Gesundheitswesen最新文献

{"title":"[Job profile and financing of peer support in health insurance-financed care in Germany: status quo and possibilities].","authors":"Guillermo Ruiz-Pérez, Madeleine Küsel, Sebastian von Peter","doi":"10.1055/a-2452-4239","DOIUrl":"10.1055/a-2452-4239","url":null,"abstract":"<p><strong>Aim of the study: </strong>Peer support workers and recovery companions in psychiatric care represent a new professional group. The aim of this study was to explore options for classification, professional integration and appropriate remuneration for this group within the SGB V healthcare system.</p><p><strong>Methods: </strong>Part of the ImpPeer-Psy5 project, this study provides recommendations for nationwide implementation of peer support workers in SGB V care. It is based on data from 56 interviews, supplemented by five expert interviews and a focus group, and analyzed using thematic analysis.</p><p><strong>Results: </strong>Peer workers' services are funded and compensated inconsistently across Germany, with remuneration generally inadequate. The pay was often perceived as disconnected from the tasks and responsibilities involved, hindering the establishment of PGB as a standalone profession. Greater independence from other professions and higher classification under the TVöD pay scale are necessary.</p><p><strong>Conclusion: </strong>Successful implementation of peer support workers requires regulated and secure funding and compensation. A national peer workers interest group would help achieve these goals. Avoiding classification in EG3 or lower is recommended.</p>","PeriodicalId":47653,"journal":{"name":"Gesundheitswesen","volume":" ","pages":""},"PeriodicalIF":0.7,"publicationDate":"2024-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142669389","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":"Der Medizinische Dienst Eine sozialmedizinische Institution der Qualitätssicherung im Gesundheitssystem.","authors":"Thomas Gaertner, Jörg van Essen","doi":"10.1055/a-2292-2855","DOIUrl":"https://doi.org/10.1055/a-2292-2855","url":null,"abstract":"<p><p>As a corporation under public law, the federally established Medical Service (MD) is an organizationally and substantively independent socio-medical expert organization. It uses its expertise to support the health and nursing care insurance companies as well as their associations and other clients from the healthcare system nationwide in ensuring medical and nursing care within the social law solidarity community consisting of statutory health and social care insurance. In relation to the 12.000 employees, the specialist tasks are carried out by doctors (20.1 %), nursing staff (40.4 %) and members of other suitable professions in the healthcare sector (5.5 %). With a total of over 2.955.000 GKV assessments, 13.200 structural audits in hospitals, significantly more than 1.600 on-site quality controls in hospitals, almost 3.000.000 nursing assessments, almost 21.900 quality inspections in nursing facilities as well as committee work at state and federal level, the MD assumes a comprehensive constitutive-constitutional and quality-assuring expert care mandate. The social-medical service provided, which is committed to the general social law principles of quality, humanity and cost-effectiveness and is regulated by guidelines issued by the MD Bund and approved by the Federal Ministry of Health, is subject to standardized, nationwide quality assurance.</p>","PeriodicalId":47653,"journal":{"name":"Gesundheitswesen","volume":" ","pages":""},"PeriodicalIF":0.7,"publicationDate":"2024-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142606806","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":"[Between Tuition Fees and Trainee Allowances: Financing of Schools in the German Health Care System].","authors":"Florian Sandeck, Alina Hanke-Szymczak, Janna Ziegler","doi":"10.1055/a-2416-0948","DOIUrl":"https://doi.org/10.1055/a-2416-0948","url":null,"abstract":"<p><strong>Introduction: </strong>Schools in the health sector play a significant role in the structure of the German education system. In addition to public schools, there are numerous schools, either substitute or supplementary, in the private sector. Many schools are directly attached to a hospital, in contrast to others operating financially independently having cooperation agreements with corresponding facilities for practical training. This article explains the differences between public, substitute and supplementary schools in the health care sector, with particular emphasis on their financing. It also shows the impact of the integration of a school at a hospital.</p><p><strong>Methods: </strong>The information regarding the types of schools was generated through expert interviews and by reviewing current laws. A schematic illustration is intended to promote further understanding of school financing in the health care sector, thus contributing to more transparency.</p><p><strong>Results: </strong>The legal framework conditions for the professions of physiotherapy, occupational therapy and speech therapy are elaborated, as well as basic German Law forming the legal basis for the Hospital Financing Act (KHG). The financing of public schools is regulated by law and is carried by the respective state or municipality. This also applies to public schools in the health care sector. Uniform regulations are also applicable to replacement and supplementary schools falling under the KHG. Trainees receive a salary if their schools cooperate with hospitals with which corresponding funding agreements are in place. However, private schools not affiliated with the KHG training fund must rely on alternative sources of funding, ultimately leading to the necessity to charge tuition fees.