Archive:
Bei den letzten beiden MVF-Fachkongressen „Impfstatus 2021“ und „Impfstatus 2022“ wurde immer wieder ein SGB-V-Paragraf genannt, der geeignet sein könnte, die Impfquoten generell zu erhöhen. Doch gibt es derzeit bundesweit keinen einzigen Vertrag dieser Art zwischen Kassen und Ärzteschaft. Warum das so ist und was man tun kann, dies zu ändern, dem ging der MVF-Fachkongress „Quo vadis Impfquote?“ nach, der am 30. Juni 2022 online stattfand.
31.07.2022
„Der Selektivvertrag gemäß § 140a konnte im Einvernehmen aller Vertragspartner zum 31.03.2022 beendet werden.“ Das schrieb am 13. Juni dieses Jahres der Bundesverband der Niedergelassenen Diabetologen e. V. (BVND) in einer Pressemeldung. Die Freude ist berechtigt, weil das Ende des Selektivvertrags den lang ersehnten Übergang in die Regelversorgung bedeutet: Seit 2008, als bei der AOK Nordost zum ersten Mal Ansätze zur Versorgungsoptimierung bei DFS-Patient:innen diskutiert wurden, kämpfen die Mitarbeiter:innen der Kasse gemeinsam mit Diabetolog:innen, dem Berliner Fußnetz, dem BVND – mit der medialen Unterstützung von „Monitor Versorgungsforschung“ – für einen unbefristeten Fußvertrag mit allen Krankenkassen.
31.07.2022
“What is the right way to make data in a sensible form more available for research purposes and for the right evaluation systems? Who is in charge in the long term and sets the standards? What can we learn from the US mail order company Amazon and its Amazon Care? And finally: Who will invest where in the future? These and other questions are addressed by Dr. Franziska Thomas, partner at the strategy consultancy Arthur D. Little, in an interview with “Monitor Healthcare Research”. She advocates for a “sensible and at the same time responsible handling of data”, which must be possible in order to, on the one hand, optimize patient care using digitally supported systems and increase the quality of life of patients, but on the other hand also to improve “understanding and knowledge of treatment success”. . Their request: “We have to become a lot faster overall and set up the right systems.”
31.07.2022
Das vom Innovationsfonds geförderte Projekt ZWEIT (Bestandsaufnahme und Bedarfsanalyse von medizinischen Zweitmeinungsverfahren in Deutschland)(1) (Fördernummer 01VSF18014) zielte einerseits darauf ab, das aktuelle Angebot von Zweitmeinungsverfahren in Deutschland abzubilden und andererseits die Inanspruchnahme und Bedürfnisse einer zweiten Meinung aus Sicht der Patient:innen und Ärzt:innen zu untersuchen.
31.07.2022
The 7th ad hoc statement from the theses paper author group deals with the topic of the changed STIKO recommendation of May 25th on vaccination in children. Surprisingly, on May 24th, the Standing Vaccination Commission (STIKO) spoke out in favor of the (single) vaccination of healthy children aged 5 to 11 years with an mRNA vaccine, preferably with “Comirnaty”. However, the studies on which the changed recommendation is based only refer to adults; the scientific justification does not provide any evidence for this age group. Consequently, the STIKO also states that the recommendation is being made as a precautionary measure because a renewed increase in SARS-CoV-2 infections is to be expected next autumn. It remains unclear whether a new variant will emerge at all (probable) and whether the vaccine based on the wild type will help against it (questionable). As of: June 23, 2022, 6:00 p.m
22.07.2022
Damage to the central nervous system and the central nervous sensorimotor cell and pathway systems often result in spastic movement disorders (SMD). According to the guidelines for the treatment of spasticity syndrome (AWMF/DGN), spasticity is defined as "increased, speed-dependent stretch resistance of the skeletal muscles, which occurs as a result of a lesion of the descending motor pathways of the central nervous system (CNS) (cerebrum, brainstem, spinal cord) and usually accompanied by other symptoms such as muscle paresis, slowing of movement, increased intrinsic muscle reflexes, pathologically uninhibited synergism and spastic dystonia". In earlier studies, spasticity was described as a "rate-dependent increase in muscle tone resulting from hyperexcitability of the spinal tonic stretch reflex" [1]. An expanded definition of the SPASM group refers to spasticity as positive phenomena produced due to a disturbance in sensorimotor control resulting from a lesion of the first motor neuron. The manifestation is persistent involuntary activation of muscles [2]. SMD is a common syndrome of diseases such as stroke, multiple sclerosis or traumatic brain injury. According to estimates, up to 260,000 people in Germany suffer a stroke every year [3]. Almost half of survivors (up to 46%) experience spasticity within the first three months after the stroke [4, 5]. Spasticity can also develop at a later point in time [4]. Severe paralysis and sensory disorders are predictors of the development of spasticity, e.g. B. as a result of a stroke, and can be associated with severe limitations in coping with everyday life [6]. If you look at the time periods after a stroke in more detail, it can be seen that within the first four weeks at 4% to 27% the patient spasticity could be observed. The prevalence increases to 19% to 26.7% in the post-acute phase (one to three months). Over a period of three months there is a PSS (Post Stroke Spasticity) of 17% to 42.6% [4].
