was reported more by women and individuals with lower educational levels. Low impairment was associated with a high perceived level of information.</p><p><strong>Conclusion: </strong>Interventions aimed at reducing heat-related health problems should target a broader audience, particularly young people, women, individuals with lower education, and working people.</p>","PeriodicalId":47653,"journal":{"name":"Gesundheitswesen","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2024-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142074171","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 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":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2024-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","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":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Correction: Quality Indicators Show Higher Fulfilment in Centers Certified by the German Cancer Society].","authors":"Stefanie Schulz, Christian Lange, Katharina Emrich, Christina Justenhoven","doi":"10.1055/a-2379-0670","DOIUrl":"https://doi.org/10.1055/a-2379-0670","url":null,"abstract":"","PeriodicalId":47653,"journal":{"name":"Gesundheitswesen","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2024-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142037349","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 guideline on carbohydrate intake for adults and children].","authors":"Isolde Sommer, Barbara Nußbaumer-Streit, Gerald Gartlehner","doi":"10.1055/a-2364-2388","DOIUrl":"10.1055/a-2364-2388","url":null,"abstract":"<p><strong>Background: </strong>Noncommunicable diseases are the leading cause of death worldwide. Unhealthy diets are a major risk factor. Among other dietary factors, poorer quality of carbohydrates in the diet is associated with an increased risk of NCDs. The proportion of dietary fibre is a particularly important indicator of the quality of carbohydrate.</p><p><strong>Objective: </strong>The aim of this World Health Organization (WHO)guideline is to provide guidance on carbohydrate intake, including dietary fibre and healthy food sources of carbohydrates.</p><p><strong>Method: </strong>This guideline was developed following the WHO Manual for Guideline Development. The process includes a review of systematically gathered evidence by an international, multidisciplinary group of experts, an assessment of the confidence in this evidence using the GRADE (Grading of Recommendations, Assessment, Development and Evaluation) approach, and the consideration of additional factors when translating the evidence into recommendations.</p><p><strong>Results: </strong>The results of seven systematic reviews inform the formulation of carbohydrate intake recommendations. The WHO recommends that carbohydrate intake should consist primarily of whole grains, vegetables, fruits and legumes. It also recommends an intake of at least 400 g of vegetables and fruit per day for adults and at least 250-400 g per day for children and young people, depending on their age. With regard to naturally occurring fiber, a daily intake of at least 25 g is recommended for adults and 15-25 g per day for children and adolescents, depending on age.</p>","PeriodicalId":47653,"journal":{"name":"Gesundheitswesen","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2024-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141581235","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":"[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":"https://doi.org/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":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2024-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","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":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Patient safety in the Innovation Fund - Characterization, results and evaluation of completed projects: Results of a scoping review].","authors":"Lorenz Harst, Felix Walther, Lilly Rüthrich, Laura Keßler, Christina Lindemann, Martin Härter, Erik Farin-Glattacker, Max Geraedts, Jochen Schmitt","doi":"10.1055/a-2309-8968","DOIUrl":"https://doi.org/10.1055/a-2309-8968","url":null,"abstract":"<p><p>The German Innovation Fund has funded various studies on patient safety. Their thematic spectrum, methodological quality, results and recommendations of the Innovation committee were to be systematically investigated in order to derive proposals for optimizing transfer success. As part of a scoping review, all Innovation Fund projects funded in the period 2016-02/2023 with a focus on patient safety were analyzed. Each included study document was critically reviewed by two independent persons. The 16 included projects addressed a wide range of populations, indications and interventions. The study quality was mostly good. The results ranged from feasible indicator sets and the prevention of adverse drug reactions to the optimization of error management. For seven projects, the Innovation Committee recommended forwarding the results to healthcare institutions with the request that they take note and/or examine the feasibility of implementation in standard care. Implementation, however, has not yet taken place. In order to facilitate implementation, the joint development of an implementation strategy by the recipients of the Innovation Committee's recommendations is necessary.