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Innovations in healthcare are primarily driven by demographic change, modern medical knowledge, the need for cost control, and the demand for better patient care. In this context, digitalization has played a key role for some time. Digitalization is also rapidly gaining momentum in healthcare; topics such as electronic prescriptions, digital patient records, and the integration of wearables are just a few examples, at least in the German healthcare system. Other nations—not only in Europe—are already further ahead in this regard and view digital infrastructure as the foundation for further digital innovations.
07.12.2020
The coronavirus pandemic has led to an unprecedented wealth of quantitative information on the development of the crisis. General access to the reporting data of the Robert Koch Institute (RKI) and the proactive use of the internet have enabled "data journalism," with daily updated maps, statistics, and graphics, to create an enormous range of information on the SARS-CoV-2 coronavirus infection situation. The so-called "dashboards" also offer users their own research options, which have never before been part of journalistic work on this scale. Nevertheless, and perhaps precisely for this reason, one gets the impression that the abundance of information does not contribute to understanding. Indicators of this are the large and growing proportions of those who no longer believe in politics, refuse to participate, and actively display their opposition. The need for explanation and guidance seems to be neglected.
07.12.2020
At the online conference “Structural migration using complex intervention” by IGiB StimMT, it became more than clear how highly complex large-scale innovation fund projects are with the aim of not only creating an add-on to standard care, but also changing it for the better. After a keynote speech by Lutz O. Freiberg, Managing Director of IGiB StimMT gGmbH, and a video message by Ursula Nonnemacher, Minister for Social Affairs, Health, Integration and Consumer Protection of the State of Brandenburg, three workshops were held with the online plenum, some of which numbered over 100 Online participants followed, discussed. The topics: “Economic dimensions of outpatient care”, “Bright and dark sides of managing large-scale innovation fund projects” and “Evaluation of complex interventions”. “Monitor Health Services Research” will present these three topic areas in a series of reports in the coming editions.
07.12.2020
In the further management of the COVID-19 pandemic, a consistent strategy of testing, contact tracing, and isolation should be pursued to protect vulnerable groups. Those over 60 are a particular focus in this regard, as infection mortality is rising sharply in this age group. This is the recommendation of the Central Institute for Statutory Health Insurance Physicians (Zi) in a discussion paper published today. This follows a call by the National Association of Statutory Health Insurance Physicians (KBV) to associations and professional societies of the medical professions, requesting contributions to the development of an action plan for the further management of the COVID-19 infection situation.
07.12.2020
With a ten-point plan, a broad alliance of health policy actors is campaigning for a higher priority for health care in Germany. “Consistently thought-out prevention must extend far beyond the boundaries of the health system and include many areas of society such as education, work, transport and the environment,” says Prof. Dr. med. Reinhard Busse, scientific patron of the alliance, which emerged from the “Health Care of the Future” initiative founded in spring 2019 by Springer Medizin (Ärzte Zeitung) and the research-based pharmaceutical company Pfizer.
07.12.2020
The group of authors hereby presents its sixth theses paper on SARS-CoV-2/Covid-19. Due to the increasing complexity of the topic, this 6th thesis paper will be published in three parts. The previous three-part division and the associated interdisciplinarity and interprofessionalism will be retained; thesis paper 6 in its parts 6.1 to 6.3 again covers the aspects of epidemiology, prevention and social policy. In this sense, paper 6.1 presented here starts with the topic of epidemiology. Based on the current state of knowledge, we estimate the number of unreported cases and make statements about the reliability of the determination of the limit values for the reporting rate that are now in the law (e.g. “35/100,000”). Alternative indices for controlling the infection process (notification index, hospitalization index) are being newly developed and presented. Essentially, it is clear that the numbers currently used for control are neither valid nor reliable and are far from being achievable (implementable). The current approach to the topic therefore contradicts the findings of promising risk communication. On the way there, we remind you of the correct terminology, for example when using the term “incidence” and, by updating the data, point out positive developments in the outcome of the epidemic (e.g. hospitalization rate, mortality) and, on the other hand, what an adequate testing strategy should look like. All of this with the aim of achieving specific prevention as the basis for “stable control” of the SARS-CoV-2 epidemic.
