Abstracts by key term: Health services research
Psychische und neurologische Erkrankungen stellen das Gesundheitssystem vor wachsende Herausforderungen. In Deutschland leiden jährlich 27,8% der erwachsenen Bevölkerung an psychischen Erkrankungen (Jacobi et al., 2014). Die häufigsten Diagnosen sind mit 15,4% Angststörungen und mit 9,8% affektive Störungen wie Depressionen (DGPPN e. V., 2025). Mit der Covid-19-Pandemie ist eine deutliche Zunahme an Angstsymptomen und depressiven Symptomen zu beobachten (Robert Koch Institut, 2024). Risikofaktoren wie chronische Schlafstörungen (Insomnie) oder andere Schlafstörungen betreffen 26,7% der Deutschen (van de Straat & Bracke, 2015). Zudem sind 1,8 Mio. Menschen von einer Demenzerkrankung betroffen, was etwa 2,2% der deutschen Bevölkerung entspricht (Blotenberg et al., 2023). Letztere ist eine altersbedingte und neurodegenerative Erkrankung, bei der im Zuge der demografischen Transformation von weiter steigenden Zahlen auszugehen ist. Die gesundheitliche und wirtschaftliche Belastung durch diese Erkrankungen ist erheblich.
30.11.2025
The healthcare landscape for patients with chronic inflammatory diseases in Germany appears highly heterogeneous, including with regard to intersectoral care. Significant differences in interdisciplinary collaboration exist, particularly with regard to its structure and organization. Uniform standards and binding quality criteria, such as those required by and for inflammation centers, are also lacking in the outpatient sector. In individual interviews and web conferences with specialists from inflammation centers and outpatient specialists in dermatology, rheumatology, and gastroenterology, recommendations were developed on how intersectoral collaboration could be optimized. The results particularly confirm the experience that uncomplicated communication between specialists working in inflammation centers and in outpatient settings is essential. A dedicated contact person in the inflammation centers and uniform access routes were clearly the top priorities for action.
02.02.2025
Since 2003, hospital services have been reimbursed through the case-volume-dependent, flat-rate reimbursement system of the G-DRG (German Diagnosis Related Groups) (Section 17b (1) Sentence 1 KHG/Reimbursement Institute 2023). Diagnosis, severity of the illness, and the operations and procedures performed, along with other parameters if applicable, are entered into the patient classification system for grouping (Reimbursement Institute 2023). Although other countries, such as the United Kingdom, Finland, and the Netherlands, also use DRG systems, Germany has a strong performance and volume incentive compared to other countries1. Despite the additional refinancing of nursing care through the nursing budget introduced in 2020 (Reimbursement Institute 2023), there is no case-volume-independent refinancing of necessary provision (Federal Ministry of Health 2023).
04.12.2023
“We need experimental spaces for health services research”
Professor Josef Hecken, the impartial chairman of the Federal Joint Committee and chairman of the Innovation Committee, underlined his suggestions for the further development of the innovation fund, which he presented in the cover interview of the MVF issue (06 /22) and in his lecture in the first part of the MVF specialist congress “Prioritisation Catalog for Health Care Research”. The new CEO of the DNVF, Prof. Dr. Wolfgang Hoffmann, and Prof. Dr. Bertram Häussler, the chairman of the board of the Berlin IGES Institute, joined forces as intellectual sparring partners to put Hecken's demands through their paces in the joint cover interview with "Monitor Healthcare Research".
