Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz最新文献

{"title":"[Guiding patients along effective treatment pathways].","authors":"Joseph Kuhn, Uwe Koch, Matthias Gruhl","doi":"10.1007/s00103-026-04306-7","DOIUrl":"https://doi.org/10.1007/s00103-026-04306-7","url":null,"abstract":"","PeriodicalId":9562,"journal":{"name":"Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz","volume":"69 10","pages":"1123-1124"},"PeriodicalIF":1.6,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149079783","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":"[A primary care system in Germany: evidence, opportunities, and implementation].","authors":"Martin Scherer, Thomas Zimmermann, Eva Hummers","doi":"10.1007/s00103-026-04296-6","DOIUrl":"10.1007/s00103-026-04296-6","url":null,"abstract":"<p><p>International comparisons show that healthcare systems with strong, coordinated primary care often achieve better health outcomes while using resources more efficiently. Against this background, this narrative review, based on the available literature and data from the Organisation for Economic Co-operation and Development (OECD), provides an overview of healthcare structures, utilization, and outcomes in Germany compared with 11 other European countries and interprets the findings in the context of healthcare systems coordinated by primary care.The results show that Germany is characterized by high utilization of healthcare services and high healthcare expenditure, while at the same time performing comparatively poorly on key health indicators, particularly avoidable mortality. Stronger coordination through primary care could help improve these outcomes.At the same time, the findings highlight that the success of primary care-coordinated healthcare systems depends critically on their structural framework. In addition to sufficient primary care capacity, interprofessional teams, robust digital infrastructure, and binding mechanisms for coordination and feedback are essential prerequisites. Strengthening primary care alone, however, is not sufficient: its effectiveness requires far-reaching structural reforms and a stronger orientation of the healthcare system toward preventive measures.</p>","PeriodicalId":9562,"journal":{"name":"Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz","volume":" ","pages":"1146-1154"},"PeriodicalIF":1.6,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13623980/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148987903","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 management and patient autonomy: An ethical tension?]","authors":"Aline Weis, Andreas Bruns, Julia Sanchez, Eva C Winkler","doi":"10.1007/s00103-026-04300-z","DOIUrl":"10.1007/s00103-026-04300-z","url":null,"abstract":"<p><p>In the context of current debates in health policy, patient management is increasingly being discussed in the German healthcare system. These measures aim to coordinate access to care, reduce both inappropriate and over-provision of care, and guide patients through a complex healthcare system according to their needs. Critics, however, see this as a violation of patient autonomy and free choice.This article examines whether, and if so, to what extent, there is a conflict between patient management and autonomy. The starting point is an analysis of whether and to what extent patient management conflicts with the principle of autonomy. This analysis is based on an understanding of autonomy that encompasses not only the absence of coercion or restrictions on freedom of choice, but also the ability to make well-considered decisions through appropriate information and support.The article demonstrates that management mechanisms are not necessarily at odds with autonomy. Rather, they can structure decision-making spaces, improve orientation, and thus support autonomous decision-making. This is supported by empirical findings that show that formal freedom of choice alone does not guarantee that patients access care in an informed and self-determined way. Instead, structuring instruments are frequently perceived as helpful support.The article then formulates three key criteria for the ethical evaluation of patient management. First, it must be examined whether management mechanisms enable or effectively prevent patients from making preference- and value-based decisions. Second, their contribution to the quality of care is crucial: control is ethically justifiable if it promotes evidence-based and coordinated care without worsening patient outcomes. Third, its significance for justice and fair resource allocation must be considered. In a solidarity-based healthcare system, patient management can be legitimate if it serves to allocate limited resources in a transparent, needs-based, and accountable manner. If these criteria are met, patient management does not conflict with the principle of respect for patient autonomy; rather, in the best-case scenario, it promotes it.</p>","PeriodicalId":9562,"journal":{"name":"Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz","volume":" ","pages":"1221-1227"},"PeriodicalIF":1.6,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13624046/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149015808","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":"Erratum zu: Anlage 8: Anforderungen an die Hygiene bei der Aufbereitung thermolabiler Endoskope : Empfehlung der Kommission für Krankenhaushygiene und Infektionsprävention (KRINKO) beim Robert Koch-Institut.","authors":"","doi":"10.1007/s00103-026-04272-0","DOIUrl":"10.1007/s00103-026-04272-0","url":null,"abstract":"","PeriodicalId":9562,"journal":{"name":"Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz","volume":" ","pages":"1255"},"PeriodicalIF":1.6,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148419003","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":"[Efficiency of streaming and integrated care models for low acuity patients in acute and emergency care-results from a prospective cohort study].","authors":"Daniela Krüger, Cornelia Wäscher, Sylwia Steinke, Felix Holzinger, Hanna Winkler, Martin Möckel, Konrad Schmidt, Anna Slagman","doi":"10.1007/s00103-026-04298-4","DOIUrl":"10.1007/s00103-026-04298-4","url":null,"abstract":"<p><strong>Introduction: </strong>According to the emergency care reform, streaming low-acuity patients to outpatient care structures seeks to relieve emergency departments (EDs). The aim was to compare the care efficiency of different streaming models at the ED site.