Gesundheitswesen最新文献

{"title":"[Access to and use of Data for better Healthcare: A Plea for a cooperative data and Research Infrastructure of Statutory and Private Health Insurers and the Network University Medicine (NUM)].","authors":"Jochen Schmitt, Peter Ihle, Olaf Schoffer, Jens-Peter Reese, Steffen Ortmann, Enno Swart, Sabine Hanß, Falk Hoffmann, Christoph Stallmann, Monika Kraus, Sebastian Claudius Semler, Ralf Heyder, Jörg Janne Vehreschild, Peter Heuschmann, Dagmar Krefting, Martin Sedlmayr, Wolfgang Hoffmann","doi":"10.1055/a-2438-0670","DOIUrl":"10.1055/a-2438-0670","url":null,"abstract":"<p><p>With the Network of University Medicine (NUM) and the Medical Informatics Initiative (MII), the BMBF is funding two pioneering, structure-building research measures that are now being merged. The data integration centers (DIZ) of the MII are to be consolidated in the NUM. The aim is to establish a standardized research infrastructure within which the existing data from the clinical routine care of the 36 German university hospitals, from clinical cohorts and clinical-epidemiological studies can be used for various research questions upon request and via coordinated processes. The legal basis for this was the MII's \"Informed Broad Consent\", which had been agreed upon with ethics committees and data protection authorities and implemented in all NUM locations, with a so-called \"health insurance module\" that allows the collection and linking of routine medical data from statutory health insurance funds (GKV) and private health insurers (PKV) as a category of care-related data (VeDa). Linking this routine data with data from hospital information systems offers particularly high potential, as no single data source provides a complete picture of medical care and the two data sources complement each other optimally. The aim now is to integrate this routine data into the NUM's secure, transparent and participatory research infrastructure in a strategic partnership with statutory health insurance funds and private health insurance companies. This promotes Germany in its role as a research location and makes a decisive contribution to improving the quality and safety of healthcare in Germany in an evidence-based manner.</p>","PeriodicalId":47653,"journal":{"name":"Gesundheitswesen","volume":" ","pages":""},"PeriodicalIF":0.7,"publicationDate":"2024-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142401521","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":"Pilotierung einer Surveillance zu akuten respiratorischen Erkrankungen: COVID-19 Monitoring mittels Arbeitsunfähigkeitsbescheinigungen.","authors":"Inga Overesch, Ulrike Junius-Walker, Johanna Schneider, Mareike Wollenweber, Karina Usipbekova, Wiebke Böhne, Ina Holle, Johannes Dreesman, Elke Mertens, Sveja Eberhard","doi":"10.1055/a-2497-6449","DOIUrl":"https://doi.org/10.1055/a-2497-6449","url":null,"abstract":"","PeriodicalId":47653,"journal":{"name":"Gesundheitswesen","volume":" ","pages":""},"PeriodicalIF":0.7,"publicationDate":"2024-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142792515","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Health Promotion and Health Literacy in the Legal Foundations of the Austrian Healthcare System].","authors":"Johannes Marent, Regina Aistleithner","doi":"10.1055/a-2415-7222","DOIUrl":"10.1055/a-2415-7222","url":null,"abstract":"<p><strong>Background: </strong>Health reform sees health promotion (HP) and health literacy (HL) as essential cornerstones for achieving health policy goals. This article examines the extent to which the legal foundation in the Austrian healthcare system provides a basis for orientation towards HP and HL. The focus of the analysis was set on medical professions, the health care and nursing professions, hospitals, and primary health care facilities.</p><p><strong>Methods: </strong>In a first step, legal and other relevant documents were reviewed. For this, a literature-based coding grid was created. In a second step, the legal bases were analyzed and interpreted using the coding grid. Recommendations were derived from the analysis of the legal basis and experts' assessments.</p><p><strong>Results: </strong>Health promotion and health literacy are included in the general legal foundations. However, HP/HL is primarily conceived as a supplementary service with separate financing and is thus less understood as an integral part of any patient contact. The primary health care units and the nursing professions have a relatively clear mandate with regard to HP/HL compared to the hospitals and medical professions. Overall, it was recognized that terminology should be used more coherently and operationalized for the respective areas of cure and care. In particular, the legal bases relating to the medical professions do not build on one another in a coherent manner.