</p><p><strong>Conclusion: </strong>Different federal/state-specific regulations contributing to the financing of health care education is often unclear and incomprehensible. Due to current laws, tuition-free education cannot be guaranteed in every federal state or at every school. It remains to be seen if or to what extent changes will take place leading to uniform, transparent and comprehensible financing of the training landscape in the health professions in the German education system.</p>","PeriodicalId":47653,"journal":{"name":"Gesundheitswesen","volume":" ","pages":""},"PeriodicalIF":0.7,"publicationDate":"2024-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142606801","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":"[Potential of a Telemedical, Inpatient-Outpatient Care Concept to Improve the Quality of Healthcare from the User's Perspective - An Acceptance Analysis of the TELnet@NRW Study].","authors":"Carolin Schmidhuber, Veronika Strotbaum, Rainer Beckers, Annette Hempen, Carina Benstöm, Gernot Marx, Sandra Dohmen","doi":"10.1055/a-2348-3136","DOIUrl":"10.1055/a-2348-3136","url":null,"abstract":"<p><strong>Objective: </strong>The aim of this study was to measure the acceptance of a telemedical, inpatient-outpatient care concept by physicians, patients and the relatives of patients. Based on a quantitative survey of acceptance, both the potential and success factors influencing the use of telemedicine were to be highlighted.</p><p><strong>Methods: </strong>The TELnet@NRW study is a national, multicenter, cluster-randomized study in stepped-wedge design conducted from February 2017 to January 2020 for the purpose of documenting changes in the quality of care through telemedicine in an inpatient-outpatient network. Consultations were focused on intensive care medicine and infectious diseases. This current study used questionnaires for specific groups of patients to determine acceptance of the telemedical care concept practiced in the main study. The survey was anonymously conducted once in either digital or paper-based form during the reporting period.</p><p><strong>Results: </strong>The answers of 126 questionnaires from physicians and 1686 questionnaires from patients and their relatives were evaluated. The physicians of both sectors attributed high potential (up to 88.4%) for telemedicine to improve guideline-adherent treatment. A trustworthy and appreciative communication during the telemedical consultation represented a positively reinforcing success factor. The additional workload generated by telemedicine inhibited acceptance, especially in the inpatient sector. A continuation of telemedicine beyond the end of the project was supported by the majority of surveyed physicians (inpatient 60.6%, outpatient 82.1%) as well as in patients and their relatives (inpatient 79.7%, outpatient 57.4%) in both sectors.</p><p><strong>Conclusion: </strong>There is widespread acceptance of telemedical, inpatient-outpatient care concepts among physicians, patients and their relatives. Low-effort processes and user-centered technology are crucial to increase the rate of use. Telemedicine has the potential to improve the quality of care and can serve as a robust component of sustainable healthcare in Germany.</p>","PeriodicalId":47653,"journal":{"name":"Gesundheitswesen","volume":" ","pages":"723-729"},"PeriodicalIF":0.7,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11555784/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141898632","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":"[Key Topics and Activities of Local and District Health Conferences between 2013 and 2022: Results of a Non-Reactive Online Screening].","authors":"Julia Brockschnieder, Julia Haas, Julia Neubauer, Kathrin Prosser, Bertram Szagun","doi":"10.1055/a-2305-7716","DOIUrl":"10.1055/a-2305-7716","url":null,"abstract":"<p><strong>Objectives: </strong>The tasks of the Public Health Service include, amongst others, health promotion and disease prevention, health reporting and health planning. In many places, local or district health conferences (HCs) have been established to network and coordinate municipal stakeholders. HCs have been defined in the laws of the German states of Baden-Wurttemberg, Berlin, Hamburg, Hesse, and North Rhine-Westphalia. As systematic and comprehensive studies of HCs are not available, a descriptive analysis of the characteristic features, key topics and activities of HCs in selected states was performed.</p><p><strong>Methods: </strong>Based on a non-reactive survey of the activities from 2013 to 2022, all HCs in four states (n=110) were covered. Data on structural features, topics and HC activities were gathered in a systematic approach. The topics these conferences dealt with were matched against the health objectives of the states. Following an internal verification of the results, univariate and bivariate analyses were performed for individual states, districts, and the year of establishment.</p><p><strong>Results: </strong>Overall, topics frequently covered by the HCs are primary care, children's and adolescent health, health at old age, infection prevention and control, physical exercise and diet as well as addiction; in some cases, frequencies of these topics differed heavily among the states and municipalities. The topics covered by the HCs showed a strong association with the health objectives of the respective states. Health care is addressed more often in administrative districts (Landkreise) than in independent cities (kreisfreie Städte). Conferences established more recently (after 2011) exhibited greater activities than older ones in terms of plenary sessions and press releases.