Zeitschrift für Evidenz, Fortbildung und Qualität im Gesundheitswesen
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Z Evid Fortbild Qual Gesundhwes · Jan 2011
Review[Using routine data for quality of care assessments: a critical review, taking quality indicators for the "National Disease Management Guideline for Chronic Heart Failure" as an example].
In December 2009, the first version of the German Disease Management Guideline (DM-CPG) for chronic heart failure was completed, including a set of proposed quality indicators for heart failure. This article explores whether proposed indicators can be derived from data collected routinely in general practices. For this purpose, previous experiences and data from the research project CONTENT (CONTinuous morbidity registration Epidemiologic NeTwork) conducted under guidance of the Department of General Medicine and Health Services Research at the University of Heidelberg, Germany, were applied. ⋯ This was the indicator measuring the proportion of patients receiving beta receptor antagonists, compared to all patients with heart failure NYHA class II to IV. Indeed, this single indicator will only be computable if the NYHA grade of heart failure severity and the presence or absence of contraindications to beta receptor antagonist therapy are routinely collected and the data merged into a central database. Against the background of these results it is obvious that a fully developed, transsectoral concept for data collection and data transfer needs to be implemented.
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Z Evid Fortbild Qual Gesundhwes · Jan 2011
Comparative StudyPreparing primary care for the future - perspectives from the Netherlands, England, and USA.
All modern healthcare systems need to respond to the common challenges posed by an aging population combined with a growing number of patients with (complex) chronic conditions and rising patient expectations. Countries with 'stronger' primary care systems (e.g. the Netherlands and England) seem to be better prepared to address these challenges than countries with 'weaker' primary care (e.g. USA). The role of primary care in a health care system is strongly related to its organisation and funding, thus determining the starting point and the possibilities for change. ⋯ Organisation and financing of health care differ widely in the three countries. However, the necessity to improve coordination and integration of chronic disease care remains a common and core challenge.
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Z Evid Fortbild Qual Gesundhwes · Jan 2011
[Benchmarking in psychiatric acute care--a demonstration project in a hospitals network].
The aim of this project was to improve treatment processes and results in acutely ill inpatients within a network of nine psychiatric state hospitals of the Landschaftsverband Rheinland by introducing a benchmarking process. The project was based upon pre-existing measures of quality management. Patient groups were selected that were characterised by a severe clinical development or a high demand for mental health care services (alcohol abuse, depression of the elderly, schizophrenia). ⋯ Although there was no constant quantifiable statistically significant improvement of quality within the three patient groups (and certainly not with respect to the overall network), there was successful improvement of essential treatment processes for certain hospitals and the overall network under benchmarking. This was especially relevant where treatment recommendations were concerned. Future projects should focus on the conformance with treatment guidelines by defining both structural and process measures as a starting point and evaluation criterion.
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Z Evid Fortbild Qual Gesundhwes · Jan 2011
[Needs assessment of a longitudinal training course in vocational training within the Verbundweiterbildung(plus)].
In Germany content-related vocational training mostly is the responsibility of the trainees themselves. The aim of this needs assessment is to explore the requirements of a longitudinal training course in vocational training. ⋯ The results of this needs assessment demonstrate the importance of vocational trainees' needs and the findings of health services research for improvement of content-related vocational training. Furthermore, the results form the basis for longitudinal training courses in vocational training, as shown in the approach of the training course within the training programme Verbundweiterbildung(plus).
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Z Evid Fortbild Qual Gesundhwes · Jan 2011
Comparative Study[Regulations concerning data transparency- a comparison between the USA and Europe].
Since 2007 a far-reaching obligation to register and publish clinical trials of pharmaceuticals on the generally accessible website www.clinicaltrials.gov has applied under the US Food and Drug Administration Amendment Act ("FDAAA") section 801. This obligation also comprises clinical trials results. In the EU clinical trials are registered with the EudraCT data base. ⋯ Since 2011, § 42b of the German Drugs Act provides that the results of clinical trials need to be reported (on the "PharmNet. Bund" website) in order to improve information for doctors and patients. The US regulations serve as a role model for an approach to keeping the general public fully informed about the start and the results of clinical drug trials and to avoiding publication bias.