Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz最新文献

{"title":"[Barriers to cycling for transportation: findings from the population-based survey \"Health in Germany\"].","authors":"Kristin Manz, Susanne Krug, Gert B M Mensink, Julika Loss","doi":"10.1007/s00103-026-04311-w","DOIUrl":"https://doi.org/10.1007/s00103-026-04311-w","url":null,"abstract":"<p><strong>Background: </strong>Traveling by bicycle rather than by car has a wide range of positive effects on individual and public health. As the proportion of journeys made by bicycle in Germany is currently low, this article examines the barriers to everyday cycling and differences between socio-demographic groups.</p><p><strong>Methods: </strong>As part of the 2025 annual survey of the Robert Koch Institute's population-based panel \"Health in Germany,\" adults were asked about their everyday use of bicycles and the barriers to cycling. Differences between socio-demographic groups were examined using regression analyses. Data from 32,374 individuals were included in the analyses.</p><p><strong>Results: </strong>The five most frequently cited barriers were poor weather conditions (51.1%), distances being too long (45.1%), not wanting to arrive at the destination sweaty (42.8%), transporting luggage or passengers (34.4%), and a lack of changing rooms and showers (31.9%). Significant differences were observed between socio-demographic groups: safety-related barriers were more relevant for women, whilst for older people and those with a lower level of formal education, their own health and fitness, as well as the lack of a (good) bicycle, were more significant. People living in rural areas were more likely to cite journeys that were too long or too hilly.</p><p><strong>Discussion: </strong>The results show that barriers to cycling exist at both the environmental and individual levels, and therefore measures are required at multiple levels. In particular, the needs of population groups who have so far used bicycles less frequently should be addressed to reduce barriers and promote health equity.</p>","PeriodicalId":9562,"journal":{"name":"Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149134766","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":"[Use of a digital health navigator in the emergency department: experiences and acceptance among patients and physicians].","authors":"Maria Schwenke, Pascal Samtlebe, Susann Homann, Anja Knöchelmann","doi":"10.1007/s00103-026-04302-x","DOIUrl":"10.1007/s00103-026-04302-x","url":null,"abstract":"<p><strong>Background: </strong>The increasing use of emergency departments (EDs) for low-acuity cases leads to growing challenges for hospitals. Since 2023, a digital patient navigator (DGL) has been implemented in the ED of the University Hospital Halle (Saale). The AI-based decision support system provides an initial assessment based on a symptom-based self-anamnesis and recommends appropriate care pathways; the collected data are also available to medical staff for consultation. This study examines patients' user experiences and evaluations as well as physicians' acceptance and use of the DGL results.</p><p><strong>Methods: </strong>In an exploratory convergent mixed-methods study, 82 patients classified in Manchester Triage Levels 4 or 5 were surveyed using the UEQ‑S and eHEALS instruments (August 2025 to January 2026). A further eight physicians were interviewed and analyzed using structured qualitative content analysis.</p><p><strong>Results: </strong>Both groups were generally open to the usage of the DGL. Patients rated comprehensibility (61%), design (54%), and data security (52%) mostly positively, while the symptom assessment was criticized. Unstable internet connections and a lack of technical equipment made usage difficult. Physicians expressed concerns regarding validity and reliability. An integration into workflows was not established. Patients saw potential in the initial orientation, while physicians saw potentials in (post-)triage and decisions regarding waiting times, information structuring, and overcoming language barriers. Time constraints and the patients' health limitations and impairments limited the use in the ED.</p><p><strong>Discussion: </strong>Critical to the implementation of the DGL was systemic fitting rather than individual acceptance. Technical barriers need to be addressed; better information and flexible data collection were deficits that hindered the sustained integration into clinical workflows. This should be the focus of future research.