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HOME 2: Entwicklung und Evaluation eines multimodalen
EEG‑HOME‑Monitorings von neurologischen Risikopatient*innen: Ergebnisse
und Erfahrungen des HOME Projekts. DAS GESUNDHEITSWESEN 2022. [DOI: 10.1055/s-0042-1753968] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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Kommunikation in Zugang und Inanspruchnahme medizinischer Versorgung aus der Perspektive von AsylbewerberInnen. DAS GESUNDHEITSWESEN 2017. [DOI: 10.1055/s-0037-1605657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Erlebte Autonomie von älteren Menschen in Sachsen-Anhalt. DAS GESUNDHEITSWESEN 2017. [DOI: 10.1055/s-0037-1605633] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Transformationsprozesse nach 1990 im Gesundheitswesen Sachsen-Anhalts aus ärztlicher Perspektive – eine qualitative Studie. DAS GESUNDHEITSWESEN 2017. [DOI: 10.1055/s-0037-1605799] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Geschlechterspezifische Bewältigungsmuster von Autonomieverlusten im Alter bei Paaren mit chronischen, alterstypischen Erkrankungen. DAS GESUNDHEITSWESEN 2017. [DOI: 10.1055/s-0037-1605901] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Indikatoren für Autonomiechancen älterer Menschen in Sachsen-Anhalt. DAS GESUNDHEITSWESEN 2016. [DOI: 10.1055/s-0036-1586573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Zugang und Inanspruchnahme: Wie erleben AsylbewerberInnen und Geduldete in Sachsen-Anhalt die medizinische Versorgung? DAS GESUNDHEITSWESEN 2016. [DOI: 10.1055/s-0036-1586513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Datenlinkage von Befragungs- mit Krankenkassendaten am Beispiel der Hypertonie – Ein Zugewinn bei Abbildung der Prävalenz? DAS GESUNDHEITSWESEN 2016. [DOI: 10.1055/s-0036-1586671] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Übergewichtige Erwerbstätige – Eine Herausforderung für die Arbeitswelt? DAS GESUNDHEITSWESEN 2016. [DOI: 10.1055/s-0036-1586521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Relevanz von Qualitätsmerkmalen bei der Krankenhauswahl für den Bürger in Sachsen-Anhalt. DAS GESUNDHEITSWESEN 2016. [DOI: 10.1055/s-0036-1586651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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[Social Security Needs Social Medicine: Self-image of Physicians Practicing Social Medicine in Statutory Health Insurances and Social Security Systems]. DAS GESUNDHEITSWESEN 2015; 77:580-5. [PMID: 26356226 DOI: 10.1055/s-0035-1555897] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVE In January, 2014, the division "Social Medicine in Practice and Rehabilitation" of the German Society for Social Medicine and Prevention established a working group on the self-image of the physicians active in the field of social medicine (medical expertise and counseling). METHODS The result of this work is the contribution presented here after consensus was achieved by specialists of social medicine from different fields and institutions (social security etc.) and in good cooperation with Prof. Dr. Gostomzyk and Prof. Dr. Robra. RESULTS Based on the importance of an up to date social medicine for claimants and recipients of benefits on the one hand and the social security system on the other, and also on a description of the subjects, objectives and methods the following aspects are presented: · The perspective of social medicine. · Qualification in social medicine, concerning specialist training and continuing medical education. · The fields of duty of experts in social medicine. · The proceedings in social medicine. The working group identified challenges for the specialists in social medicine by a narrowed perception of social medicine by physicians in hospitals and practice, accompanied by an enlarged importance of expertise in social medicine, by the demand for more "patient orientation" and gain of transparency, and concerning the scientific foundation of social medicine. CONCLUSIONS The working group postulates: · The perspective of social medicine should be spread more widely.. · Confidence in experts of social medicine and their independency should be strengthened.. · The not case-related consulting of the staff and executives should be expanded.. · Social medicine in practice needs support by politics and society, and especially by research and teaching.. · Good cooperation and transfer of experiences of the different branches of social security are essential for the impact of social medicine..