</p><p><strong>Conclusion: </strong>HCs are marked by a wide range of key topics which are based on health objectives of the respective states; however, noticeable differences exist between rural and urban areas. Conferences established more recently show a higher level of activity than older ones, which might point to sustainability issues under the current constraints. Whereas differences between rural and urban areas had already been noted for health-reporting activities, this was not the case for HC activities. The hypotheses derived from this descriptive analysis warrant further examination in order to ensure that the HCs create a sustainable impact.</p>","PeriodicalId":47653,"journal":{"name":"Gesundheitswesen","volume":" ","pages":"739-745"},"PeriodicalIF":0.7,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11555775/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140853115","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 Show Must Go on\": Medical Assistants and Their Experience Managing Vaccination during the Covid-19 Pandemic].","authors":"Anastasia Suslow, Kathrin Schlößler, Nino Chikhradze, Romy Lauer, Horst Christian Vollmar, Ina Carola Otte","doi":"10.1055/a-2319-3045","DOIUrl":"10.1055/a-2319-3045","url":null,"abstract":"<p><strong>Background: </strong>With the beginning of the Covid-19 vaccinations in primary care, a new and work-intensive responsibility arose for medical assistants (MA). In addition to their existing duties and the challenges posed by Covid-19, they had to organize, plan, and in some cases carry out the vaccinations and follow up on the documentation.</p><p><strong>Methods: </strong>A total of 21 semi-structured interviews were conducted with MA between April and September 2021. Particularly considering the timing of the interview, questions were asked about the daily work routine and the associated vaccine organization. The interviews were then analyzed using MAXQDA software based on Kuckartz's qualitative content analysis.</p><p><strong>Results: </strong>The MA criticized a lack of organization and transparency in the planning and implementation of vaccinations. Each vaccination had to be pre- and post-processed, resulting in an immense bureaucratic effort. Additional work and stress were the results. Also, MA had to deal with difficult patients.</p><p><strong>Conclusion: </strong>The experience of MA must be taken into consideration in the future to create guidance for dealing with an increased demand for vaccinations. The guidelines for the future must ensure that MA are relieved and supported by a meaningful organization during such events.</p>","PeriodicalId":47653,"journal":{"name":"Gesundheitswesen","volume":" ","pages":"705-711"},"PeriodicalIF":0.7,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11555776/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141761677","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 for Non-Surgical Management of Chronic Primary Low Back Pain in Adults in Primary and Community Care Settings].","authors":"Isabel Moser, Isolde Sommer, Gerald Gartlehner","doi":"10.1055/a-2375-3671","DOIUrl":"10.1055/a-2375-3671","url":null,"abstract":"<p><strong>Background: </strong>Low back pain is a very common condition that affects most people at some point in their lives. It represents a burden on those affected, reducing their ability to participate in activities of normal life; at the same time, dealing with it increases the economic costs of healthcare.</p><p><strong>Aim: </strong> The aim of this guideline was to contribute to WHO activities for reducing the impact of low back pain in adults and to support the WHO approach to integrated care for older people in primary care.</p><p><strong>Methods: </strong>In December 2023, the World Health Organization (WHO) published the \"WHO guideline for non-surgical management of chronic primary low back pain in adults in primary and community care settings\". It was developed following the process according to the WHO handbook for guideline development. The team at the WHO Collaborating Centre for Evidence-Based Medicine at the University for Continuing Education Krems (Austria) translated the summary of this guideline for its application in German-speaking countries.</p><p><strong>Results/conclusion: </strong>The guideline addresses 37 interventions for the treatment of chronic primary low back pain in primary care and provides 24 recommendations and one good practice statement. No recommendations were made regarding twelve interventions due to equivocation or lack of sufficient evidence. The recommended interventions are intended to provide a range of options to support and personalize care for adults with chronic primary low back pain.</p>","PeriodicalId":47653,"journal":{"name":"Gesundheitswesen","volume":" ","pages":"715-722"},"PeriodicalIF":0.7,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11555783/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142298691","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":"[On the Potential of Prevention Counselors in the Primary Care Setting: Evaluation Study of an Intervention in the State of Brandenburg (Germany)].","authors":"Tim Holetzek, Sylvia Euler, Philipp Jaehn, Laura Josephin Schliephacke, Andrea Trunev, Christine Holmberg","doi":"10.1055/a-2266-9954","DOIUrl":"10.1055/a-2266-9954","url":null,"abstract":"<p><strong>Purpose of the study: </strong>The study investigates the extent to which medical assistants can support primary prevention measures in family practices as prevention advisors.</p><p><strong>Methods: </strong>Between July 2019 and December 2020, preventive measures were implemented by trained prevention counselors in general practitioners' practices in a rural region in Brandenburg. They consisted of longer-term support for individuals in lifestyle changes in the areas of \"nutrition\", \"exercise\" and \"relaxation\". The accompanying process and outcome evaluation included pre-post comparisons of selected medical parameters as well as the investigation of possible changes in health literacy and health-related quality of life using standardized questionnaires (HeiQ-Core, SF-12v2). Furthermore, thematic analyses of training documents, participant surveys using a questionnaire, two focus groups with prevention counselors, and five interviews with study participants were conducted.