Zeitschrift für Evidenz, Fortbildung und Qualität im Gesundheitswesen
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Z Evid Fortbild Qual Gesundhwes · Jan 2011
[Developing quality indicators: background, methods and problems].
Quality indicators (QIs) are used in many areas of health care in order to measure, compare, and improve quality. QIs are specific, measurable aspects of care that can be used to assess its quality. Assessing the quality of care contributes to quality improvement. ⋯ QIs can be developed on the basis of expert opinion, scientific evidence or clinical practice guidelines. For the efficient development of high quality QIs, rigorous, approved, and evidence-based development methods are needed. At present, there is no gold standard for the development of QIs.
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Z Evid Fortbild Qual Gesundhwes · Jan 2011
[Balancing benefit and harm in palliative care: the difficult position of palliative medicine in view of the promises of curative medicine].
The significance of palliative care as an interdisciplinary and multi-professional approach to treating patients with extremely severe medical conditions should be investigated using the same methodological standards as for clinical medicine in general. Clinical studies in palliative medicine show that certain standards, e.g. in pain therapy, have still not been sufficiently implemented. There is also a lack of methodologically appropriate studies to investigate palliative medicine as a complex intervention. This research deficit is all the more regrettable as - specifically in the field of oncology - it can be demonstrated that the benefit provided by the services of palliative care teams is very large, especially for patients with a particularly unfavorable course of the disease.
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Z Evid Fortbild Qual Gesundhwes · Jan 2011
[The role of benchmarking seen from the perspective of the Federal Joint Committee (G-BA)].
The Federal Joint Committee as the guardian of quality assurance has a vested interest in benchmarking in health care. This is reflected in the fact that essential features of benchmarking can be found in the cross-institutional quality assurance procedure, which is the main quality assurance measure of the G-BA. However, a morphological analysis of the various quality assurance methods reveals differences in these characteristics. ⋯ Benchmarking is correlated more with the sub-goal of promoting quality rather than with quality control. To other sub-goals pursued with quality assurance, there is rather an indifferent relationship. Whether and to what extent benchmarking will shape these measures is therefore a question of how quality assurance will be put into practice.
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Z Evid Fortbild Qual Gesundhwes · Jan 2011
[Perspectives and experiences of vocational trainers in General Practice: a survey in Baden-Wuerttemberg].
In order to ensure the delivery of primary care part of the vocational medical training must take place in the general practice setting. In Germany, this requires the authorization to provide general practitioner (GP) training. While in many countries specific qualification programmes for GP trainers are obligatory, this does not yet apply in Germany. The aim of this survey was to explore perspectives and experiences of GP trainers focusing on their needs in view of a possible qualification course. ⋯ For the first time the perspectives and experiences of GP trainers have been explored in the present study. The results may provide a basis for the development of a qualification programme for GP trainers in Germany.
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Over the last ten years changes in the legal framework of the German health care system have promoted the development of new health service models to improve chronic care. Recent innovations include the nation-wide introduction of disease management programmes (DMPs), integrated care contracts, community nurse programmes, the introduction of General Practitioner (GP)-centred care contracts, and new opportunities to offer interdisciplinary outpatient care in polyclinics. The aim of this article is to describe the recent developments regarding both the implementation of new health care models by statutory health insurance companies and their evaluation. ⋯ Only for DMPs, evaluation is legally mandatory; its methods are inappropriate, though, for studying the effectiveness of DMPs. Further study results on the effectiveness of DMPs mostly focus on the DMP Diabetes mellitus type II and show consistent improvements regarding process parameters such as regular routine examinations, adherence to treatment guidelines, and quality of life. More research will be needed to determine whether DMPs can also help reduce the incidence of secondary disease and mortality in the long term.