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(Früh-)Erkennung demenzieller Erkrankungen aus hausärztlicher Sicht – Ergebnisse des Projektes NEUROTRANS. DAS GESUNDHEITSWESEN 2015. [DOI: 10.1055/s-0035-1563170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Krankenhausletalität bei Herzinfarkt in Krankenhäusern mit und ohne Linksherzkatheterlabor – eine Mehrebenen-Analyse in Sachsen-Anhalt. DAS GESUNDHEITSWESEN 2015. [DOI: 10.1055/s-0035-1563221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Machbarkeitsstudie – hausärztliche Kriterien zur Reduktion einer Polypharmazie. DAS GESUNDHEITSWESEN 2015. [DOI: 10.1055/s-0035-1563168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Welche Faktoren bestimmen eine gute Versorgung von Patienten mit akuter Nierenschädigung? Zur Integration einer handlungsrelevanten Zusatzinformation in stationäre Abläufe – ein Mixed Methods-Ansatz. DAS GESUNDHEITSWESEN 2015. [DOI: 10.1055/s-0035-1562976] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Determinanten der Inanspruchnahme ärztlicher Leistungen aus Patientensicht anhand von Fallvignetten basierend auf EQ-5D™. DAS GESUNDHEITSWESEN 2014. [DOI: 10.1055/s-0034-1386892] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Wissenschaftliche und praktische Kompetenzen im Studium – Erfahrung der Studierenden der Medizin, der MINT-Fächer, der Geistes- und Sozialwissenschaften und der Rechts- und Wirtschaftswissenschaften. DAS GESUNDHEITSWESEN 2014. [DOI: 10.1055/s-0034-1386988] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Kompetenzentwicklung mit Vignetten – ein Beispiel aus der Primärversorgung. DAS GESUNDHEITSWESEN 2014. [DOI: 10.1055/s-0034-1386888] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Abstract
From 2004 to 2012, the German Ministry of Education and Research (BMBF) established its first funding programme for the promotion of prevention research. 60 projects on primary prevention and health promotion and the meta-project entitled "Cooperation for Sustainable Prevention Research" (KNP) received BMBF grants under this programme during this period. The experience and knowledge gained and recommendations arising from the research funded under this programme are compiled in memorandum format. The "Memorandum on Prevention Research - Research Areas and Methods" highlights 5 research areas that are considered to be especially relevant from the perspective of the involved scientists and practice partners.The promotion of structural development and sustainability enhancement in disease prevention and health promotion are central areas that should branch out from existing nuclei of crystallization. Improving the health competence of the population and of specific subpopulations is another major area. Research in these areas should contribute to the development of theoretical concepts and to the empirical testing of these concepts. The transfer of knowledge for effective use of developed disease prevention and health promotion programmes and measures is still a scarcely researched area. Among other things, studies of the transfer of programmes from one context to another, analyses of the coop-eration between politics and science, and the continued theoretical and conceptual development of transfer research are needed. Long-term data on the effects of intervention studies are also needed for proper evaluation of sustainability. The latter dem-onstrates the importance of method development in disease prevention and health promotion research as an area that should receive separate funding and support. This research should include, in particular, studies of the efficacy of complex interventions, health economic analyses, and participative health research.
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Geriatriespezifische Fallanalyse auf der Basis von stationären Routinedaten einer Krankenkassen - Eine methodische Herangehensweise. DAS GESUNDHEITSWESEN 2012. [DOI: 10.1055/s-0032-1322058] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Was sagt uns die stetig zunehmende Zahl stationärer Notfallaufnahmen? DAS GESUNDHEITSWESEN 2012. [DOI: 10.1055/s-0032-1322110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Determinanten der Inanspruchnahme medizinischer Leistungen aus Sicht der Bürger - eine regionale Befragung mit Fallvignetten. DAS GESUNDHEITSWESEN 2012. [DOI: 10.1055/s-0032-1322112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Weiterentwicklung des Projektes Qualitätssicherung der stationären Versorgung mit Routinedaten (QSR). DAS GESUNDHEITSWESEN 2008. [DOI: 10.1055/s-0028-1086271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Stillquoten von Säuglingen im Alter von zwei Monaten – Ost-West-Vergleich und Einfluss von Hebammenbetreuung. DAS GESUNDHEITSWESEN 2008. [DOI: 10.1055/s-0028-1086396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Hohe Akzeptanz der Kurzzeitchirurgie – Ergebnisse einer Patientenzufriedenheitsbefragung im zeitlichen Verlauf. DAS GESUNDHEITSWESEN 2008. [DOI: 10.1055/s-0028-1086432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Autonomie und Regulation im Gesundheitswesen als Gegenstand eines Wahlpflichtkurses im vorklinischen Studienabschnitt. DAS GESUNDHEITSWESEN 2008. [DOI: 10.1055/s-0028-1086281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Einfluss von Hebammenbetreuung auf postpartale Erschöpfungszustände. DAS GESUNDHEITSWESEN 2008. [DOI: 10.1055/s-0028-1086395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Risk factors for community-acquired pneumonia in German adults: the impact of children in the household. Epidemiol Infect 2007; 135:1389-97. [PMID: 17291378 PMCID: PMC2870694 DOI: 10.1017/s0950268807007832] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