</p><p><strong>Results: </strong>Four primary care practices and two health care facilities were recruited and seven health care workers were trained as prevention counselors. Thirty-eight individuals were enrolled in the prevention program. Although overall counseling sessions were conducted according to training specifications, various individual as well as structural barriers ensured low uptake of the intervention.</p><p><strong>Conclusions: </strong>The extent to which preventive measures adapted to the individual can be successfully established in primary care practices with the help of health care workers trained as prevention counselors depends strongly on the respective practice structures as well as the patient clientele. Temporal integration and coordination of the activities of prevention advisors in the daily practice routine seems to be likely to lead to success in interventions of the kind evaluated here.</p>","PeriodicalId":47653,"journal":{"name":"Gesundheitswesen","volume":" ","pages":"730-738"},"PeriodicalIF":0.7,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11555778/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140869457","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":"[Should I Stay or Should I go? Resilience, Intention to Quit and Job Satisfaction among Nurses in Intensive Care Units].","authors":"Nina Füreder, Gabriele Herber, Elke Stadlmayr","doi":"10.1055/a-2389-8453","DOIUrl":"10.1055/a-2389-8453","url":null,"abstract":"<p><strong>Aim: </strong>Addressing the global nursing shortage is crucial to both national and international public health efforts. This paper aims to highlight the importance of resilience and its impact on primary care nurses' job satisfaction and intentions to quit, especially in the face of current challenges.</p><p><strong>Methods: </strong>The study utilized a mixed methods design involving nurses in intensive care units of a university hospital in Austria. In the first phase of data collection, qualitative focus group interviews were conducted to gather insights on the current challenges and stressors faced by nursing professionals. Building on relevant literature, a quantitative survey was then administered to all nurses, using scales measuring resilience, intention to quit, and job satisfaction in order to examine the relationships between these variables. In addition, a data structuring of the resilience scale by factors was achieved with the help of confirmatory factor analysis. Subsequently, the correlations of the resilience factors with the other variables were examined by means of an additional correlation, regression and mediation analysis.</p><p><strong>Results: </strong>The results showed negative correlations with regard to resilience and intention to quit as well as with regard to job satisfaction and intention to quit. In contrast, job satisfaction and resilience correlated significantly positively with each other. The negative correlation between resilience and the intention to quit was confirmed, but only for the factors \"goal focus\" and \"pride and commitment\". A closer examination of the two factors and their associated items revealed a connection to both professional identity and organizational identity.</p><p><strong>Conclusion: </strong>This study provides valuable insights for health care leaders and health care decision makers to effectively lead, develop, and thereby retain primary care nurses. The authors argue that improving resilience and strengthening organizational identity are important influencing factors in increasing job satisfaction and reducing nurses' intention to quit.</p>","PeriodicalId":47653,"journal":{"name":"Gesundheitswesen","volume":" ","pages":"691-704"},"PeriodicalIF":0.7,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11555780/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142366957","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":"[Participation in children's hospitals: approaches to participatory formats for paediatric patients].","authors":"Julia Bauer, Holly Clark, Michaela Coenen, Christoph Klein, Eva Annette Rehfuess, Carolin Ruther, Stephan Voss, Varinka Voigt-Blaurock, Caroline Jung-Sievers","doi":"10.1055/a-2270-2840","DOIUrl":"10.1055/a-2270-2840","url":null,"abstract":"<p><p>Based on the UN Convention on the Rights of the Child, children and young people have the right to participate in all matters and decisions that affect them. This applies in particular when they are patients in a children's hospital. In the international context, established formats for the participation of young patients regarding health issues already exist, for example \"Children's Councils\" or \"Young Person's Advisory Groups\". In Germany, such approaches are still mostly lacking. It thus remains important to develop suitable formats that enable meaningful and effective participation of young patients in the health system. These formats must be chosen in such a way that they can realistically be implemented in clinical settings as well as in pediatric research, and that they can be sustained in the long term. In order to strengthen the consideration of children's rights in the health system, the advancement of such participatory formats as well as their sustainable implementation and evaluation are desirable.</p>","PeriodicalId":47653,"journal":{"name":"Gesundheitswesen","volume":" ","pages":"712-714"},"PeriodicalIF":0.7,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11555779/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140868033","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}