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Original article

If you have a problem, go to Leipzig

With three quite different positions on the innovation fund, the specialist symposium "Health and Care 2016," organized by the Leipzig Health Forums, demonstrated once again that such events are of great value; not only because they demonstrate the importance of regionality in healthcare, but also because an event that is not held in Berlin might encourage greater openness.

30.03.2016
Quality, ethics and economic efficiency are compatible

While AOK CEO Dr. Christopher Hermann described primary care as an "alternative standard care" during the presentation of the current HZV evaluation, he agreed with Prof. Dr. Gerd Glaeske (University of Bremen/Socium) that the "Healthy Kinzig Valley" is a "development laboratory for new care elements in the German healthcare system" – which was also the title of his lecture of the same name at a parliamentary evening organized by Gesundes Kinzigtal GmbH, MQNK eV, and OptiMedis AG as the responsible management partner, which celebrated the 10th anniversary of the Kinzig Valley at the Baden-Württemberg State Representation in Berlin. A decade of "Healthy Kinzig Valley" – certainly a good reason to look back and, above all, forward.

30.03.2016
Treatment pathways between geriatrics, surgery and rehabilitation

Around 370,000 people in Germany received a new hip or knee joint in 2014. Surveys show that the majority of patients are satisfied with the outcome of the procedure. However, the demands on artificial joint replacements will increase, partly due to demographic changes. Experts are therefore calling for patient-oriented treatment concepts with better networking between the system's stakeholders. This is a conclusion from the White Paper on Joint Replacement by the IGES Institute, which was commissioned by the German Association of Medical Technology (BVMed). "The White Paper highlights that we have achieved high levels of patient satisfaction and treatment quality in Germany," commented BVMed Managing Director and Board Member Joachim M. Schmitt.

30.03.2016
Specialized professionals are in demand

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
Drug therapy safety by the G-BA

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
Diversity of tasks for health services research 2020

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
“Implementation Science is applied skepticism”

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
Occupational therapy prescriptions for children with developmental disorders from registered child psychiatrists

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
Prioritization according to quality: From measurement to control

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
Course of treatment in endoprosthesis implantation

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

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