The objective of this case-control study was to identify the main risk factors for community-acquired pneumonia (CAP) in a German adult population. A self-administered questionnaire was given to CAP cases provided by the German competence network CAPNETZ and population-based, randomly selected controls (sex- and age-matched). Multivariate analysis showed that in addition to known risk factors such as previous CAP [odds ratio (OR) 1.6, 95% confidence interval (CI) 1.3-2.1], more than one respiratory infection during the previous year (OR 3.6, 95% CI 2.9-4.5), chronic pulmonary diseases (OR 2.3, 95% CI 1.7-3.0), number of comorbidities (OR 1.6, 95% CI 1.4-1.9), and number of children in the household (2 children: OR 2.2, 95% CI 1.5-3.4; > or = 3 children: OR 3.2, 95% CI 1.5-7.0) were independent risk factors for CAP. This was pronounced in particular in people aged < or = 65 years. The most likely explanation for this finding is higher exposure to infectious agents.
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Einsparpotenziale im medizinfernen Bereich deutscher Krankenhäuser – eine regionale Effizienzfront-Analyse. DAS GESUNDHEITSWESEN 2006. [DOI: 10.1055/s-2006-948661] [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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31
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Überlegungen zur Krankenhausplanung mit Leistungsdaten. DAS GESUNDHEITSWESEN 2006. [DOI: 10.1055/s-2006-948688] [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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Welcher Anteil stationärer Leistungen lässt sich ambulant erbringen? Eine Hochrechnung mit dem Leistungskatalog nach §115b SGB V. DAS GESUNDHEITSWESEN 2006. [DOI: 10.1055/s-2006-948686] [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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Behandlungsrealität und Ergebnisqualität diabetologischer Schwerpunktpraxen in Sachsen-Anhalt unter den Bedingungen des DMP Diabetes-mellitus Typ2. DIABETOL STOFFWECHS 2006. [DOI: 10.1055/s-2006-944091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Tracerbezogene Bewertung der Qualität stationärer Versorgung anhand von GKV-Routinedaten. DAS GESUNDHEITSWESEN 2005. [DOI: 10.1055/s-2005-920627] [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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Fallvignetten – ein Instrument zur Analyse von Determinanten der Krankenhausaufnahme. DAS GESUNDHEITSWESEN 2005. [DOI: 10.1055/s-2005-920572] [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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Patientenloyalität zur Evaluation neuer Versorgungskonzepte am Beispiel einer Praxisklinik. DAS GESUNDHEITSWESEN 2005. [DOI: 10.1055/s-2005-920615] [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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Sind risikoadjustierte Analysen mit administrativen Routinedaten möglich? DAS GESUNDHEITSWESEN 2005. [DOI: 10.1055/s-2005-920650] [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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Qualitäts- und Klinikberichte auf der Basis von GKV-Routinedaten. DAS GESUNDHEITSWESEN 2004. [DOI: 10.1055/s-2004-833898] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Tägliches Nasespülen reduziert Atemwegsbeschwerden – eine randomisierte Crossover-Studie. DAS GESUNDHEITSWESEN 2004. [DOI: 10.1055/s-2004-833862] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Präventive Hausbesuche im Alter: eine systematische Übersicht und Bewertung der vorliegenden Evidenz. DAS GESUNDHEITSWESEN 2004. [DOI: 10.1055/s-2004-833972] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Patientenzufriedenheit beim ambulanten Operieren in einer Praxisklinik. DAS GESUNDHEITSWESEN 2004. [DOI: 10.1055/s-2004-833990] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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[Preparing for the G-DRG system: portfolio analysis of the hospitals in Saxony-Anhalt, Germany]. DAS GESUNDHEITSWESEN 2002; 64:203-6. [PMID: 11965569 DOI: 10.1055/s-2002-25203] [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: 10/16/2022]
Abstract
Diagnosis-Related Groups are scheduled for step-by-step introduction into the German hospital system. Initially DRG base rates will be specific to each hospital (i. e. in keeping with the present budget), but eventually (by 2007) a common base rate will be reached in each federal state. This development may have grave financial consequences for some hospitals where initial base rates are above average and hence likely to be reduced. Therefore, we grouped the remunerations paid by the AOK Saxony-Anhalt (i. e. the largest statutory health insurance company in this federal state) for a total of 308,495 hospital cases in fiscal year 2000 according to hospital and diagnoses, expressed them as a percentage difference from the average remuneration, and analysed them jointly with the average length of stay (LOS). We found considerable differences between hospitals in terms of the payments per case and the LOS, independent of the stratification of the cases. For example, Magdeburg University Clinical Centre registered hospitalisations that were short (below average) but expensive (well above average), hence there is less scope for further rationalization of the LOS in this hospital compared to others. Considerable adjustments will become necessary in due course when switching over from hospital-specific base rates to a common regional base rate.