</p><p><strong>Conclusions: </strong>Having adequate staff is the key to HP/HL. If these are in place, competencies in the field of HP/HL should be required, promoted, evaluated, and rewarded. HP/HL should be an integral part of any care setting. The concepts of health promotion and health literacy should be operationalized in the legal frameworks of health professions and organizations. This is especially true for the Physicians' Act and for hospitals. Furthermore, the role of patients should be strengthened and the involvement of users in the planning of health services should be further developed.</p>","PeriodicalId":47653,"journal":{"name":"Gesundheitswesen","volume":" ","pages":"788-797"},"PeriodicalIF":0.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11626911/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142298692","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":"[Impact of Non-Pharmacological Measures during COVID-19 Pandemic in Adolescents - A Cross-sectional Study of 649 10th Grade Pupils in the City of Witten, Germany (GeWIT-Study)].","authors":"Paul Wiesheu, Anne-Lisa Heye, Judith Tillmann, Nessia Rachma Dianti, Klaus Völkel, Klaus Weckbecker, Eva Münster","doi":"10.1055/a-2335-2251","DOIUrl":"10.1055/a-2335-2251","url":null,"abstract":"<p><strong>Aim: </strong>The aim of this study was to examine the impact of the COVID-19 pandemic and non-pharmacological interventions, with a particular focus on the subjective experiences of pupils in relation to the measures, the extent to which quarantine and illness with COVID-19 influenced their perception of the disease, the protective measures taken and the groups that were particularly affected.</p><p><strong>Methods: </strong>From November 2021 to February 2022, a written survey of tenth grade pupils from all nine secondary municipal schools in the city of Witten, Germany was conducted. Descriptive statistics were used to analyze and evaluate the data.</p><p><strong>Results: </strong>98.3% of the pupils present in class (n=649) were included in the survey. Of the study population, 12.9% stated that they had already had COVID-19 and 43.6% had been quarantined. 27.3% of the pupils reported that mask-wearing was not easy for them, while 65.2% found wearing a mask easy. Furthermore, 33.4% reported that distance learning had negatively impacted their well-being, and 6.9% of the pupils reported that they had experienced more violence during the pandemic. Fear of COVID-19 was reported by 10% of the pupils, and was less frequently reported if pupils had already been infected with COVID-19 or had been quarantined. 75.7% reported no fear of COVID-19.</p><p><strong>Conclusion: </strong>The COVID-19 pandemic and the non-pharmacological measures to address it presented significant challenges and were a substantial burden on the pupils. The present study shows that the pandemic and/or the measures had a negative impact on the pupils. It is imperative to critically examine the measures, particularly in relation to vulnerable groups such as gender-diverse or socio-economically disadvantaged pupils. Education that is needs-based and target group-oriented can facilitate increased acceptance and perceptions of safety of implemented measures among pupils.</p>","PeriodicalId":47653,"journal":{"name":"Gesundheitswesen","volume":" ","pages":"761-768"},"PeriodicalIF":0.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11626913/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141761680","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":"[An After-Action Review at Municipal Level in the Public Health Service - Lessons Learned at the Corona Unit of the Duesseldorf Public Health Authority after the end of the Covid-19 Pandemic, March 2023].","authors":"Hannah Höglund-Braun, Anne Lisa Quartey, Maya Ganter, Lutz Ehlkes, Steffen Geis, Max Skorning, Sybille Rehmet, Anna Kuehne","doi":"10.1055/a-2329-7058","DOIUrl":"10.1055/a-2329-7058","url":null,"abstract":"<p><strong>Background: </strong>After-Action Reviews (AARs) represent structured, qualitative evaluations of crisis interventions. Here, we describe the implementation of an AAR to assess the Corona Unit of the Duesseldorf Health Department.</p><p><strong>Methods: </strong>We employed an after-action review (AAR) using the working group format supplemented by structured interviews with key personnel. Our approach was guided by the guidelines for AARs provided by the World Health Organization (WHO) and the European Centre for Disease Prevention and Control (ECDC).