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More and more general hospitals are seeking ways to optimize the care of patients with cognitive impairments, whose number is steadily growing according to the Robert Koch Foundation. Therefore, the foundation funded the study "General Hospital Study (GhoSt) - Dementia in General Hospitals. Prevalence and Care Situation" conducted by the Mannheim University of Applied Sciences and the Technical University of Munich. This study, for the first time, provides representative data on the number, distribution, and care needs of inpatients with cognitive impairments. The results provide starting points for hospitals to optimize their staffing planning.
30.03.2016
Therapeutic freedom allows physicians to prescribe optimal medication for their patients. However, with the increasing economization of pharmaceutical supply, substitution often takes place in the pharmacy following the physician's prescription, taking into account, among other things, discount agreements. Since this can impact patient compliance in certain cases, the Federal Joint Committee (G‑BA) has been tasked with exempting critical active ingredients from substitution.
30.03.2016
The tenth anniversary celebration of the German Network for Health Services Research (DNVF) took place in conjunction with the 4th DNVF Forum on Health Services Research in the venerable auditorium of the Langenbeck-Virchow-Haus in Berlin. Rather than looking back too much, the focus was on looking forward, and they jointly explored the challenges facing health services research from the perspective of policymakers, service providers, and the scientific community itself up to 2020. The answers from the many speakers were remarkably similar: There are countless challenges, but one core element: the patient!
30.03.2016
With the Chair of "Health Services Research and Implementation Science in Healthcare," Heidelberg University has established the first of its kind in Germany. The chair's holder, Professor Dr. Michel Wensing, is considered one of the few German-speaking experts in the field of implementation science, with over 350 scientific publications (H-index 37), over 25 randomized trials, and 35 supervised doctoral students. "Monitor Gesundheitsforschung" spoke with the Dutch native about his field, which is still relatively unknown in Germany.
30.03.2016
For the treatment of developmental disorders, the focus is on medically oriented and psychological-educational support measures. One of the medically oriented support measures is occupational therapy (Jašcenoka & Petermann, 2013; Pietz, Moog, & Blank, 2014; Tal-Saban et al., 2014). Ergotherapeutic measures are complex, activating and action-oriented methods. The aim is to improve impaired motor, sensory, psychological and cognitive abilities through activity in the areas of self-care, productivity and leisure (Arbesman, Bazyk, & Nochajski, 2013; Sauer et al., 2010). Children with developmental disabilities represent a very large group of clients in preschool and school age in outpatient occupational therapy (Becker & Jagusch-Espei, 2011). Studies have shown that occupational therapy interventions can contribute to an increase in visual perception, motor and coordination performance and promote a generally positive developmental course (Frank, 2008; Hüttemann & Brauchle, 2011; Poulsen et al., 2007; Whitney & Hilton, 2013 ). Furthermore, occupational therapy intervention in group therapy can have a positive effect on clients' self-esteem (McWilliams, 2005). In Germany, occupational therapy is prescribed by practicing doctors, according to which occupational therapy takes place in occupational therapy practice (DGN, 2011; Gauggel, 2014; Küther, 2014). Child psychiatrists are primarily responsible for the treatment and outpatient care of children with developmental disabilities (DGN, 2011; Hintzpeter et al., 2014; Lehmkuhl, Köster & Schubert, 2009). However, like other doctors, they are under financial pressure from health insurance companies, so a prescription must always be justified (Ärzte Zeitung, 2014; Szucs, 2014). So far, little is known about the specific prescribing behavior of child psychiatrists in Germany for occupational therapy.
31.03.2015
The medical care for patients in Germany is undisputedly one of the best in the world, and this particularly applies to the care in hospitals. However, since the introduction of the flat-rate payment system, a steady increase in the number of cases has been observed, which has now led to a critical intensification of work in hospitals. The precarious current situation is exacerbated by a reduction in personnel, partly caused by a shortage of skilled workers, partly for cost reasons, particularly in nursing, as well as by other circumstances that originated long before the introduction of the DRG system. These consist, on the one hand, in the state-side deficit in financing investment costs, which has been increasing for decades, as well as in the historically grown structural deficits in the hospital landscape - which not only means the high hospital density in Germany compared to international standards, but also, in particular, the relevant regional differences when compared within Germany (1).
31.03.2015
It can be assumed that due to demographic developments, increasing mobility in old age and the increasing number of obese people, osteoarthritis and thus also the implantation of knee endoprostheses will continue to increase in the coming years (Großschädl/Stronegger 2013; Weinstein et al. 2013; Koenig and Kirschner 2003). Knee arthroplasty is a highly standardized procedure that is well suited to be processed using a treatment pathway. Through the implementation of clinical treatment paths, an improvement in the process could be achieved, which is partly responsible for the fact that the revision rate and length of stay for knee prosthesis implantations has been continuously reduced (Loftus et al. 2014; König/Kirschner 2003; Lüring et al. 2010). The main benefit of presenting the course of treatment for knee endoprostheses and using this as a guide in practice is that this ensures structured patient care (Lüring et al. 2010). The analysis of specific routine data using an adapted treatment path makes it possible to identify potential in the course of treatment and opens up possibilities for improvement in terms of better therapy results [Graf/Hofmann 2003; Wirth 2003]. The most important data source for health services research in Austria is routine data from social health insurance providers. If the data is well prepared, it is possible to analyze it to create transparency with regard to trends and costs in health services research as well as basic knowledge for health care planning (Pfaff et al. 2011; Howell et al. 2009).
31.03.2015
One in five patients over the age of 65 in Germany receiving primary care suffers from peripheral arterial disease (PAD) (Diehm et al 2009). As a chronic, slowly progressive disease that progresses in stages, it is usually the result of a manifestation of atherosclerosis in the arteries supplying the leg. Atherosclerosis is a systemic disease and one of the most important causes of cardiovascular disease and death in western industrialized nations (Barrows et al 2009). In the course of PAD, there can be significant limitations in the patient's mobility, exercise capacity and quality of life. A feared long-term consequence is amputation (DGA 2009).
31.03.2015
The quality assessment of medical care based on quality indicators plays an important role in the German health care system. The quality dimensions "Structure, process and result quality" developed by Donabedian in 1966 represent an established classification for quality indicators (1). Another way of classifying quality indicators is, for example, the throughput model according to Pfaff (2), which differentiates between input, throughput, output and outcome of the respective measurement objectives. In this context, measurement targets represent the event of the quality indicator to be measured. “Quality indicator” is not a protected term and is used by different actors in the healthcare system for a variety of issues. In inpatient care in particular, quality indicators are used to measure and depict the quality of care (3,4). Quality indicators are also increasingly used in the outpatient area (5-7) and across sector boundaries (8) to measure the effect of healthcare.
31.03.2015
Health statistics from the Organization for Economic Cooperation and Development (OECD) are often used to classify healthcare provision in Germany. Accordingly, the German case number rates for certain procedures are among the top internationally. These country rankings are repeatedly taken up in the specialist and daily press. A frequently cited example is hip replacement surgery, which, according to OECD statistics, is only carried out more frequently in Switzerland than in Germany (Fig. 1). Another question that is often discussed is the amount of health care spending. Here, the German healthcare system is considered expensive by international comparison, as shown by the OECD country ranking of healthcare spending per capita, in which Germany ranks 6th (Fig. 2). However, ranking using OECD data as a benchmark is fraught with a number of methodological problems. These problems result, on the one hand, from incomplete data in the reports to the OECD and from their lack of comparability. On the other hand, the OECD data generally do not take into account the influence of the different age structure in the individual countries, although the use of services and the level of health expenditure are age-dependent.