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[Subjective need for help and objectified geriatric assess. Comparison of the Halberstädter Gerontologic Study and the Augsburger Senior Study]. Z Gerontol Geriatr 2002; 35:60-9. [PMID: 11974518 DOI: 10.1007/s003910200009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
The Halberstadt Geriatric Study and the Augsburg Senior Citizens Study contain common elements of geriatric assessment (self-assessment of functional dependence, objective evaluation of the functional status). In our cross-sectional investigation, the objective was to examine associations between functional dependence and functional tests and to investigate whether association patterns differed between the surveyed groups. The prospective Halberstadt study began in the German Democratic Republic in 1983 within the framework of a vocational examination before employees entered retirement. In 1995 the study was reactivated; 367 survivors answered a postal questionnaire of which 167 persons took part in a test battery including performance and psychometric tests. The 214 Augsburg test persons had already taken part in the MONICA survey (monitoring of trends and determinants of cardiovascular disease). In 1997 they were assessed in a follow-up study, the aim being to determine the functional status of an elderly cohort through interviews and functional tests. In both studies functional dependence was defined by the (I)ADL concept [(instrumental) activities of daily living]. The participants' functional status was determined with the help of performance tests such as foot tapping and cognitive tests such as the Mini-Mental State Examination. Additionally, medical diagnoses and the use of medical facilities were investigated. The presence of functional dependence was consistently and predominantly significantly associated with the functional status assessed by performance tests. These results were largely confirmed by a logistic regression model. Our results show that even in populations with a different socialization, performance tests are stable indicators of functional dependence and should therefore be incorporated in geriatric assessment programs. The introduction of a standardized assessment program with subsequent intervention measures could lead to a delay of functional dependence and need of care and reduce costs in the health care system.
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[The "Adjusted Annual Index" (aJaX): A proposal for the use of the IMPP results in the evaluation of teaching at German medical faculties]. Dtsch Med Wochenschr 2002; 127:193-8. [PMID: 11821990 DOI: 10.1055/s-2002-19905] [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: 10/17/2022]
Abstract
BACKGROUND AND OBJECTIVE Teaching evaluations should create an incentive to improve academic teaching quality. Teaching also gains importance in the performance-oriented allocation of resources. The results of the country wide written examinations conducted by the Federal Institute for Medical and Pharmaceutical Examination Questions (IMPP) are obvious indicators for purposes of comparative evaluation. However, a comparison of medical faculties is confounded by heterogeneous proportions of students in the so called "reference group" This group includes students who attend their examinations within the regular duration of study; these candidates achieve significantly better results than other students. This contribution describes a comparative educational achievement index (aJaX) adjusting for the varying proportions of students in the reference group. MATERIAL AND METHODS The IMPP publishes the results of the examinations, disaggregated according to faculties, type of examination, examination subjects, examination semester and membership in the reference group. Aggregation of the semi-annual data to annual data leads to equal treatment of faculties with different admittance regulations. The proportion of students in the reference group is taken into account by calculating an adjusted annual index (aJaX) which compares the observed result of the respective medical faculty with the result one would expect if the average (federal) outcome would apply to a faculty with an equal proportion of students in the reference group (i. e. indirect standardisation). RESULTS The success rates of the faculties, as defined by the adjusted annual index aJaX, lie with a few exceptions in the interval between 0.95 and 1.05 during the years 1994 to 2000. The results of the second year examinations demonstrate the largest variance. Over time strong deviations rarely occur. These stable results are not observed with the frequently used reference-autumn-index (ReX), which only takes into consideration the results of the reference groups in the autumn examinations. Temporal trends therefore become more clearly visible in the aJaX. The faculties of the new federal states show a clear upward trend in the analysed period. CONCLUSIONS The results of the medical faculties in the uniform examinations can be compared using an adjusted annual index aJaX. Advantages of the aJaX lie in its stability and neutrality, which are obtained by the annual aggregation of data and the reference group adjustment. The low degree of scatter emphasises a high standardisation in academic medical teaching. However, the aJaX measures only one output of teaching. For the assessment of teaching efficiency in the sense of an input/output relation, inputs must also be taken into account, such as the final school grades of the entering and transferring students.
