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van den Bussche H, Berger K, Kemper C, Barzel A, Glaeske G, Koller D. Inzidenz, Rezidiv, Pflegebedürftigkeit und Mortalität von Schlaganfall. AKTUELLE NEUROLOGIE 2010. [DOI: 10.1055/s-0030-1248398] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Luck T, Riedel-Heller SG, Luppa M, Wiese B, Wollny A, Wagner M, Bickel H, Weyerer S, Pentzek M, Haller F, Moesch E, Werle J, Eisele M, Maier W, van den Bussche H, Kaduszkiewicz H. Risk factors for incident mild cognitive impairment--results from the German Study on Ageing, Cognition and Dementia in Primary Care Patients (AgeCoDe). Acta Psychiatr Scand 2010; 121:260-72. [PMID: 19824992 DOI: 10.1111/j.1600-0447.2009.01481.x] [Citation(s) in RCA: 88] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVES To provide age- and gender-specific incidence rates of MCI among elderly general practitioner (GP) patients (75+ years) and to identify risk factors for incident MCI. METHOD Data were derived from the longitudinal German Study on Ageing, Cognition and Dementia in Primary Care Patients (AgeCoDe). Incidence was calculated according to the 'person-years-at-risk' method. Risk factors were analysed using multivariate logistic regression models. RESULTS During the 3-year follow-up period, 350 (15.0%) of the 2331 patients whose data were included in the calculation of incidence developed MCI [person-years (PY) = 6198.20]. The overall incidence of MCI was 56.5 (95% confidence interval = 50.7-62.7) per 1000 PY. Older age, vascular diseases, the apoE epsilon4 allele and subjective memory complaints were identified as significant risk factors for future MCI. CONCLUSION Mild cognitive impairment is frequent in older GP patients. Subjective memory complaints predict incident MCI. Especially vascular risk factors provide the opportunity of preventive approaches.
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van den Bussche H, Du Moulin M. Berufseinstiegsprobleme und Berufsausstiegstendenzen bei Absolventen und Absolventinnen des Medizinstudiums in Deutschland und in anderen OECD-Ländern. DAS GESUNDHEITSWESEN 2009. [DOI: 10.1055/s-0029-1239121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Eisele M, Kaduszkiewicz H, Schön G, Koller D, Wiese B, Hoffmann F, Glaeske G, van den Bussche H. Inanspruchnahmeverhalten von ambulanten Gesundheitsleistungen vor, während und unmittelbar nach Diagnosestellung einer Demenz – Inwiefern unterscheiden sich Demenzkranke von nicht demenziell Erkrankten? DAS GESUNDHEITSWESEN 2009. [DOI: 10.1055/s-0029-1239212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Gedrose B, Kromark K, Köhl N, Robra B, Rothe K, Schmidt A, Stosch C, Wagner R, Alfermann D, van den Bussche H. Karriereplanung von Absolventen und Absolventinnen des Medizinstudiums vor Beginn der Facharztweiterbildung. DAS GESUNDHEITSWESEN 2009. [DOI: 10.1055/s-0029-1239087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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van den Bussche H, Ernst A, Jahncke-Latteck Ä, Schramm U. Kooperation zwischen Hausärzten und Pflegediensten bei Demenzpatienten – Erste Ergebnisse der Interventionsstudie KOVERDEM. DAS GESUNDHEITSWESEN 2009. [DOI: 10.1055/s-0029-1239123] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Barzel A, Eisele M, Bussche HVD. [Outpatient management of stroke patients from the viewpoint of general practitioners in Hamburg--an exploratory study]. DAS GESUNDHEITSWESEN 2008; 70:170-6. [PMID: 18415925 DOI: 10.1055/s-2008-1062731] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
OBJECTIVE Stroke is the archetype of a chronic disease, with a considerable burden on ambulatory care. After discharge from hospital or inpatient rehabilitation, stroke patients are attended primarily by general practitioners (GPs). Little is known about the quality of outpatient care for stroke patients, so this study focused on the views of professionals involved in outpatient care. METHODS A postal survey of 443 general practitioners from Hamburg, Germany was undertaken. Results were compared with a parallel survey carried out with physiotherapists and occupational therapists. RESULTS 89 questionnaires were analysed. Based on a response rate of 28% the results cannot be seen as representative, but they do provide important information. As it seems, problems in ambulatory care do not start after discharge from hospital, but are partly caused by inpatient care. GPs see therapeutic benefits in ambulatory care for only half of their chronic stroke patients. They assess their own therapeutic efforts as effective in terms of medication, but they are less successful in changing their patients' behaviour with regard to lifestyle. Estimations of the prevalence of post-stroke depression vary substantially, with a mean of 47%. With regard to their daily practice, 60% of GPs do not find guidelines to be helpful. All in all, respondents describe the situation of chronic stroke patients and their families to be complex and difficult to manage. In addition to their professional performance, GPs carry out duties related to case management - as do the therapists. CONCLUSION The care of stroke patients is not only the responsibility of a single group of professionals, but is a rather complex task involving different health-care professionals. The rehabilitation process and the interdisciplinary cooperation need to be further analysed to ensure a good cooperation between health-care professionals and to improve the quality of ambulatory care for stroke patients.