22.07.2022
Health systems in Western societies all face similar challenges: The complexity of health care is increasing, not least due to the demographically-related increase in chronic diseases and multimorbidity (Sin, Askar et al. 2015, Seger and Gaertner 2020) and the advancing specialization and fragmentation in the Medicine. At the same time, there is a glaring shortage of skilled workers, especially in rural regions, which no longer only affects nursing and primary care (German Institute for Applied Nursing Research eV Cologne 2021). Against this background, it is important to make optimal use of the available resources in terms of expertise and service provision. The German Science Council postulated interprofessional collaboration as a strategy for the effective organization of health services in order to be able to master the complex challenges of care in the future (Wissenschaftsrat 2012).
22.07.2022
Small children's clinics in Mecklenburg-Western Pomerania are affected or threatened by closures, even though the number of chronically ill children, for example with diabetes, asthma and obesity, is increasing. One in six children now suffers from a chronic health disorder [1]. Both economic factors, such as problematic remuneration via the DRG system, as well as personnel factors influence the clinical operations of small children's hospitals. On a personnel level, the clinics compete with each other for assistants and specialists - but also in competition with a branch for specialists. In this competition, small departments, regardless of specialty, have a disadvantage in their attractiveness in that a much higher frequency of service by doctors is necessary to maintain care. In order to maintain a 24-hour service system, a high level of personnel is required. In the case of smaller departments, these maintenance costs are largely independent of how many planned beds they hold, as a base of qualified staff is necessary. If the number of cases increases while personnel costs remain the same, a better profit situation can be assumed [2]. Minimum staffing limits for medical staff equivalent to the minimum nursing staff limits only exist in the form of the “specialist standards” and in perinatal centers, the “cash cows” of inpatient pediatric and adolescent medicine, which are only available at large clinics.
22.07.2022
Die Medikalisierungs- und die Kompressionsthese sind zwei „konkurrierende“ Ansätze in Bezug auf die Frage, in welchem Gesundheitszustand ein längeres Leben, insbesondere die Lebensjahre in höherem Alter verbracht werden. Neben der individuellen Bedeutung von Quantität und Qualität der Lebensjahre ist die Relevanz dieser Frage für das Gesundheitswesen hoch, denn nicht nur in der Vergangenheit ist die Zahl bzw. auch der Anteil der älteren Menschen gestiegen, es wird im Kontext des demografischen Wandels ein weiterer Anstieg, auch der Lebenserwartung, prognostiziert – und die Auswirkungen auf die Versorgungsbedarfe bzw. Ausgaben im Gesundheitswesen können beträchtlich sein.
22.07.2022
In the mid-1980s, an interdisciplinary group of researchers from California began to investigate a phenomenon that is extraordinary from the perspective of organizational research: organizations that have the potential to produce catastrophic errors on a daily basis, but (almost) never do so over long periods of time. By studying nuclear power plants, military aircraft carriers and civil aviation, the research group identified design principles and practices that enable the high reliability of these organizations (e.g. Weick 1987; Roberts 1990). This is due to the culture and respective routines of classic high-reliability organizations (HROs). Designing interventions based on principles of high reliability theory is also more than obvious for healthcare organizations that strive for high reliability with a view to patient safety and avoiding errors, among other things. However, it is questionable whether the requirements of classic HROs also apply to healthcare organizations.