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[Guidelines of the German Society of Digestive and Metabolic Diseases for treatment of dyspepsia]. ZEITSCHRIFT FUR GASTROENTEROLOGIE 2001; 39:937-56. [PMID: 11778153 DOI: 10.1055/s-2001-18536] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
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Workplace conditions predict the risk of premature death and functional dependence after retirement--results of a gerontological follow-up study in Germany. Public Health 2001; 115:345-9. [PMID: 11593444 DOI: 10.1038/sj/ph/1900787] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/24/2001] [Indexed: 02/21/2023]
Abstract
Between 1983 and 1985, 595 employees who were entering retirement in East Germany were given a medical examination and asked to assess their workplace conditions. Ten years later, we examined whether occupational predictors were associated with death and functional dependence among the study participants and assessed how the surviving pensioners coped with activities and instrumental activities of daily living. We assigned the occupational factors reported between 1983 and 1985 to two scales: demands and resources. Multiple logistic regression analyses were carried out to examine the association of occupational and medical predictors with the outcome variables death and functional dependence. Workplace resources but not demands were significantly associated with a reduced chance of death in women, independent of medical diagnoses. For men neither of these associations were verified. Concerning functional dependence individual items such as 'control over work content' (for both sexes) significantly reduced the risk of developing ADL-dependence. The associations remained stable after medical diagnoses were additionally taken into consideration. The results of our study highlight the influence of occupational factors beyond working life and support the importance of starting geriatric health promotion before retirement age.
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[Prevention of congenital malformations by means of folic acid - insurmountable problems due to the German penal code and German drug legislation when preparing a preconceptional model in Saxony-Anhalt]. DAS GESUNDHEITSWESEN 2001; 63:430-4. [PMID: 11507668 DOI: 10.1055/s-2001-15925] [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: 10/17/2022]
Abstract
For the last 20 years the prophylactic effect of the vitamin folic acid against the occurrence of neural tube defects has been known but in Germany this fact has not been realized by the public. The recommendations by medical institutions fail, among other reasons, because a folic acid prescription by gynaecologists comes too late in the course of events, i.e., women go to the gynaecologist when pregnancy has already set in and it is too late for preventive measures. An effective folic acid prophylaxis must take place before the onset of pregnancy. Data from the regional surveillance of congenital anomalies of the German Federal State of Saxony-Anhalt and interviews with women in maternity, as well as gynaecologists, indicate that there is a substantial knowledge deficit concerning folic acid prophylaxis. In 1998, therefore, a working group was set up in Saxony-Anhalt. It comprises representatives from interested institutions and has the goal of rectifying the knowledge deficit of women of childbearing age by way of a broad-based campaign while making use of the results of regional congenital anomalies monitoring. A pharmaceutical company was enlisted for cost-free distribution of its folic acid product. Legal problems with the prescription drug laws, the law against unfair competitive practices, the advertising of medicaments law and the SGB V (social code) made it impossible to procure multivitamins containing folic acid free of charge for women wanting a child. A highly differentiated legislation has hitherto prevented an elementary improvement in prevention.