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Barzel A, Eisele M, van den Bussche H. Ambulante Versorgung von Schlaganfallpatienten aus der Sicht Hamburger Physio- und Ergotherapeuten. PHYSIOSCIENCE 2007. [DOI: 10.1055/s-2007-963640] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Kothe R, Sommerfeldt D, Morfeld M, Quellmann C, Weidtmann K, Fuhrhop I, van den Bussche H, Gawad KA. [The new curriculum for surgery in Hamburg, Germany]. Chirurg 2006; 77:622-9. [PMID: 16786341 DOI: 10.1007/s00104-006-1180-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
In October 2004, the medical faculty of Hamburg University started a program to restructure completely clinical teaching according to new state regulations of June 2002. In this new curriculum design, the surgical disciplines were horizontally and vertically interconnected and integrated, with a focus on practical training and problem-based teaching. This study describes the concept of clinical teaching and presents the student evaluation results of the first four blocks with a focus on performance in surgical disciplines. There was high student satisfaction with the new program, compared with results before October 2004 and also with respect to other disciplines within the new curriculum. This was especially true for the practical courses in the newly established skills lab. Future developments in e-learning and practical teaching in the skills lab are necessary to overcome restrictions on medical education due to changes in the German health care system.
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Dunkelberg S, Zingel D, Noack A, van den Bussche H, Kaduszkiewicz H. Welche Patienten werden (nicht) in das DMP Diabetes eingeschlossen? DAS GESUNDHEITSWESEN 2006; 68:289-93. [PMID: 16773549 DOI: 10.1055/s-2006-926768] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
AIM The disease management programme for diabetes mellitus type 2 (DMP) is joined by many General Practitioners. Aim of the study is to compare patients included in this programme with patients not included and to explore reasons for the selection. METHODS 10 GPs in Hamburg participated. From each patient list 10 participants in the DMP and the same number of non-participants were randomly selected. HbA1c before start of the programme, presence of insulin therapy, comorbidity and language skills were documented. GPs reported their estimation of the compliance and their reasoning in the selection process. The hypothesis for the primary endpoint was: Diabetics not included have a worse HbA1c value than those included in the DMP. RESULTS The hypothesis was not confirmed. In both groups similarly good HbA1c values were observed (7.0 in DMP participants, 7.3 in non-participants). The included participants differed from those not included with respect to age (statistically significantly younger) and a better compliance. In the subgroup of patients younger than 70 years the patients included have a better HbA1c and get insulin more frequently (both n. s.). CONCLUSIONS One part of the patients seems to be not included into the DMP for good reasons. Two questions should be further evaluated: To what extent are patients included although they already have a good metabolic situation? And to what extent are patients with a poor compliance not included, although they might benefit from participation?
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Dunkelberg S, Noack A, Sperber S, Zingel D, van den Bussche H, Kaduszkiewicz H. [Disease Management Program for diabetes mellitus type 2: cooperation or resistance of the general practitioner]. DAS GESUNDHEITSWESEN 2006; 68:26-31. [PMID: 16463242 DOI: 10.1055/s-2006-926483] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
AIM of the study was to seize the attitudes of General Practitioners (GPs) towards the disease management program (DMP) for type 2 diabetes implemented in summer 2003 in Germany. Moreover we were interested in the way GPs realise the program in daily practice, e. g. how many patients and which patients they include. METHOD A postal questionnaire was sent twice to all GPs in the region of Hamburg (n = 1.230), in November 2003 and in December 2004. Response rate without reminder was 20 respective 16 percent. RESULTS In 2004 81 percent of the GPs taking part in the survey participate in the DMP. These doctors include a third of their patients with type 2 diabetes into the program. 65 percent of the GPs nevertheless do not believe, that the patients will benefit from the program. 47 percent of the participating GPs object to DMP in general. Only 66 percent say they follow the DMP guidelines for pharmacotherapy. Half of the doctors state they actively canvass patients for the program, while one fifth says they advice patients against participation. The GPs participate in first line to supply the demand of the patients and because of the public pressure less because they think the DMP is good in respect of content. In 2003 critics and pessimism regarding benefit for patients were even stronger than in 2004. CONCLUSIONS GPs participate in the DMP diabetes half-heartedly and with doubts. The results suggest selections in the inclusion of patients. Further research should find out whether patients being likely to profit from the DMP are systematically not included.