24.11.2020
As early as 1927, the dentist Alfred Kantorowicz recognized that plaque (bacterial plaque) has an influence on dental health and that carious areas can develop (Kantorowicz 1927: 386). Since caries is one of the most common diseases in society (Rupf et al. 2019: 336), there is a need for preventive measures through dental prophylaxis (Schubert 2010: 347). The development of caries can be prevented through appropriate prophylactic measures. In addition to the six-monthly examination by the dentist, the use of fluorides and the right diet without excessive sugar consumption, daily tooth brushing is one of the four features of dental prophylaxis (German Working Group for Dentistry 2016). Especially in childhood and adolescence, it is important to educate this target group about caring for their teeth and to encourage them to do so, because missing or incorrect oral prophylaxis at this age can lead to lifelong problems and effects on dental health (Straehle et al. 1996: 13) . It is therefore necessary to introduce children to dental care at an early age and to begin oral hygiene at home before the first tooth emerges (Hertwig 2019: 69). On the one hand, children should learn the correct tooth brushing technique, and on the other hand, daily brushing should become a routine habit (Jacobson 2016).
08.10.2020
Patient safety is a central goal in healthcare (Rodwin et al. 2020: 1; Zech et al. 2017: 333) and is defined as the “absence of adverse events” (Schrappe 2018: 3). In addition to medical skills and knowledge, successful communication has proven to be a central part of patient safety and its safeguarding, both within the staff team and between staff and patients (Barlett et al. 2008: 1555-1562; Leonard et al. 2004: 85-90; Hickson et al. 1992: 1359-1363). Disturbed communication, for example due to the use of medical terms that patients and relatives do not understand, or language barriers such as a lack of German or other languages can lead to a loss of information and reduced patient safety (Barlett et al. 2008: 1555-1562; Leonard et al. 2004: 85-90; Hickson et al. 1992: 1359-1363). There are other reasons for suboptimal communication and various barriers that prevent the implementation of successful communication. These include, for example, insufficient information transfer, work overload, lack of mutual respect, an insufficient feeling of belonging to a team or low self-confidence (Zegers et al. 2020). Too little further training was also identified as a risk factor (Olde Bekkink et al. 2018: 262-270). Lyndon and colleagues summarized in a review that successful communication in healthcare should be respectful, clear, direct and explicit (Lyndon et al. 2011: 94). Consistently implementing successful communication requires intensive listening, good administrative support, and community engagement to overcome hindering hierarchies and professional stereotypes to ensure patient safety.
08.10.2020
Back pain is one of the most frequently diagnosed diagnoses both nationally and internationally. Around 85% of the population are affected by back pain at least once in their life (Schmidt et al. 2007). Among those insured by the AOK, Barmer and DAK, back pain is the diagnosis with the most days of incapacity for work (WIdO 2011; Ed. 2010; Research 2011; Raspe 2012). Back pain incurs considerable costs in the healthcare system, estimated at around 49 billion euros per year (Kuntz et al. 2017; Wenig et al. 2009). Due to the frequency of back pain, it is the most significant cause of years of life lost in Germany (Plass et al. 2014). Depending on the respective data base, a prevalence of 32 – 49% is assumed in Germany (Raspe 2012). The demographic, socioeconomic and biological influencing factors of back pain are now well researched. Both national and international studies have shown that, overall, back pain occurs more frequently in women, older people and population groups with low socioeconomic status (Kuntz et al. 2017). Regional differences in the frequency of operations for various indications such as osteoarthritis and intervertebral disc damage have also now been well studied. The result shows that in regions with a high density of orthopedists, treatment tends to be conservative, while in regions with a low density of orthopedists, operations tend to be performed more quickly (Schäfer, Pritzkuleit, Hannemann et al. 2013; Schäfer, Pritzkuleit, Jeszenszky et al. 2013; Pollmanns, Wesermann, and Drösler 2018).
08.10.2020
The increase in new infections reported daily, the problem of travelers returning, the reopening of schools and kindergartens, the approaching election campaign - our group of authors needed to decide whether there should be a fourth paper after the theses from the beginning of April, the beginning of May and the end of June , no long discussions. The enormous dynamics of the current situation cannot be overlooked, especially since positive developments are now becoming visible behind the numbers, such as the quite significant drop in the hospitalization rate, the low intensive care utilization due to CoViD-19, the decline in mortality to 0.4% of infected people and - let's pick it out - initial findings of an apparently persistent cellular immunity, which seems to significantly strengthen the somewhat unreliable antibody-related defense (as is common in viral diseases).