</p><p><strong>Results: </strong>Participants identified nine relevant challenges with potential for improvement in three categories: (I) challenges in recruiting requested personnel, (II) overarching coordination issues, and (III) frequent relocations. Participants proposed solutions for these challenges: (I) 1. Routine cross-agency inquiries for voluntarily available personnel, 2. consideration of resources from municipal subsidiaries and involvement of personnel with leadership experience from other departments, 3. Better coordination of deployment and onboarding, 4. proposal for early communication regarding different compensation regulations, (II) 5. establishment of an overarching coordination authority for the crisis unit, 6. clearer delineation of responsibilities within the crisis unit with explicit job profiles, 7. establishment of a shared working platform, and 8. creation of a central dashboard for generating all situation reports. Additionally, they identified (III) 9. a facility for housing a crisis unit in case of an emergency.</p><p><strong>Conclusion: </strong>This study represents one of the first applications of an AAR for evaluating crisis structures at the level of a local Public Health Authority (LPHA) in the context of the COVID-19 pandemic. While some of the identified challenges are specific to Duesseldorf, many municipalities faced personnel recruitment and coordination challenges during the COVID-19 pandemic. Municipal crisis plans can be reviewed and adjusted concerning the identified challenges. Sharing evaluation results among LPHA stakeholders can contribute to strengthening crisis structures in the long term.</p>","PeriodicalId":47653,"journal":{"name":"Gesundheitswesen","volume":" ","pages":"769-775"},"PeriodicalIF":0.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11626909/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140960275","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":"[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":" ","pages":"798-802"},"PeriodicalIF":0.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11626924/pdf/","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":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[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-2312-6116","DOIUrl":"10.1055/a-2312-6116","url":null,"abstract":"<p><strong>Aim: </strong>In 2003, a certification program was introduced by the German Cancer Society in Germany to ensure high standards of oncological care. The present study investigated whether there were differences in the concordance to guideline-based recommendations between centers certified by the German Cancer Society and medical facilities without such certification. In this context, quality indicators derived from clinical guidelines were evaluated.</p><p><strong>Methods: </strong>The database of the cancer registry of Rhineland-Palatinate, Germany was used to calculate fulfilment of target values for 14 quality indicators. Analysis of quality indicators followed specifications given in treatment S3-guidelines for breast, colorectal and lung cancer. Analyses were done by R and SAS.</p><p><strong>Results: </strong>All 14 quality indicators showed that concordance with guideline-based recommendations was higher in certified centers compared to uncertified medical facilities; 13 of these differences were statistically significant.</p><p><strong>Conclusion: </strong>Higher quality of oncological treatment in certified centers has widely been discussed in the WiZen study. The results of our study support this assumption with respect to concordance with quality indicators.</p>","PeriodicalId":47653,"journal":{"name":"Gesundheitswesen","volume":" ","pages":"783-787"},"PeriodicalIF":0.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11626929/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141471590","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":"[Physician Numbers and Employment in Bavaria: Trends in statistics of the Bavarian Medical Association and the Association of Statutory Health Insurance Physicians of Bavaria].","authors":"Sophie Gigou, Laura Corazza, Sandra Fett, Martin Tauscher, Roman Gerlach, Ewan Donnachie, Antonius Schneider","doi":"10.1055/a-2328-4088","DOIUrl":"10.1055/a-2328-4088","url":null,"abstract":"<p><strong>Background: </strong>Although the number of places at medical schools and physicians in Germany has increased continuously over the past 25 years, there is a threat of a shortage of physicians. Based on data from the Bavarian Medical Association (BLÄK) and the Association of Statutory Health Insurance Physicians of Bavaria (KVB), an analysis of the number of physicians in Bavaria over a longer period of time was carried out in order to understand current developments and possible starting points for the future organization of medical care. The figures were analyzed with regard to the distribution of physicians by outpatient and inpatient sector as well as with regard to the development of the number of employees, the scope of employment and the gender distribution in the outpatient sector.