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von dem Knesebeck O, Döhner H, Kaduszkiewicz H, van den Bussche H, von Renteln Kruse W. Forschung zur Versorgung im höheren Lebensalter. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2006; 49:167-74. [PMID: 16416109 DOI: 10.1007/s00103-005-1213-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Three examples serve to highlight challenges for health care that stem from population ageing and the health situation of the elderly. The first challenge is to develop and evaluate prevention and health promotion programmes for the elderly. Two promising interventions are outlined: 'preventive home visits' and 'active health promotion in old age'. The second challenge is to improve the coordination of health and social care measures. Case management is presented as one adequate approach in this regard. The third challenge stems from the increasing prevalence of age-specific diseases. In terms of dementia it is pointed out that it is important to improve early diagnosis and to integrate self-help groups and counselling services into therapy.
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Behnke M, Moulin M, Taube K, Lehmann K, van den Bussche H. Evaluation eines häuslichen Gehtrainings als Form der strukturierten Rehabilitationsnachsorge bei Patienten mit chronisch-obstruktiver Lungenerkrankung (COPD). DAS GESUNDHEITSWESEN 2005. [DOI: 10.1055/s-2005-920690] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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von Renteln-Kruse W, Dieckmann P, Anders J, Rösler A, Krause T, van den Bussche H. [Medicine in old age and in the elderly. Educational concepts in area Q7 of the accreditation requirements and its first evaluation by students]. Z Gerontol Geriatr 2005; 38:288-92. [PMID: 16133758 DOI: 10.1007/s00391-005-0274-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2004] [Accepted: 11/18/2004] [Indexed: 11/25/2022]
Abstract
Until very recently, medicine in old age was not an obligatory part of the medical students' education in Germany. This has been changed by an educational reform. However, there are no obliging recommendations or procedures on which issues of medicine in old age should be taught. Therefore, we describe the development of a new curriculum, first experiences with the teaching, and the results of its evaluation by the students at the University of Hamburg. As a result, the subjects and the didactic teaching were both well accepted by the students and judged as interesting and instructive.
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van den Bussche H. Fragen und Thesen zu medikamentösen Behandlungsoptionen der Alzheimer-Demenz mit Acetylcholinesterase-Hemmern. Z Gerontol Geriatr 2005; 38 Suppl 1:I18-20. [PMID: 16189731 DOI: 10.1007/s00391-005-1105-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
The paper reviews the evidence for the recommendation of cholinesterase inhibitors and asks critical questions concerning the reasons for the discrepancy between the weak evidence and the recommendation of these drugs in therapy guidelines. Furthermore, the argument of the severe underuse of these drugs is examined.
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Li GL, de Vries JJ, van Steeg TJ, van den Bussche H, Maas HJ, Reeuwijk HJEM, Danhof M, Bouwstra JA, van Laar T. Transdermal iontophoretic delivery of apomorphine in patients improved by surfactant formulation pretreatment. J Control Release 2005; 101:199-208. [PMID: 15588905 DOI: 10.1016/j.jconrel.2004.09.011] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2004] [Accepted: 09/16/2004] [Indexed: 11/28/2022]
Abstract
The objective of the present study is to evaluate the efficacy and the safety of transdermal iontophoretic delivery of R-apomorphine, a potent dopamine agonist, in combination with surfactant pretreatment in patients with advanced Parkinson's disease. Iontophoresis patches were applied in 16 patients for 3.5 h, with 0.5 h of passive delivery followed by 3 h of current application at a current density of 250 microA/cm2. Eight of these patients were treated with a surfactant formulation prior to iontophoresis. The pharmacokinetics, pharmacodynamic effects, systemic and local side effects of R-apomorphine were assessed. The plasma concentration vs. time profiles upon iontophoresis of R-apomorphine were described successfully by a novel pharmacokinetic model. The model suggests that only 1.9% of the dose that has been released from the patch accumulated in the skin. The patients treated with the surfactant formulations showed a statistically significant increase of bioavailability (from 10.6+/-0.8% to 13.2+/-1.4%) and of the steady state input rate (from 75.3+/-6.6 to 98.3+/-12.1 nmol/cm2 h) compared to the control patients (iontophoresis without absorption enhancers). In five out of eight patients in the study group and in three out of eight patients in the control group, clinical improvement was observed.