</p>","PeriodicalId":9562,"journal":{"name":"Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz","volume":" ","pages":"1165-1173"},"PeriodicalIF":1.6,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13624017/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148943963","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":"[Patient steering from a health economics perspective: conditions for effective cost-sharing in a European comparison].","authors":"Sebastian Böhme, Jessica Paas, Zoe Konjer, Jonas Meyrer, Jonas Schreyögg","doi":"10.1007/s00103-026-04301-y","DOIUrl":"10.1007/s00103-026-04301-y","url":null,"abstract":"<p><p>Rising health expenditures and demographic change increasingly challenge the financing and steering of healthcare in Germany. Cost-sharing instruments are recurrently discussed as a means of reducing inappropriate utilisation, most recently in the context of a primary care gatekeeping system. This article analyses the institutional design and empirical evidence on financial steering instruments in four European health systems (Germany, the Netherlands, France, Denmark) and synthesises the findings from a health economics perspective. The effectiveness of copayments emerges as a function of three interrelated conditions: the type of service, the behavioural-economic design and the institutional architecture. Uniform copayments are regressive and disproportionately burden insured persons with low income. Based on the international evidence, a reintroduction of the previous German practice fee (Praxisgebühr) is not advisable. A more promising approach would design copayments as a targeted steering instrument at points where inappropriate utilisation is empirically identified, such as when patients inappropriately bypass a coordinated care pathway. This requires accounting for behavioural-economic effects and income-related differences. Configured in this way, copayments can contribute to improving patient steering without jeopardising access to standard care.</p>","PeriodicalId":9562,"journal":{"name":"Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz","volume":" ","pages":"1136-1145"},"PeriodicalIF":1.6,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13623994/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149015795","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":"[Age and gender aspects in the utilization of emergency departments and their consideration in the management of emergency care].","authors":"Kalina Witt, Viktoria Bogner-Flatz, Ulrike von Arnim, Mandy Schulz, Kristine Huber, Claudia Ritter-Rupp, Sarah Oslislo","doi":"10.1007/s00103-026-04252-4","DOIUrl":"10.1007/s00103-026-04252-4","url":null,"abstract":"<p><strong>Introduction: </strong>Emergency department (ED) care should be guided according to patient needs and demand. Age and gender influence consultation and care patterns. This study aims to analyze these factors as well as upstream care pathways in order to reduce misallocation and improve quality of care.</p><p><strong>Methods: </strong>Between March and November 2024, standardized patient surveys were conducted in 5 Berlin and 18 Bavarian emergency departments (n = 10,040). Data collected included sociodemographic characteristics, presenting complaints, subjective urgency, physician contacts, and awareness of the 116117 hotline. Influencing factors were analyzed using logistic regression; only cases indicating \"male\" or \"female\" were included.</p><p><strong>Results: </strong>A total of 9835 questionnaires were analyzed (49.6% female); patients were predominantly from older age groups. Reasons for presentation differed by gender: for example, women more frequently reported pain as well as neurological or abdominal complaints, whereas men more often presented with injuries. Health-related anxiety was a key motive for seeking care in about 37.8% of cases and was more common among women. A prior attempt to contact ambulatory care was reported by 48.7% of women and 44.2% of men (p < 0.001). Direct ED visits were more frequent in cases of higher urgency and injuries. Awareness of the 116117 hotline was 67.0% among women and 60.3% among men and decreased with age; willingness to use digital self-assessment tools was higher among younger individuals.</p><p><strong>Discussion: </strong>Age and gender influence both utilization patterns and the steerability of emergency care. Target group-specific, low-threshold, and digital interventions may help reduce misallocation and improve quality of care.</p>","PeriodicalId":9562,"journal":{"name":"Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz","volume":" ","pages":"1194-1203"},"PeriodicalIF":1.6,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13623991/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148216497","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":"[Environment and health-prerequisites for safety and resilience. Position paper of the Environmental Public Health Commission].","authors":"Annette Peters, Hajo Zeeb, Caroline Herr, Wolfgang Straff, Claudia Traidl-Hoffmann, Tobia Lakes, Claudia Hornberg","doi":"10.1007/s00103-026-04303-w","DOIUrl":"10.1007/s00103-026-04303-w","url":null,"abstract":"<p><p>Negative environmental impacts on human health-which are a central focus of