</p>","PeriodicalId":47653,"journal":{"name":"Gesundheitswesen","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2024-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141989151","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":"[Digital Healthcare: Requirements for a Successful Transformation].","authors":"Oliver Steidle, Kerstin Rego, Thomas Petzold","doi":"10.1055/a-2184-5572","DOIUrl":"10.1055/a-2184-5572","url":null,"abstract":"<p><p>Digital transformation of healthcare is the dominating discussion topic for all healthcare stakeholders. Digital transformation encompasses all areas of healthcare and is far more than digital healthcare applications (DiGA), digital care applications (DiPA), telemedicine applications, telematics infrastructure activities, and applications from the fields of eHealth, mHealth, or Telehealth. All existing care processes and structures in the healthcare system are undergoing an inventory in order to transfer analog components of care into a digital context. The digital transformation is not taking place exclusively in economic sectors such as healthcare, but is a process of change throughout society in the collection, use, provision, linking and evaluation of information (=data). For the healthcare sector, it is clear that different technical concepts are used, while digital healthcare takes place in different places and at different times, may include different user (groups) and retains, expands or changes the healthcare context. Established healthcare functions such as diagnostics, therapy, documentation and the management of healthcare services are retained and transferred to a digital context. In addition, new application areas will emerge, such as the overarching access to health data by different actors, real-time-driven monitoring systems of holistic health data, (clinical) decision systems, or the provision of data for health services. Even if the majority of the digital transformation has not yet taken place, it is assumed that these functions and application areas of healthcare will serve to sustainably improve the quality of care and benefit the well-being of all (future) patients. For the transfer of existing processes into a digital context and the establishment of new application areas, there are prerequisites for healthcare institutions and the healthcare system itself.</p>","PeriodicalId":47653,"journal":{"name":"Gesundheitswesen","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11404342/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139503082","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":"[Opportunities and Challenges Of The Ethics Review Of Qualitative Health Services Research: A Survey Of Qualitative Researchers].","authors":"Kerstin Kremeike, Saskia Jünger, Christine Preiser, Charlotte Ullrich, Margret Xyländer","doi":"10.1055/a-2189-2563","DOIUrl":"10.1055/a-2189-2563","url":null,"abstract":"<p><p>Ethics committees ensure compliance with ethical principles in medical research. They are oriented towards clinical studies, but also review e. g., qualitative research. Using a semi-structured online survey, we collected data on experiences of qualitative researchers with the review by ethics committees and analysed them via content analysis. In July 2019, 73 researchers took part in the survey. Five main topics were derived from their statements regarding the ethics review of qualitative research: 1. relevance of qualitative research expertise; 2. cooperation between researchers and ethics committees; 3. transparency of review criteria; 4. dealing with formal review requirements; 5. evaluation of the review's significance for qualitative research. The results show the potential of ethics review for reflection on ethical questions in qualitative research. Prerequisites for this are the fit with the characteristics and quality criteria of qualitative research, the presence of qualitative research expertise in ethics committees, the transparency of the ethics review process as well as openness to different professional cultures and a constructive communication culture.</p>","PeriodicalId":47653,"journal":{"name":"Gesundheitswesen","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11404343/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139693214","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":"[Training of Medical Assistants in Ophthalmology: Survey of a Sample of Large Ophthalmic Centers].","authors":"Ursula Hahn, Ulrich Kellner","doi":"10.1055/a-2250-1614","DOIUrl":"10.1055/a-2250-1614","url":null,"abstract":"<p><p>The shortage of specialists in SHI-accredited medical care is increasingly affecting medical assistants (MFA) in medical practices and Medical Care Center (MVZ). Training can mitigate the associated problems in the future, but currently only 42% of practices provide training. A survey of a sample of large ophthalmic centers was conducted to test the hypothesis that larger practices and MVZs provide disproportionate training. In addition, an interaction between ownership (physician-owned (äE); third-party owned (F)) and training engagement was evaluated. In a questionnaire-based complete survey (2022) of large ophthalmic centers of different ownerships organized in a network, the training rate by main operating site (HBS), the number of MFA trainees (MFA-A) per HBS, staffing problems and planned change in training commitment were collected. The distribution measures of the quantitative data were analyzed overall and separately by sponsoring organization and tested for significance.Results were compared to data from a representative survey (2020/2021) of all practices and MVZs. In order to determine the proportion of all ophthalmic MFA-A accounted for by the sample, their total number was determined in an extrapolation. The training rate of the total of 100 HBS of the 14 surveyed centers (11 äE, 3 F) of the sample was 82% (äE: 93%, F: 79%), which was higher than the representative survey (41%). In the sample, there were on average 5.9 MFA-A per HBS (äE: 5.6, F: 7.1), in the comparative survey 1.5. 50% of the centers in the sample reported staffing problems, 25% wanted to expand their training commitment; the comparative values of the representative survey were 11% for both parameters. Stratified by sponsorship, neither training rate nor MFA-A per HBS showed significant differences. According to projections, there were nearly 1,966 MFA-A working in ophthalmology in 2021, of which 19.5% were at centers in the study population. Of all the MFA-A in the sample, 71% were at the significantly larger centers by number of HBS owned by third-party. The survey confirms the positive correlation between the size of practices and MVZ and commitment to training. There are no significant differences according to the ownership of organization.</p>","PeriodicalId":47653,"journal":{"name":"Gesundheitswesen","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11404335/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140858320","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}