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van den Bussche H, Steinberg B, von Brandis S, Sperber S, Zimmermann T. [Effectiveness of an outpatient disease management programme for chronic heart insufficiency patients]. DAS GESUNDHEITSWESEN 2004; 66:656-60. [PMID: 15499509 DOI: 10.1055/s-2004-813593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
The effectivity of a disease management programme (DMP) for outpatients suffering from chronic heart insufficiency (CHI) in primary care is presented. The programme is predominantly based on a weekly telephone monitoring by a case manager using a standardised questionnaire that scores CHI-relevant information of the patient. If the score exceeds a predefined limit the patient's general practitioner is alarmed. An observational study including a total of 115 patients indicates a significant decline of the hospital admission rate (p < 0.0001), as the primary outcome measure, whereas the total length of hospitalization remained constant. The findings are compared with other studies' results and the aims of a randomised controlled trial on the efficacy of DMP on patients with chronic heart failure are discussed.
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Kaduszkiewicz H, Beck-Bornholdt HP, van den Bussche H, Zimmermann T. Fragliche Evidenz für den Einsatz des Cholinesterasehemmers Donepezil bei Alzheimer-Demenz - eine systematische Übersichtsarbeit. FORTSCHRITTE DER NEUROLOGIE-PSYCHIATRIE 2004; 72:557-63. [PMID: 15472779 DOI: 10.1055/s-2004-830077] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
OBJECTIVE Objective of this systematic review is to determine the level of scientific evidence for the use of Donepezil in Alzheimer's Disease. METHODS Ten randomised controlled double-blind trials testing Donepezil versus Placebo were identified in MEDLINE and EMBASE. All ten trials were included in this systematic review. Following a detailed catalogue of criteria the methodological standard of the ten trials was assessed. RESULTS The authors of eight trials postulated statistically significant differences in favour of Donepezil. Unfortunately, the methodological standard of all studies was insufficient. The methodological shortcomings are discussed in detail. CONCLUSION With regard to severe methodological deficiencies the evidence for the use of Donepezil in moderate to severe Alzheimer's Disease is lacking. But even if the trials had been conducted in a methodologically correct way the clinical relevance of the postulated positive results would have to be questioned.
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van den Bussche H, Dunkelberg S. [Who should decide on applications for medical rehabilitation? A critical reappraisal of the proposals of the Advisory Board on Concerted Action in Health Care]. REHABILITATION 2003; 42:350-3. [PMID: 14677106 DOI: 10.1055/s-2003-812544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Summary. In Germany the allocation of rehabilitation services depends on a decision of one of the social insurance funds. This decision is taken on the basis of an assessment of the application file by a physician of the fund. The general practitioner who may be the best informed professional as to the patients' disability, has no decision power in this allocation process. In 2001, however, the prestigious Advisory Board to the Ministry of Health proposed to leave the allocation to the general practitioner or another physician in office practice, thus restricting the role of the fund to verifying the appropriateness of the decision of the GP. This proposal is reviewed on the basis of the results of a survey among all general practitioners in the four Länder of Hamburg, Schleswig-Holstein, Mecklenburg-Vorpommern and Sachsen-Anhalt (n = 2110; response rate of 46%) done between 1999 and 2001. Furthermore, several steps and measures are proposed in view of increasing the involvement of the GP in the allocation process and of improving the communication between the funds and the general practitioners.