the health sciences-are primarily the result of human interference with ecosystems. This is evident in global and local issues such as climate change, environmental pollution, biodiversity loss, emerging pandemics, and the numerous health consequences of war. In times of multiple crises, the interplay between the environment and health should be a priority, as it forms the foundation for a resilient society.In a globalized world marked by political and ecological tensions, it is clear that environmental, health, and security issues are closely intertwined. An intact environment is not only an ecological and ethical goal but also serves as a central health resource that contributes significantly to the stability and security of modern societies.Using three illustrative areas-climate change and health, air pollutants and health, and biodiversity and health-conclusions regarding environmental and health-related security issues are presented. Based on these findings, the Environmental Public Health Commission summarizes specific recommendations for ensuring and continuing cross-sectoral cooperation on environment and health.</p>","PeriodicalId":9562,"journal":{"name":"Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz","volume":" ","pages":"1228-1236"},"PeriodicalIF":1.6,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13623984/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149036317","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":"[Mapping municipal psychosocial services for children and parents: access and coordination barriers in preventive care-a mixed methods study].","authors":"Sarah Beierle, Anika Reinhart, Susanne Kuger, Sabine Walper, Birgit Reißig, Silvia Schneider, Lukka Popp, Babett Voigt, Freia De Bock","doi":"10.1007/s00103-026-04307-6","DOIUrl":"10.1007/s00103-026-04307-6","url":null,"abstract":"<p><strong>Background: </strong>Services for the primary and secondary prevention of mental disorders in children are distributed across the health, education and social sectors. Comprehensive prevention requires their coordinated collaboration at the municipal level. However, there is currently no systematic scientific assessment of municipal psychosocial service landscapes for families.</p><p><strong>Methods: </strong>In two socially disadvantaged neighbourhoods in a large city in western Germany and one in eastern Germany, professionals from the health, education and social sectors were interviewed (N = 19), and psychosocial prevention services were mapped online across sectors. Services were categorised according to support functions, and the results were fed back into the interview findings.</p><p><strong>Results: </strong>Professionals described the service landscape as fragmented and difficult to navigate; information and navigation barriers particularly affect low-income and immigrant families. The mapping identified 122 facilities providing 360 services visible online. It revealed sector-specific patterns; indications of potential undersupply in specialised paediatrics, child and adolescent psychotherapy, and child and adolescent psychiatry; limited outreach to migrants; and differences in the digital findability of services.</p><p><strong>Discussion: </strong>The mixed-methods approach provides a basis for developing an instrument for the systematic assessment of psychosocial service landscapes. However, the mapping captured only services visible online and has not yet included waiting times, further barriers to access or actual service use. Future instruments should address these aspects in greater detail and involve professionals in the development of the instrument.</p>","PeriodicalId":9562,"journal":{"name":"Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz","volume":" ","pages":"1204-1212"},"PeriodicalIF":1.6,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13624005/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148943792","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":"[Patient navigation in severe mental illness-challenges, models, and perspectives].","authors":"Martin Lambert, Anja Zimmermann, Jürgen Gallinat","doi":"10.1007/s00103-026-04299-3","DOIUrl":"10.1007/s00103-026-04299-3","url":null,"abstract":"<p><p>Severe mental illness (SMI) is associated with chronic courses, significant functional impairments, and increased mortality. At the same time, care for this population is characterized by fragmentation, lack of continuity, and insufficient coordination. Against this background, patient navigation has gained importance as an approach to improving the quality and efficiency of care. The aim of this narrative review is to present key evidence-based models of care for individuals with SMI, to analyze structural challenges in service provision, and to derive principles for effective patient navigation.The evidence shows that community-based, multidisciplinary, and continuous care