Das Gesundheitswesen
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Das Gesundheitswesen · Nov 2016
[What are the Prerequisites for a Successful Cooperation between Nursing Homes and Physicians? - Results of a Mixed-methods Cross-Sectional Study in Bavarian Nursing Homes].
Aim: This mixed-methods cross-sectional study examined the cooperation between nursing home staff and physicians in Bavarian nursing homes in order to understand which organisational and communication measures are resulting in satisfying teamwork among professional groups in nursing homes. Methods: In 3 interview rounds nursing home staff, general practitioners, medical specialists, dentists, nursing home residents, and relatives in 52 nursing homes were interviewed using a questionnaire that was enhanced after every round. Additionally, focus group interviews have been performed in 2 nursing homes. ⋯ Measures for improvement of medical care in nursing homes most frequently suggested by interview partners responsible for patient care were: better communication (9%), better remuneration of physicians' nursing home visits (7%, nurses and physicians) and less bureaucracy and regular physicians' visits (5% in each question). Conclusion: Because of the composition of our study sample it cannot be assumed that the results are representative for all Bavarian nursing homes. Confidence in one another, low number of persons in charge, binding agreements and regular physicians' nursing home visits are essential for a successful cooperation between providing physicians and nursing home staff.
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Das Gesundheitswesen · Nov 2016
Review[Health services Research Faces New Challenges: Consequences for Definition and Concept].
In Germany, Health Services Research (HSR) is undergoing rapid and impressive development. Starting from the translation of methods in individual health care (efficacy-effectiveness gap) and the social-scientific description as well as analysis of health care structures and processes, now it is the implementation of complex interventions on the organizational and system level that is the center of interest. This development is mainly triggered by the establishment of the so-called innovation funds by means of legislation in 2015, which has the task to evaluate structural changes and reforms in outpatient and integrated health care. ⋯ Improvement science and implementation research represent fields of research from the perspective of improvement and the translation of knowledge and change of attitude, respectively, which are of great importance for HSR. Insofar as HSR is dealing with improvement and translation of complex interventions, the health care politics constitute an important transfer factor itself. Considering that, in the present situation, the political level represents both the main sponsor and the main demander of HSR results, improving methodological standards and further expansion of research structures of HSR are urgently needed.
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Das Gesundheitswesen · Nov 2016
[When Chance Decides About Access to Health Care: The Case of Refugees in Germany].
Health and access to health care are considered a human right. "Regular" immigrants such as work migrants in Germany have the same entitlement to health care coverage through the statutory health insurance as the majority population. This, however, is not the case for refugees and asylum seekers. According to paragraphs 4 and 6 of the Asylum Seekers' Benefit Act, their entitlement is restricted to care for acute pain, pregnancy and childbirth, as well as immunizations in the first 15 months. ⋯ Furthermore, they may negatively affect social integration of asylum seekers. Therefore, the restrictions of entitlement in paragraphs 4 and 6 of the Asylum Seekers' Benefit Act need to be lifted immediately. Asylum seekers should be granted the same entitlements to health care as the majority population in the whole of Germany.