Abstracts by keywords: Shared decision making
Relatives such as children, spouses, parents, siblings or friends often play central roles in outpatient and inpatient care. Although most of the discourse is about relatives providing care, relatives also act, for example, as referrers, mediators, information seekers, translators or decision-makers (Bischofberger, 2011). They are thus (regardless of the patient's care needs) essential support in the treatment and management of numerous diseases (Reifegerste, 2019). At the same time, however, they can also disrupt care processes or at least be perceived accordingly by healthcare professionals because, for example, they impede the patient's recovery by providing too much support, their absence makes discharge more difficult, or they confront the doctors with too high expectations (Wilz & Meichsner, 2012 ). However, the majority of them show a high level of motivation to support the patient in coping with illnesses, so that the question arises as to how their motivation can be integrated well into care processes. Although the relatives are omnipresent in health care - be it with positive as well as negative consequences - they are often not considered as a stakeholder of the care. They are “hidden in plain sight” (Wolff & Roter, 2008). In nursing facilities, in paediatrics, oncology or palliative care, they are usually considered to be key participants. In many other areas of care, on the other hand, they are sometimes regarded as an annoying appendage of the patient, ignored or even actively avoided, even if there are hardly any diseases or patients in which they play no role at all (Reifebarste, in press).
28.07.2020
On April 9, 2013, the Cancer Early Detection and Registration Act (KFRG) came into force. This law takes up the central recommendations of the National Cancer Plan (Federal Ministry of Health 2012): in addition to the establishment of nationwide cancer registries, this includes, among other things, the review of age limits, the promotion of informed decision-making, the optimization of information materials and the accompanying evaluation of early detection measures . Organized early detection programs should be offered for colon and cervical cancer, to which health insurance companies invite people. The Federal Joint Committee (G-BA) was commissioned with the specific design of the KFRG.
24.07.2017
The so-called multi-criteria decision analysis (MCEA) can be used to support complex technology assessments. Multi-criteria decision analysis procedures have their origins in decision theory or operations research and are used there to make decisions under uncertainty. They assist decision makers in evaluating a finite number of alternative health interventions using a finite number of performance criteria. In addition to conjoint analysis, the elimination and choice translating reality method (ELECTRE) and the multiattribute utility theory (MAUT) (Lootsma/Schujit 1997), the most widely used multi-criteria decision analysis tools include the Analytic Hierarchy Process (AHP).
24.01.2013
In Germany, medical care is largely financed by contributions from insured persons. This results in the normative and ethical obligation of statutory health insurance to provide the optimum level of health services with maximum benefit for the insured. It is important to reduce waste, use resources efficiently, and all results must be meaningful, especially for patients. The health insurance companies, together with the service providers and the patients, are responsible for achieving these goals and a primarily scientifically based approach (SGB V §§ 2, 12, 35b, 70). The question of what is useful is described, for example, in SGB V § 35b as “improving the state of health, shortening the duration of the illness, extending the lifespan, reducing side effects and improving the quality of life”. This maxim can be found in an identical form in the G-BA's Rules of Procedure, in the Drug Benefit Assessment Ordinance or in the IQWiG method paper for benefit assessment. The statement that the benefit assessment has to be based on “patient-relevant target values” is of particular importance. “In this context, “patient-relevant” should be understood as how a patient feels, can perceive their functions and activities or whether they survive.” (IQWiG 2011, p. 30f)
24.01.2013
Patient coaching as an innovative service in healthcare serves the purpose of promoting therapy adherence (compliance, adherence), active participation and self-management of patients in overcoming their illness, taking into account individual preferences. In this episode, examples are given of the efficiency reserves that can be expected from patient coaching compared to the effects of drug discount agreements, and that some health insurance companies have integrated patient coaching programs into their care management as pilot projects. A classification matrix is presented for more transparency of coaching programs. In addition, numerous open questions are addressed, which could be answered by appropriate health services research.
01.10.2009
Patient coaching as an innovative service in the healthcare system serves the purpose of promoting compliance, adherence, active participation and self-management of patients in coping with their illness, taking individual preferences into account. In this article, based on a definition of patient coaching, its necessity is derived from the high non-compliance or non-adherence rate, particularly among chronically ill and multimorbid patients. These are patients who require approximately 4/5 of all services provided by the health system. Compliance and adherence are described in terms of their importance as descriptive markers for the quality of patient cooperation in the treatment process. It should be noted that they should also be questioned with regard to their different causes (e.g. system-related, communication-related, individual/preference-related) so that a targeted and promising intervention can result in individual cases.
01.08.2009
Health management services are knowledge-based services. They can be used in different care settings and in different phases of the indication-specific disease progression. A distinction is made between selective, periodic to sequential and continuous HMS interventions. The instruments start with simple reminder or e-mail educational services (Infocept), lead through more data- and technology-driven call centers or risk assessments to personnel-intensive offers such as case or disease management programs. In the future, personal health coaching and behavior modification will become more important if you really want to achieve sustainability. The costs for HMS instruments and programs range between 5 euros and 2,000 euros per intervention or year. The benefit lies in improved medical outcomes. Financing can be provided by cost bearers, service providers, product providers, additional insurance or personal contributions.