approaches-such as assertive community treatment, crisis intervention, and early intervention programs-can improve clinical and functional outcomes, reduce hospitalizations, and enhance continuity of care. At the same time, it becomes clear that the isolated implementation of individual intervention models is insufficient to sustainably address structural deficits.Integrated and stepped care models enable the systematic linkage of evidence-based interventions along a continuous care pathway. Current findings indicate that such approaches can improve quality of care while being implementable without additional costs and may even generate cost savings. Patient navigation thus represents a key strategy to strengthen continuity of care, reduce fragmentation, and sustainably improve patient outcomes as well as resource efficiency.</p>","PeriodicalId":9562,"journal":{"name":"Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz","volume":" ","pages":"1213-1220"},"PeriodicalIF":1.6,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13623803/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148981946","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":"[Patient navigation in the German healthcare system: Between hopes for reform, historical legacies, and overregulation : A commentary on the current debate].","authors":"Franz Knieps","doi":"10.1007/s00103-026-04294-8","DOIUrl":"10.1007/s00103-026-04294-8","url":null,"abstract":"","PeriodicalId":9562,"journal":{"name":"Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz","volume":" ","pages":"1125-1127"},"PeriodicalIF":1.6,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149029676","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":"[Which chronic conditions are suitable for specialist-led care within a primary care system? : An exploratory analysis based on routine data from physicians participating in the statutory health insurance system].","authors":"Sandra Mangiapane, Emil Hu, Dominik von Stillfried","doi":"10.1007/s00103-026-04293-9","DOIUrl":"10.1007/s00103-026-04293-9","url":null,"abstract":"<p><strong>Background: </strong>With the introduction of general practitioner (GP) gate keeping, specialists would also be able to assume primary care responsibilities for patients with severe chronic conditions. The aim of this study was to develop a data-driven method for identifying potentially suitable conditions and to illustrate the relevance of individual medical specialties to patient care.</p><p><strong>Methods: </strong>Using nationwide claims data of statutory health insurance physicians for 2024, the proportions of cases and treatment days per patient treated by primary care physicians and specialists were determined for each ICD‑3 code (the first three digits of the International Classification of Diseases). Categories were considered to have high relevance for specialist care if for more than half of the patients, at least 60% of treatment cases and at least 50% of treatment days were attributable to specialists. F33, G35, K51, M05, and N25 were analyzed in greater detail as examples.</p><p><strong>Results: </strong>There were 173 ICD-3 codes highly relevant to specialist care. With regard to the five selected ICD-3 codes, patients with impaired renal function (N25) had the highest proportion of specialist care: 83% of patients were receiving nephrological treatment, with nephrologists accounting for 77% of disease-specific cases but only 37% of all treatment days. For all five indications, general practitioners accounted for the highest proportion of all treatment days (43% to 55%). Of these patients, 92 to 97% were treated by general practitioners.</p><p><strong>Discussion: </strong>If specialists were to take on the role of primary care coordinators for these patients, they would have to coordinate care across a broad range of medical specialties. This would likely limit their cross-specialty coordination tasks to individual cases or restrict it to their own specialty.</p>","PeriodicalId":9562,"journal":{"name":"Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz","volume":" ","pages":"1155-1164"},"PeriodicalIF":1.6,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13623776/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148911043","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":"Tätigkeitsbericht der Zentralen Ethik-Kommission für Stammzellenforschung (ZES) : 23. Bericht nach Inkrafttreten des Stammzellgesetzes (StZG) für den Zeitraum vom 01.01.2025 bis 31.12.2025.","authors":"","doi":"10.1007/s00103-026-04273-z","DOIUrl":"https://doi.org/10.1007/s00103-026-04273-z","url":null,"abstract":"","PeriodicalId":9562,"journal":{"name":"Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz","volume":"69 10","pages":"1237-1247"},"PeriodicalIF":1.6,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149079812","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}