</p><p><strong>Methods: </strong>Data were taken from the annually published and systematically compiled numbers of physicians from the BLÄK (2000 to 2022) as well as the outpatient billing data of practicing and employed physicians in Bavaria (2010 to 2022), processed by the KVB. Descriptive analyses were performed.</p><p><strong>Results: </strong>Since 2000, the number of physicians in Bavaria has risen by 83% in the inpatient setting and by 35% in the outpatient setting. As a result, more physicians have been working in hospitals than in outpatient care since 2010. In the outpatient setting the trend is moving away from establishing one's own practice and full-time work towards salaried and part-time employment. Employed physicians have lower average working hours than self-employed physicians. The proportion of women among physicians has steadily increased, with female physicians more likely to be employed and working part-time compared with male physicians. Nevertheless, part-time employment is also prominent among male physicians in some specialties today.</p><p><strong>Conclusion: </strong>The trend towards practicing in salaried and part-time positions continues unabated and is represented across all specialties, suggesting that more physicians are needed to maintain the number of working hours over time. In addition to incentives and subsidies, this reality must be taken into account when planning care. At the same time, it is questionable whether increasing medical school places without managing them according to need is the right way to address the shortage of physicians in outpatient care when an ever-increasing proportion of physicians is working in inpatient care.</p>","PeriodicalId":47653,"journal":{"name":"Gesundheitswesen","volume":" ","pages":"803-813"},"PeriodicalIF":0.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11626927/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141628075","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":"Evaluating the Usefulness of Population-Wide COVID-19 Testing in the Omicron Era: Insights from a German Model.","authors":"Afschin Gandjour","doi":"10.1055/a-2328-4165","DOIUrl":"10.1055/a-2328-4165","url":null,"abstract":"<p><strong>Background: </strong>The Omicron variant of SARS-CoV-2, which has become dominant worldwide since late 2021, presents a unique challenge due to its high rate of asymptomatic transmission. This study evaluates the efficacy and value of population-wide testing, including self-testing, in the context of COVID-19, particularly under the Omicron variant, using data from Germany.</p><p><strong>Methods: </strong>A decision-analytical model and secondary data was used for assessing the impact of systematic screening and testing for COVID-19. Various scenarios were taken into consideration including seasonal patterns of COVID-19 transmission and the potential for annual waves. The model assessed the clinical benefits of testing against the backdrop of vaccine effectiveness, transmission rates, and the potential to prevent severe clinical events, including death, ICU admission, and long COVID syndrome.</p><p><strong>Results: </strong>The study found that the value of mass testing and self-testing for private use was highly contingent on the transmission rate and the scenario of COVID-19 waves (seasonal vs. continuous). For winter waves, a very high incidence rate was required to justify testing, while for continuous waves, testing could be valuable for those in contact with individuals in their last decade of life. The analysis highlighted the limitations of mass testing when community transmission rates were low and the potential value of testing in high-risk contacts or amidst new outbreaks.</p><p><strong>Conclusion: </strong>The findings suggest that the resumption of testing during winter waves is unlikely to provide significant clinical benefits given the current understanding of Omicron's transmission and immunity waning. This study underscores the need for a nuanced approach to COVID-19 testing policies, considering both the epidemiological context and the practical implications of testing strategies.</p>","PeriodicalId":47653,"journal":{"name":"Gesundheitswesen","volume":" ","pages":"776-782"},"PeriodicalIF":0.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11626928/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141761683","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":"COVID-19 Aufarbeitung: Wahrheit, Versöhnung und Entwicklung, nicht Abrechnung.","authors":"Manfred Wildner","doi":"10.1055/a-2418-2896","DOIUrl":"10.1055/a-2418-2896","url":null,"abstract":"","PeriodicalId":47653,"journal":{"name":"Gesundheitswesen","volume":"86 12","pages":"757-760"},"PeriodicalIF":0.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11626910/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142786603","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}