Original article
Pharmaceutical research is making rapid progress; Year after year, drug authorities approve new therapies. But some innovations do not reach patients or only reach them with a delay. What obstacles are there – and what needs to change?
29.11.2021
Den Weg für eine bürgernahe Versorgungsforschung von unten – bottom up – will die Medizinische Hochschule Brandenburg, eine staatlich anerkannte Universität in kommunaler und freigemeinnütziger Trägerschaft, mit ihrem neuen Masterstudiengang Versorgungsforschung bereiten. Angesiedelt am 2019 gegründeten Zentrum für Versorgungsforschung Brandenburg (s. MVF 05/19) sollen sich ab kommendem Sommersemester 2022 Masterstudenten an ganz handfesten Problemstellungen nicht nur ein neues Verständnis von umfassender Bildung, Forschung und Entwicklung in Medizin, Psychologie, Psychotherapie und weiteren Gesundheitsberufen bilden, sondern mit ihrer forscherischen Arbeit zu nachhaltigen Ansätzen und Methoden in Forschung, Lehre und Versorgung im Land Brandenburg gelangen.
29.11.2021
The establishment of the Department of Health Services Research is closely linked to computer science in Oldenburg. Projects on the communication and analysis of health data have been underway there since 1990. At the affiliated institute OFFIS – under the direction of Prof. H.-J. Appelrath – solutions for analyzing data from the Epidemiological Cancer Registry of Lower Saxony were developed, which are now also used in other German states. Furthermore, the interoperability of information systems, particularly the development of reference implementations and tools for the DICOM standard under the direction of Prof. P. Jensch, was a key research focus. From 2005 onward, topics such as Ambient Assisted Living (AAL) – i.e., technologies for supporting independent living for older people in their homes – human-technology interaction, and support for caregivers – under the direction of Prof. A. Hein and Prof. S. Boll – were added to the research profile. Based on this experience, computer science in Oldenburg supported the development of the new Faculty of Medicine and Health Sciences and, in particular, conceived and helped establish the Department of Health Services Research.
29.11.2021
In his lecture “Regional budgets instead of DRG and individual performance remuneration” Prof. Dr. Andreas Beivers, Professor of Economics and Dean of Studies for Health Economics at the Fresenius University of Applied Sciences in Munich, explains the background and possible future of our current compensation system. He compared a compensation and incentive system to a good navigation system that “somehow gets us where we want to go, preferably efficiently.”
29.11.2021
In June 2021, Schüttig and Sundmacher published the results of a Delphi survey and a retrospective data analysis in the “Monitor Healthcare Research” on how incorrect utilization in emergency rooms can potentially be avoided. They identified emergencies described by the authors as “outpatient-sensitive” and classified them in such a way that treatment could potentially be carried out by contracted doctors on an outpatient basis as part of standard care. As a result of a regression analysis, the authors showed a positive relationship between the proportion of people with a migrant background and the rate of outpatient-sensitive emergencies as defined by them. The authors suspect that this can be explained by cultural differences in the use of hospital emergency rooms, but also by language barriers (Schüttig and Sundmacher 2021). The following article is dedicated to the topic of how often and to what extent such a “language barrier” is to be expected among people with a migrant background and what measures are needed to reduce or perhaps completely eliminate it in the German healthcare system. For this purpose, we use our own research results from the last 25 years in the field of migration research/public health as well as generally accessible data from the Federal Statistical Office.
29.11.2021
At the end of December 2020, Germany began vaccinating the population against Covid-19. By February 2021, several vaccines had already been approved in many countries including Germany [1]. However, until June 2021, the Covid-19 vaccination could only be offered to certain groups of people due to limited vaccine availability. The prioritization was based on the level of risk of severe or fatal courses of Covid-19 disease as well as on the basis of occupational exposure or close contact with vulnerable groups of people. The highest priority was, among others, people over 80 and employees of medical facilities or retirement homes. High priority included people over 70 and people with defined serious chronic illnesses (e.g. dementia or mental disability). Increased priority was given to people over 60 and people with other illnesses (e.g. diabetes mellitus or stroke) [2]. In addition, close contacts of those in need of care and pregnant women had to be prioritized. The vaccination prioritization was lifted nationwide for all vaccines on June 7, 2021. Studies conducted in Germany in 2021 showed a high acceptance rate among healthcare workers [3] and among older people [4].
29.11.2021
Although more and more people are being vaccinated against Covid-19, the weekly number of new cases remains relatively high worldwide. In addition, several SARS-CoV-2 variants have been described (Gómez et al., 2021), and there is a significant risk of repeated waves of Covid-19 in the coming years. In this context, further research is needed to better understand the epidemiology of Covid-19. In recent months, several studies have examined the prevalence of Covid-19 and the characteristics of people diagnosed with the disease. The proportion of people diagnosed with Covid-19 has been found to vary greatly by setting and country (Elimian et al., 2020; Fan et al., 2020; Guerriero et al., 2021; Haimovich et al., 2020; Lusignan et al., 2020; Mani et al., 2020; Pouwels et al., 2021; Santos-Hövener et al., 2020; Shen et al., 2020; Shepard et al., 2021; Sundaram et al., 2021 ). Although these studies have advanced the field, most of them included participants regardless of their potential symptomatology, so little is known about the specific prevalence of Covid-19 in people with common Covid-19 symptoms (e.g. cough, fatigue, or fever) is known. Regarding the sociodemographic and clinical characteristics of people diagnosed with Covid-19, the literature has also provided some contradictory results. For example, one study found that people with diabetes have an increased risk of Covid-19 compared to people without diabetes (Fan et al., 2020), while another study found that this was not the case ( Lusignan et al., 2020). Given these discrepancies, more data are needed on the frequency of Covid-19 diagnosis among individuals with common Covid-19 symptoms, as well as on the sociodemographic and clinical characteristics of this population.
29.11.2021
Nationally and internationally, mathematical models of the infection process in the corona pandemic have had an enormous political impact. However, the model-heavy nature of the political decision-making processes has also been widely criticized. From both a technical and a sociological perspective, criticism of maneuvers appears to be necessary due to numerous indications. The extent to which the performance of government-related epidemic modeling in particular has met the challenges should be critically questioned and evaluated in wider circles. Model uncertainties and the complexity of the problem of the spread of infectious diseases should be given greater attention. There needs to be a deeper awareness that mathematical models cannot replace practical medical experience and classical concepts for controlling complex systems.
29.11.2021
Experiences with the COVID-19 pandemic over the past 1.5 years suggest an improvement in inpatient care for patients with COVID-19. Key goals of inpatient treatment are the restoration and maintenance of adequate oxygenation [1]. Severe complications such as sepsis and acute respiratory distress syndrome (ARDS) must be managed. Mechanical ventilation is an essential measure for critically ill patients. In a few situations, dexamethasone and treatment with monoclonal antibodies may be beneficial. Adjustments to public infection control measures that impact the social life of the population, in line with hospital resources, should be based on improved outcomes. Otherwise, the disease burden would remain unchanged if the same number of hospitalizations represented a smaller proportion of an increasing number of infected individuals.
29.11.2021
The thesis paper author group presents its 4th ad hoc statement with twelve concrete demands that should be initiated on the new health minister's first working day. The group of authors is speaking out at a time when the new appointment at the top of the Federal Ministry of Health makes a new beginning seem possible. As of November 28, 2021, 6:00 p.m