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[Evaluation of the public health service law of the Saxony-Anhalt region--community affairs, transfer of power and loss of control]. DAS GESUNDHEITSWESEN 2001; 63:289-96. [PMID: 11441671 DOI: 10.1055/s-2001-14216] [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: 10/17/2022]
Abstract
AIM In the state of Saxony-Anhalt, a new Public Health Service law came into force in 1998. Our study investigated whether this new legislation has led to an extension of duties performed by regional health departments and to a subsequent increase in expenditure. METHODS Guided interviews at all administrative levels of the public health system were conducted. The catalogue of duties was systematized and a questionnaire was developed and distributed to all regional health departments (response rate: 17 out of 24). Data concerning revenues and expenditures of the regional health departments were analysed on the basis of the administrative districts' budget data. RESULTS Regional health departments stated that there had been practically no change in their activities over the last few years. When questioned about the coverage of 58 specific duties, a considerable disparity was evident between departments. A core group of "classical" duties comprising environmental health and hygiene, child health protection, individual health appraisal, and public health supervision are carried out on an established basis. Some duties were handled by external institutions, others, mostly community health duties, were not performed on an extensive scale. When asked about the desired model for their health department, most departments preferred the model of being an executor of sovereign duties, however a corporate model was deemed to be almost as acceptable. The following fields will gain increasing significance in the future: environmental medicine, health reporting, preventive medicine, co-ordination of regional health care, and health promotion. Since 1995, staff has been reduced in all regional health departments (-10.4%; 1999: 2.92 employees per 10,000 inhabitants). In 1999, expenditures amounted to an average of 24.64 German Marks per capita (range 14.20-44.58 DM). The number of inhabitants and the revenue of the regional districts were determinants of their health budgets. CONCLUSION Our results showed that no uncompensated additional expenditure by regional authorities resulted from this law. So far, most districts have not perceived regional health as a community affair offering possible competitive advantages. The federal state lost considerable influence at the regional level. Recommended are regional health priorities, conjoint staff development, and state guidance by a head agency providing leadership and support, while leaving responsibility with the districts.
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[Necessary and desirable future emphasis in social medicine from the theoretical viewpoint]. DAS GESUNDHEITSWESEN 2001; 63:140-6. [PMID: 11329904 DOI: 10.1055/s-2001-11968] [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: 10/17/2022]
Abstract
Social medicine, like medicine as a whole, is based on biomedical science and has responsibilities in clinical care, at the same time linking the health system, an important element in the welfare state, to society. Social medicine investigates and expands the scientific basis for securing and promoting health by way of social action, sharing common roots with public health. In the biomedical sphere, emphasis is on improving our understanding of the biological foundations of social behaviour; scanning and assessing the ethical, legal, economical and social implications of scientific progress; influencing the social and economic effects of demographic developments, and improving the scientific basis of preventive, styles of living and interventions. In the clinical sphere, the main objectives are to expand such areas as clinical epidemiology and clinical health economics, to assert patients' rights and to promote population-related medicine in the training of doctors. As far as the health care system is concerned, emphasis is on restoring the solidarity concept between the healthy and the sick as the principle of statutory health insurance, and on securing transparency of performance, quality, and cost. A further objective is to encourage more creative management by the health insurance funds by granting freedom of contract. Open public discussion about the rationale of an ethical health care system is required, discussion in which independent experts trained in population-related medicine must play an active part.
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Self rating of health is associated with stressful life events, social support and residency in East and West Berlin shortly after the fall of the wall. J Epidemiol Community Health 2000; 54:575-80. [PMID: 10890868 PMCID: PMC1731731 DOI: 10.1136/jech.54.8.575] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
STUDY OBJECTIVE To compare the health status and factors influencing the health of populations that had previously lived under different political systems. DESIGN Cross sectional health and social survey using postal interviews. The relation between self reported health and psychosocial factors (stressful life events, social support, education, health promoting life style and health endangering behaviour) was investigated. To determine East-West differences a logistic regression model including interaction terms was fitted. SETTING East and West Berlin shortly after reunification 1991. PARTICIPANTS Representative sample of 4430 Berlin residents aged 18 years and over (response rate 63%). RESULTS Of all respondents, 15.4% rated their health as unsatisfactory. Residents of East Berlin rated their health more frequently as unsatisfactory than residents of West Berlin (Or(age adjusted)= 1.29, 95%CI 1.08, 1.52), these differences occurred predominantly in the over 60 years age group. Logistic regression showed significant independent effects of stressful life events, social support, education, and health promoting life style on self rated health. The effects of education and health promoting life style were observed to be more pronounced in the western part of Berlin. Old age and female sex showed a stronger association with unsatisfactory health status in the eastern part of Berlin. CONCLUSIONS For subjects aged over 60 years there was evidence that living in the former East Berlin had an adverse effect on health compared with West Berlin. The impact of education and a health promoting lifestyle on self rated health seemed to be weaker in a former socialist society compared with that of a Western democracy. This study supports an "additive model" rather than a "buffering model" in explaining the effects of psychosocial factors on health.
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