Abstracts by keywords: health services research
Bundeswehr missions abroad have become a piece of normality (Frank Bötel 2016). But these missions are accompanied by stressful experiences for the soldiers and consequences for their mental health. For example, 2.9 % of the soldiers deployed in 2009 as part of the ISAF mission in Afghanistan met the DSM-IV-TR criteria for post-traumatic stress disorder 12 months after the deployment (Wittchen et al. 2012). This 12-month prevalence is not only significantly higher compared to the control soldiers who are not deployed, but also compared to the rates of the age- and gender-adjusted German general population (Jacobi et al. 2014). In addition, it must be feared that the prevalence rates of mental illness after foreign assignments in general (Kang and Hyams 2005), and that of post-traumatic stress disorder (PTSD) in particular (Brewin et al. 2012) will even increase over the years. A key task that not only the Bundeswehr but all those involved in the care of mentally ill people have to face is how to deal with soldiers of the Bundeswehr who have become mentally ill as a result of the deployment (Holtherm 2014). From the point of view of care, the situation is made more difficult by the fact that soldiers, after leaving the Bundeswehr, switch to the civilian German care system, in which the vast majority of service providers no longer have any personal experience with the military system. So far, however, there are no meaningful scientific findings for Germany either on the subjective need for care or on the objective need for care of former soldiers who are now in the civilian health system.
06.12.2017
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
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
Direct contracts started out as discount contracts for pharmaceuticals. In the meantime, however, it is becoming apparent that they are covering more and more areas of care through general practitioner and specialist contracts. Everyone should benefit from these contracts: Health insurance companies have a better influence on the service, service providers receive better remuneration and patients better care. But it shouldn't cost more either. Whether this is successful can only be shown by means of health services research. It should also be noted that direct contracts must not put you in a worse position than standard care. This specification, which has received little attention in the previous discussion, is a steep template for health services research.