Archive:
Versorgungsstrukturen auf dem Land flexibler zu gestalten, das hat sich die Bundesregierung mit dem am 1. Januar dieses Jahres in Kraft getretenen Versorgungsstrukturgesetz (GKV-VStG) vorgenommen. Dazu gehören sowohl eine zielgenauere Bedarfsplanung als auch eine verbesserte Verzahnung zwischen ambulantem und stationärem Sektor, wie Bundesgesundheitsminister Daniel Bahr in seinem Grußwort zum Fachkongress „Versorgung 2.0“ erklärte. Der erneut […]
01.04.2012
Literature research on the topic of “risks in health services research” is not fruitful because the topic has obviously only rarely been addressed so far. In order to differentiate the risks of health services research from the risks of other forms of research, we assume - in addition to the definitions of health services research offered so far (1) - that the primary goals of research and care are fundamentally different. In a traditional research project, the primary goal is to gain knowledge, while in a care project the primary interest is to provide the best possible care without the aim of gaining new knowledge at the same time. When this concept of the primary goals of research and care is applied, health care research projects are characterized by the combination of both goals.
27.02.2012
Literature research on the topic of “risks in health services research” is not fruitful because the topic has obviously only rarely been addressed so far. In order to differentiate the risks of health services research from the risks of other forms of research, we assume - in addition to the definitions of health services research offered so far (1) - that the primary goals of research and care are fundamentally different. In a traditional research project, the primary goal is to gain knowledge, while in a care project the primary interest is to provide the best possible care without the aim of gaining new knowledge at the same time. When this concept of the primary goals of research and care is applied, health care research projects are characterized by the combination of both goals.
27.02.2012
Cultural and epidemiological differences between Turkish and German patients with type 2 diabetes lead to inadequate healthcare provision for migrants of Turkish origin in Germany. Due to the current lack of care for migrants of Turkish origin (Robert Koch Institute 2008, p. 101; Aumiller 2009, p. 13; Icks et al. 2009, p. 132), the largest ethnic minority in Germany, there is a need for diabetes education programs tailored to the specific needs of this patient group. The aim of this pilot study was therefore to evaluate the innovative diabetes education program "Conversation Map©" in Turkish, which is specifically designed for the needs of this migrant group with type 2 diabetes. The joint project, entitled "Understanding Diabetes Together," was implemented in collaboration with Novitas BKK.
27.02.2012
Literature research on the topic of “risks in health services research” is not fruitful because the topic has obviously only rarely been addressed so far. In order to differentiate the risks of health services research from the risks of other forms of research, we assume - in addition to the definitions of health services research offered so far (1) - that the primary goals of research and care are fundamentally different. In a traditional research project, the primary goal is to gain knowledge, while in a care project the primary interest is to provide the best possible care without the aim of gaining new knowledge at the same time. When this concept of the primary goals of research and care is applied, health care research projects are characterized by the combination of both goals.
27.02.2012
Breast cancer is the most common type of cancer in women. In Germany, approximately 71,600 women were diagnosed with breast cancer in 2008; around 17,000 died from it (1). This corresponds to approximately 30% of new cancer cases and 15% of deaths (2). In recent years there have been significant advances in the treatment of breast cancer. Today, thanks to improved surgical methods and modern medications, the majority of patients can be cured. In order to reduce the risk of recurrence, patients affected by carcinoma are usually prescribed adjuvant therapy with tamoxifen or aromatase inhibitors for a period of five years. The active ingredient tamoxifen has proven itself in adjuvant therapy after surgical tumor removal in premenopausal patients. It is considered a standard medication for antihormone therapy and reduces the number of breast cancer relapses by half (3, 4). Aromatase inhibitors are a treatment option that is mainly used in postmenopausal women. According to many studies, aromatase inhibitors are superior in use to tamoxifen (5-8).
27.02.2012
Despite significant advances in diabetes therapy, patients with type 2 diabetes have an increased risk of developing cardiovascular complications (1,2). In cases of inadequate metabolic control under non-pharmacological measures and oral antidiabetic treatment, early initiation of insulin therapy is therefore recommended (3). Among short-acting insulins, the analog insulin glulisine is characterized by particularly rapid and high absorption from the subcutaneous tissue (4). Compared to short-acting human insulin (regular insulin), glulisine has been shown to reduce postprandial blood glucose elevations more effectively and to normalize postprandial microcirculation more rapidly (5). Antidiabetic treatments aimed at influencing postprandial glucose excursions also have a positive impact on clinical parameters of coronary heart disease and its consequences (6,7). However, there are currently no prospective data on the effects of short-acting insulins on the risk of cardiovascular complications in type 2 diabetes. This raises the question of whether the pharmacological advantages of glulisine have an impact on the occurrence of cardiovascular complications compared to regular insulin under real-world care conditions.
27.02.2012
Self-help in the healthcare system is not individual self-help, but self-organized mutual assistance between people who share the relevant characteristics and life situations significantly shaped by these characteristics, and thus, in cooperative terms, meet the needs of their members on a mutual basis. It is self-organized, but social—in this case, a communal care practice. This applies especially at the micro level of social group activities. The specific characteristics of rare diseases (Achse 2010: 26) will be considered shortly. Professionalization and formalization begin with the formation of associations at the meso- and macro-levels (cf. www.achse-online.de; www.namse.de, and pan-European www.eurodis.org). This, in turn, will be of interest shortly, especially from a political science perspective.
27.02.2012
The disease management programs (DMP) aim to improve medical care for chronically ill patients across the board. The goal of the treatment program is to coordinate patient treatment throughout the entire course of a chronic illness and across the boundaries of individual service providers and to optimize the patient's health based on medical evidence. On the one hand, it is about minimizing the “variance” of treatment by the practitioner (Glaeske 2011) and enabling treatment principles for treatment by the medical profession based on medical evidence. On the other hand, the patient should also be actively involved in the treatment process. In the doctor-patient interaction, treatment goals should be set in terms of lifestyle changes or the achievement of medical values. The treatment steps and the health condition are recorded in a documentation form by the treating doctor. As part of the legal evaluation of the DMP, service expenditure and survey data on health-related quality of life are also collected for a sample of patients. This data is linked and evaluated – in a pseudonymized form – at the individual level.
24.02.2012
Die größten Hindernisse sieht Prof. Dr. Karl Wegscheider, Direktor des Instituts für Medizinische Biometrie und Epidemiologie am Universitätsklinikum Hamburg Eppendorf und u.a. Vorsitzender des Wissenschaftlichen Beirates des Bundesversicherungsamtes (BVA) zur Evaluation der Disease-Management-Programme, nicht in der Frage der Studiendesigns, sondern in der weit verbreiteten Verfolgung von Partikularinteressen im Gesundheitswesen. Die Verbesserung der Versorgung steht nach Meinung Wegscheiders an zweiter Stelle hinter den eigenen wirtschaftlichen oder politischen Interessen der handelnden Parteien, die entgegen vielen Lippenbekenntnissen oft gar kein Interesse an Transparenz hätten. Sein Vorwurf: „Überlebte Strukturen werden abgeschottet und verteidigt, als wären sie nicht Mittel zum Zweck, sondern selbst der Zweck des Gesundheitswesens.“ Entsprechend sei Forschung häufig nicht wirklich gewollt und Ergebnisse, die zu Konsequenzen führen müssten, würden ausgesessen.