Zeitschrift für Evidenz, Fortbildung und Qualität im Gesundheitswesen
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Z Evid Fortbild Qual Gesundhwes · Jan 2011
Patient participation and shared decision making in Germany - history, agents and current transfer to practice.
The main focus of the present paper is to describe 1) the healthcare system specific influences on patient participation in medical decision making and 2) the current state of research and implementation of shared decision making (SDM) after ten years of substantial advances in health policy and research in this field. WHAT ABOUT POLICY REGARDING SDM? The "Medical Patients Rights Act" is to standardise all the rights and responsibilities within the scope of medical treatment. This also comprises the right to informed decisions, comprehensive and comprehensible information for patients, and decisions based on the partnership of clinicians and patients. ⋯ The development and implementation of decision support tools for patients and professionals as well as the implementation of trainings for healthcare professionals require stronger efforts. WHAT DOES THE FUTURE LOOK LIKE? With the support of health policy and with the utilisation of scientific evidence, the transfer of shared decision making into practice is considered to be meaningful in the German healthcare system. The translation into routine care will remain an important task for the future.
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Z Evid Fortbild Qual Gesundhwes · Jan 2011
[The user oriented hospital - chances and challenges for the healthcare industry].
Hardly any other part of the healthcare sector is under such a pressure to change as the hospital sector. Hospitals are high-performers in coping with complex changes in modernising patient care, process design, quality, cost-effectiveness and service orientation. But, what really makes value to the patient? Currently, this question is raised with new seriousness. ⋯ In terms of business development, user orientation does not only yield important impulses for stronger patient centred care, but also opens up chances for better quality and competitive advantages. Nevertheless, it requires a new understanding of innovation processes which considers value for patients and quality of results and outcome as a relevant scale for measuring effects of change management. Finally, the methods of the assessment of user oriented healthcare delivery are an essential challenge for the evaluation of cooperative healthcare services.
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Z Evid Fortbild Qual Gesundhwes · Jan 2011
Case Reports[What should physicians know about diagnostic testing?].
Many diagnostic tests ordered by physicians cannot be justified by rational criteria. However, this is not necessarily a problem of knowledge or lack thereof. The rational use of diagnostic tests must also be understood as a behavioural problem. ⋯ Working environments should be examined as to the feedback they provide for clinicians. Remuneration and utilization patterns may be more important determinants of test-ordering than a clinicians' knowledge. Nevertheless, a basic understanding of Bayes' theorem and likelihood ratios are an essential part of the medical curriculum.
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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.
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Z Evid Fortbild Qual Gesundhwes · Jan 2011
[Implementing population-based integrated care for a region: a work-in-progress report on the project "Gesundes Kinzigtal"].
The regional integrated care model "Gesundes Kinzigtal" pursues the idea of integrated health care with special focus on increasing the health gain of the served population. Physicians (general practitioners) and psychotherapists, physiotherapists, hospitals, nursing services, non-profit associations, fitness centers, and health insurance companies work closely together with a regional management company and its programs on prevention and care coordination and enhancement. ⋯ The article describes the special funding model of the project, the engagement of patients, and the different health and prevention programmes. The programmes and projects are developed, implemented, and evaluated by multidisciplinary teams.