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Bullinger M, Morfeld M, Kohlmann T, Nantke J, van den Bussche H, Dodt B, Dunkelberg S, Kirchberger I, Krüger-Bödecker A, Lachmann A, Lang K, Mathis C, Mittag O, Peters A, Raspe HH, Schulz H. [SF-36 Health Survey in Rehabilitation Research. Findings from the North German Network for Rehabilitation Research, NVRF, within the rehabilitation research funding program]. DIE REHABILITATION 2003; 42:218-25. [PMID: 12938044 DOI: 10.1055/s-2003-41645] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
The SF-36 Health Survey and its 12-item abridged form is an instrument for the assessment of health related quality of life that can be used with healthy persons and patient populations. Its use has been recommended within a large German multicentre rehabilitation research programme. The paper examines missing data across all five study projects of the North German Network for Rehabilitation Research (NVRF) as well as psychometric properties of the instrument. In addition, data were compared to representative norm data using the SF-36 (SF-12) in the German National Health Survey. Results showed that there were few missing data in the SF-36. Examining the impact of age, gender and health status yielded effects of higher age and female gender on missing data. Psychometric analyses showed good to excellent results of the instrument in terms of scale fit and reliability. In terms of convergent validity, medium to high correlation of the SF-36 subscales with comparable instruments (e. g. SCL-90-R) could be found. Summarizing, the SF-36/SF-12 can be recommended for use in rehabilitation research. Analyses regarding sensitivity should be conducted in future studies.
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Lemke R, Peter M, Tirre A, van den Bussche H, Alpers E, Defaire F, Grasselli M, Haupt G, Leuschner C, Meißner U, Stephan U, Wolf M, Breitbart E. Training of Patients with Atopic Dermatitis and Psoriasis vulgaris in an Ambulant Neighborhood Rehabilitation Program: Presentation of a Pilot Project. ACTA ACUST UNITED AC 2001. [DOI: 10.1159/000057972] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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van den Bussche H, Kilbinger C. [General medicine in France and in Germany: current situation and future trends]. CAHIERS DE SOCIOLOGIE ET DE DEMOGRAPHIE MEDICALES 2001; 41:81-102. [PMID: 11433960] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/20/2023]
Abstract
The health care system has been built up, both in France and Germany, on the same Bismarckian model: health insurance is financed by contributions from employers and employees, ambulatory care is provided by GPs and specialists in private practice ... etc... Since the 90's, in both countries, there has been a move to strengthen the prestige of GPs and broaden their functions in view of lowering the cost of the health system. However, cost containment has not been the single objective. Several laws have been voted for initiating the gatekeeping function of GPs, controlling the installation of specialists in ambulatory care (private practice), reducing the free choice of care providers by the patients... At the same time, post-graduate training in general practice has been strengthened. Due to historical and cultural reasons, several differences appear in the two countries. For example, confidentiality is strictly observed in Germany and health ID appears only in the French system. We are at the start of a long process. Its success will depend on two conditions: the generalization of the gatekeeping function (which should be entrusted to GPs) and the separation of physicians' income level from the amount of the services they provide to the patients.
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Dunkelberg S, van den Bussche H, Verbeck A, Niemann D. [Comparison of two different educational concepts in general practice]. ZEITSCHRIFT FUR ARZTLICHE FORTBILDUNG UND QUALITATSSICHERUNG 2000; 94:765-72. [PMID: 11127785] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/15/2023]
Abstract
In a postgraduate training course in general practice in Hamburg two different educational concepts were used and compared with each other. One was oriented more towards problem-based learning, the other more towards lectures. The participants were asked to fill in a written questionnaire after each day (n = 970) and at the end of the course (n = 26). Both courses achieved good results. On a five point scale the median of the general satisfaction was 4. The problem oriented course, however, was judged better than the other in many respects.
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Niemann D, van den Bussche H, Dunkelberg S, Becker-Philipps K. [Problem-based learning in graduate general practice education: the why and how]. ZEITSCHRIFT FUR ARZTLICHE FORTBILDUNG UND QUALITATSSICHERUNG 2000; 94:143-7. [PMID: 10782511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/14/2023]
Abstract
This paper describes the experiences with different concepts of problem oriented learning in a postgraduate training course in general practice in Hamburg. It is argued that for postgraduate training of general practitioners a four-step-model is more adequate than the "classical" seven-step-model.
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Lachmann A, van den Bussche H, Dunkelberg S, Ehrhardt M. [Need for rehabilitation from the viewpoint of the general practitioner]. DIE REHABILITATION 1999; 38 Suppl 2:S148-53. [PMID: 10652713] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/15/2023]
Abstract
In Germany, the general practitioner plays an important role in the allocation process of rehabilitative measures. A survey concerning the questions of need, demand and effectiveness of medical rehabilitation measures as seen from the general practitioner's perspective in Hamburg, Schleswig-Holstein und Halle/Saale (n = 956) in 1999 shows that general practitioners have a rather positive attitude towards rehabilitation in general. With regard to the different measures within the rehabilitation system they show a differentiated opinion. As they see a large percentage of over- and underuse of rehabilitation they would appreciate that their information on the patient would be more intensively taken into account in the allocation process.
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