04.02.2023
While in the United States (the “motherland” of health services research [8,13,16]) more than one billion US dollars have been invested in research projects since 2009 to expand the health services research concepts of comparative effectiveness research (CER) and patient-centered outcomes research ( PCOR) in everyday research [3-7], health services research in Germany is still at an early stage of development [8]. At least in Baden-Württemberg, there has been a state-funded program to promote health services research since 2011 [17,18]. Here, too, the discipline has not yet been implemented across the board in research and teaching, and health services research has not yet been included as a compulsory subject in the study regulations for human medicine by the medical faculties in Baden-Württemberg (as of December 2013). The possibilities for anchoring health care research in studies are therefore limited, especially since content relevant to health care research has hardly been implemented in the cross-sectional area (QB) “health economics, health system, public health care” that was included in the licensing regulations in 2003 and in socio-medical teaching [9-12] . The question therefore arises as to how health services research can be successfully implemented into medical studies in order to sensitize future doctors and scientists to the issues facing the discipline. In addition to the QB and socio-medical teaching, corresponding teaching content could be implemented in the clinical subjects and as part of a compulsory elective course (WPV). In principle, the requirements for an elective course are regulated differently at the universities in Baden-Württemberg; in Tübingen (according to the study regulations of May 6, 2013) a minimum number of hours of 40 teaching units is required.
31.03.2015
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
The severely mentally ill represent an important group in the care of the mentally ill. The blatant lack of care initiated the Psychiatry Enquete 40 years ago, and in fact most of these patients are now cared for in a multi-professional and community-based manner. Nevertheless, the severely mentally ill participate insufficiently or not at all in the current enormous increase in knowledge in the field of psychosocial treatment options. The right to a hospital bed, specialist treatment and access to all available psychopharmacological substances are important but not sufficient for the treatment of the severely mentally ill (Kilian 2014). Access to evidence-based outpatient psychosocial forms of treatment, such as acute treatment at home [home treatment], family-related psychoeducation or supported employment [supported employment], depends to this day on more or less random constellations of laypeople, politicians, those affected, psychiatric... Experts and activities from municipalities, independent organizations or other actors (Kilian 2014). However, in addition to somatic treatments (e.g. psychotropic drugs) and psychotherapeutic interventions, psychosocial therapies are an important and central pillar in the treatment of people with serious mental illnesses. They are mainly aimed at improving the individual possibilities of those affected to live in their social environment and to participate in social life and to enable inclusion.
24.01.2013
Current data from a cross-sectional study of referral patients from 29 general practitioner practices in Germany suggest that around a quarter of referrals take place at the request or request of the patient [1]. Information about such transfers in Germany is mainly based on opinion pieces and experience reports. There are numerous hits on the topic in the open Internet search service Google, especially in health-related public publications and general medical publications (“medical tribune”, “Ärztezeitung”, etc.). Referrals are sometimes issued after this without any doctor-patient contact having taken place [2-3]. Such referrals can lead to oversupply and thus endanger patient safety and strain medical and solidarity-funded resources. Due to the sparse scientific data for the German care system, the aim of this work was to collect experiences and opinions from general practitioners in the context of the active demand from patients explore transfer.
24.01.2013
The positive effects of such occupational therapy interventions, which ideally take place in the home environment, were demonstrated by Graff and colleagues in a study in which not only the everyday skills of the patients improved, but also the quality of life of both dementia patients and caring relatives (8, 9). Another area in which occupational therapy plays a central role in treatment and is listed accordingly in the guidelines is rheumatic diseases, such as rheumatoid arthritis, psoriatic arthritis and spondyloarthritis (5). Although positive effects of ergotherapeutic measures have been shown for these diseases, there has been a decreasing trend in prescriptions for rheumatism patients in recent years (10). According to Thieme et al., the reasons for this are: presumably in the budgeting of the remedies combined with the fear of recourse claims by the health insurance companies, in the complexity of the prescription of remedies for those insured by the statutory health insurance companies, in the low appreciation and/or supposedly low evidence of physical therapies and in the long time constant until the noticeable onset of effects (10) . The aim of this article was therefore to present the care profile of patients with occupational therapy prescriptions over a 5-year period. For this purpose, in addition to the age structure, the sex ratio, the living space (city/countryside), the insurance status and the diagnoses of the patients were examined.
24.01.2013
Healthcare innovations aim to make healthcare better and/or more economical. Important starting points and components (without claiming to be exhaustive) are in particular: process optimization with a view to the entire treatment chain, the development of incentive mechanisms for prevention, remuneration models with a focus on the quality of results and not on the quantity and number of services, and active patient participation.