</p><p><strong>Methods: </strong>This prospective, multicenter cohort study compared three study arms in a primary-data cohort of low-acuity patients and a routine-data cohort of unselected patients: 1) a hospital-operated outpatient practice (hospital practice), 2) an on-call practice operated by the Association of Statutory Health Insurance Physicians (SHI practice), and 3) standard care with physician-assessed streaming potential. The primary endpoint was care efficiency: the proportion of patients directed to the alternative care structure or the assessed streaming potential. The secondary endpoint was patient safety (ED revisit, hospital admission).</p><p><strong>Results: </strong>Among low-acuity patients (primary-data cohort: n = 1096), care efficiency was 49.5% (n = 145) for the hospital practice and 77.2% (n = 322) for the SHI practice. The physician-assessed streaming potential was 73.4% (n = 240). Among unselected ED patients (routine-data cohort: n = 68.010), care efficiency was 11.4% (n = 2558) for the hospital practice and 29.9% (n = 13.668) for the SHI practice. An ED revisit within 30 days occurred in 2.1% (n = 1) after treatment in the hospital practice (no hospital admissions) and in 10.4% (n = 14) after treatment in the SHI practice (hospital admissions: 7.5%, n = 10).</p><p><strong>Discussion: </strong>The streaming and care of low-acuity patients at the ED site was more efficient in the SHI practice but was associated with potentially greater safety risks. Care efficiency in the primary-data cohort is likely overestimated due to recruitment, whereas the routine-data cohort provides more realistic estimates.</p>","PeriodicalId":9562,"journal":{"name":"Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz","volume":" ","pages":"1183-1193"},"PeriodicalIF":1.6,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13623996/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149001332","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 role of family navigators in maternity clinics in the continued care of families].","authors":"Maria Hänelt, Petra Steffen, Ilona Renner","doi":"10.1007/s00103-026-04304-9","DOIUrl":"10.1007/s00103-026-04304-9","url":null,"abstract":"<p><strong>Background: </strong>The proportion of families identified as experiencing psychosocial difficulties in maternity clinics has increased. Therefore, evidence-based development of the healthcare system is urgently needed. This study aims to investigate whether family navigators in maternity clinics can contribute to improving patient management, specifically by referring families in need of support from the clinic to appropriate psychosocial and medical services.</p><p><strong>Methods: </strong>Between May 16 and August 31, 2024, a nationwide survey of all maternity clinics with more than 300 births per year was conducted. The response rate was 48% (256 clinics). The sample is representative nationwide.</p><p><strong>Results: </strong>In 2024, family navigators were place at 67% of maternity clinics in Germany. Clinics with family navigators reported significantly more often that they systematically assess the support needs of (expectant) mothers and families than clinics without such services. Facilities with family navigators more frequently refer families experiencing stress to further psychosocial services (services tailored to a specific, identified need for support).</p><p><strong>Discussion: </strong>Psychosocial difficulties experienced by families can be identified and explored in maternity clinics. Family navigators in maternity clinics can optimize care for families and thus fulfill specific aspects of patient management for (expectant) mothers.</p>","PeriodicalId":9562,"journal":{"name":"Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz","volume":" ","pages":"1174-1182"},"PeriodicalIF":1.6,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13624030/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148918211","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":"[Dual assignment in crisis preparedness: extent and implications of volunteer engagement in civil protection from the hospital perspective : An online survey at Ulm University Hospital].","authors":"Simon Mayer, Sophie Witte, Udo X Kaisers, Manuel Königsdorfer","doi":"10.1007/s00103-026-04309-4","DOIUrl":"https://doi.org/10.1007/s00103-026-04309-4","url":null,"abstract":"<p><strong>Introduction: </strong>The current security situation calls for greater resilience and comprehensive crisis preparedness within the German healthcare system. At the same time, around 90% of civil protection in Germany relies on voluntary work. Clinical staff who also volunteer in civil protection may face competing demands in crisis situations and are unable to be available to both sectors simultaneously. This dual role has so far been scarcely investigated systematically from the perspective of hospitals.</p><p><strong>Methods: </strong>Between 14 January and 15 February 2026, all staff at Ulm University Hospital (UKU), including those at the Service Company Ulm University Hospital (DUU), were surveyed. The questionnaire comprised eleven items on professional role, voluntary work, alert procedures and other characteristics.