Zeitschrift für Evidenz, Fortbildung und Qualität im Gesundheitswesen
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Z Evid Fortbild Qual Gesundhwes · Dec 2016
How contextual issues can distort shared decision making.
Shared decision making in medicine has become a widely promoted approach. The goal is for patients and physicians to reach a mutual, informed decision by taking into consideration scientific evidence, clinical experience, and the patient's personal values or preferences. Shared decision making, however, is not a straightforward process. ⋯ Shared decision making has become a central theme in good quality health care because it has a strong ethical component. Advocates of shared decision making, however, must realize that not all patients prefer to participate in decision making. For those who do, however, we must ensure that shared decisions can be made in a neutral environment as free of biases and conflicts of interest as possible.
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Z Evid Fortbild Qual Gesundhwes · Nov 2016
[Evaluation of the population-based 'Integrated Health Care System Gesundes Kinzigtal' (IHGK). Findings on health care quality based on administrative data].
The management company "Gesundes Kinzigtal GmbH" signed an agreement on integrated healthcare with the statutory health insurer AOK Baden-Württemberg, effective as of November 1, 2005. The aim of the evaluation was to check whether the extent of overuse and underuse of healthcare services in the area of intervention declined or increased compared with usual care. ⋯ Compared with the control group, which represents the secular trend, significant improvements of healthcare quality in the intervention group (6 out of 18 indicators) are considerably more frequent than significant changes for the worse (0 out of 18 indicators). To date, the effects are not very strong, as all insured persons from the Kinzigtal form the basis of the analysis irrespective of their participation in the integrated care program. Claims data are appIicable to indicator based evaluation, but it would be necessary to consider additional years to see whether observed positive trends could be enhanced.
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Z Evid Fortbild Qual Gesundhwes · Nov 2016
[Five-year experience with Train-the-Trainer courses for general practice trainers - a qualitative and quantitative analysis].
A Train-The-Trainer course (TTT course) for general practice trainers was developed as part of the program Verbundweiterbildungplus Baden-Württemberg. The course included aspects of training such as organizational and legal knowledge as well as didactic skills for trainers in 9.5 teaching units (45minutes each). The present article analyzes the evaluation of the course and considers possible future developments for TTT courses in Germany. ⋯ The participants gave a very positive overall rating and claimed to have benefited from the course contents. Future projects should address further qualifications of general practice trainers and facilitate the exchange with colleagues on an ongoing basis.
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Z Evid Fortbild Qual Gesundhwes · Nov 2016
[How do general practitioners evaluate collaborative care of elderly depressed patients? Results of a qualitative study].
Depression is a very common disease among the elderly. Various studies demonstrated the need to improve the care for elderly depressed patients. Within the GermanIMPACT trial specifically trained care managers were engaged to cooperate with general practitioners (GPs). This study investigates how GPs evaluate this cooperation and their attitude towards collaborative care. ⋯ Due to the general overall positive valuation of care managers as well as their positive attitude towards collaborative care a continuation of the IMPACT program in Germany should be considered. More investigation needs to be done to answer the question how care managers can be integrated in everyday primary care.
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Z Evid Fortbild Qual Gesundhwes · Oct 2016
[Assessment of the significance and the requirements of medical postdoctoral lecture qualifications in Germany by the assessment committees].
The postdoctoral medical lecture qualification (Habilitation) represents the highest academic qualification in Germany, which is successfully completed by approximately 850 candidates in medicine and health sciences per year. However, there is only a limited number of respective academic positions available. In addition, structures in education and society have changed over the last years, challenging the importance of this specific German qualification. The aim of this study was to elicit the opinions of members of German habilitation committees concerning the requirements, processes and the overall importance of the postdoctoral medical lecture qualification. Furthermore we wanted to evaluate potential needs for reforms. ⋯ From the committee members' point of view the German PLQ has still a role to play and, despite controversy, is still regarded as a timely qualification. However, there is clear-cut evidence for local, national and international reforms in order to create equality of opportunity for the candidates and to open up suitable career options.