</p><p><strong>Results: </strong>Of the 1310 participants (out of 8500 respondents), 134 (10.2%) stated that they were active as volunteers in civil protection. Where multiple responses were possible, volunteers were most frequently active in aid organisations (n = 72; 50.3%), followed by the volunteer fire service (n = 43; 30.1%), the German Armed Forces (n = 10; 7.0%) and the Federal Agency for Technical Relief (n = 5; 3.5%). Of the volunteers, 29.9% held a leadership role within their respective organisation.</p><p><strong>Discussion: </strong>The results highlight the potential extent of dual assignments at a German university hospital. To ensure effective crisis preparedness, such dual assignments should be systematically recorded and coordinated deployment plans developed between the organisations involved.</p>","PeriodicalId":9562,"journal":{"name":"Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149104702","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":"Gesundheitliche Beurteilung von Materialien und Gegenständen für den Lebensmittelkontakt im Rahmen des Lebensmittel- und Futtermittelgesetzbuches : 232. Mitteilung.","authors":"","doi":"10.1007/s00103-026-04284-w","DOIUrl":"https://doi.org/10.1007/s00103-026-04284-w","url":null,"abstract":"","PeriodicalId":9562,"journal":{"name":"Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz","volume":"69 10","pages":"1250-1254"},"PeriodicalIF":1.6,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149079814","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 management and personal responsibility as part of a statutory health insurance reform: possible approaches for Germany].","authors":"Andreas Beivers, Annette Höhmann","doi":"10.1007/s00103-026-04292-w","DOIUrl":"10.1007/s00103-026-04292-w","url":null,"abstract":"<p><p>Against the backdrop of the precarious financial situation of Germany's statutory health insurance system (GKV), the introduction of a primary care physician system, in which patients first consult a general practitioner and are referred to a specialist if necessary, is currently the subject of intense debate. The aim is better coordination of care and an overall increase of efficiency in the healthcare system.This discussion paper examines the extent to which a primary care physician system can serve as a key component of a fundamental transformation of the healthcare system and identifies the systemic prerequisites for this. In addition to examining other European countries, the paper also discusses experiences from Germany and offers recommendations. It explores a redefinition of personal responsibility as well as the potential of incentive systems for the sustainable establishment of such a system. Bonus programs modeled after successful loyalty schemes could offer an opportunity to design patient management in a way that is effective, accepted, and socially balanced.Patient management is not a matter of discipline, but of system design. A transformation of the statutory health insurance system that integrates patient management and a modern definition of personal responsibility strengthens not only economic efficiency but also solidarity. Patient management and personal responsibility are not moral appeals, but economic necessities. A solidarity-based system remains stable only if it is efficiently organized.</p>","PeriodicalId":9562,"journal":{"name":"Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz","volume":" ","pages":"1128-1135"},"PeriodicalIF":1.6,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13623797/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148911085","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":"[What are anonymized data? : Options for providing cancer registry data for research in compliance with the General Data Protection Regulation].","authors":"Joachim Hübner, Jana Johne, Maria Heil, Benjamin Barnes","doi":"10.1007/s00103-026-04305-8","DOIUrl":"https://doi.org/10.1007/s00103-026-04305-8","url":null,"abstract":"<p><p>Every day, large amounts of patient-related data are collected in the healthcare system. The prerequisite for using such data for research purposes is usually that the consent of the persons concerned has been obtained or that the data are provided in anonymized form. Both researchers and data holders are often uncertain about what anonymization means and how it can be achieved. Is it sufficient to remove directly identifying information such as name and address? If not, what additional information that could enable identification must be considered? And can a dataset only be considered anonymized if it can be made available to the general public without risk?This article highlights the tension between the needs of research and the data protection interests of the individuals concerned, using the example of cancer registry data. Based on the definition of personal data in Art. 4 No. 1 of the General Data Protection Regulation (GDPR) and current case law of the European Court of Justice (ECJ), it is argued that anonymity is not a property solely inherent to the data. Rather, it depends on the specific risk of re-identification, which is also influenced by the context in which the data are to be provided. The article highlights ways in which the probability of re-identifying a data subject can be minimized, both through data pre-processing and through legal and contractual restrictions on data use. If the remaining risk is judged to be-in the words of the ECJ-\"de facto negligible,\" the pre-requisites for providing data in anonymized form have been met.</p>","PeriodicalId":9562,"journal":{"name":"Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149029768","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}