Das Gesundheitswesen
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Das Gesundheitswesen · Oct 2012
[Strategies to prevent the transmission of multidrug-resistant pathogens and their practical implementation in oupatient care].
Multidrugresistant pathogens which are highly relevant for infection control in hospitals and other health-care facilities are a serious public health problem and a big challenge for all players in the health sector. In order to prevent the spread of multi-resistant pathogens the Commission for Hospital Hygiene of the Robert Koch-Institute (RKI) has published guidelines. These recommendations refer to the consequent implementation of an infection control management in all health care settings, including outpatient care. In Germany there are only few data available concerning infection control management and the implementation of preventive strategies in outpatient care. ⋯ Implementation of an infection control management concerning multidrug-resistant pathogens in outpatient care is problematic. Prevention strategies are commonly not known or not adequately implemented into daily practice. Actions to improve the situation should focus at the individual level (e.g., trainings in the context of the initiative "clean hands" ), the institutional level (improving networking, bonus schemes) and the social level (financial and legal support for outpatient care centres to bear the expenses of infection control management, "search and destroy").
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Das Gesundheitswesen · Aug 2012
[Linkage of secondary data with cancer registry data on the basis of encrypted personal identifiers - results from a pilot study in North Rhine-Westphalia].
The Cancer Registry of North-Rhine-Westphalia stores exclusively encrypted personal identifiers of registered cancer patients. Therefore, comparisons with secondary data sets can only be performed by record linkage procedures that are based on encrypted personal identifiers. We report on a pilot study which linked encrypted personal data from the disease management program for patients with diabetes mellitus type 2 (DMP-DM2) with the database of the EKR NRW in order to test the feasibility and efficiency of these record linkage procedures. ⋯ The DMP-DM2 records were encrypted and linked to cancer registry data with a moderate personnel and financial input and high efficiency. Linked records were instantly usable for epidemiological analyses. Experiences of the pilot study suggest that future linkage studies can further advance the level of data protection, without losses in efficiency, by moderately complex software modifications and amendments of the data flow.
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In physician rating sites (PRS), patients are able to share their experiences and indicate their satisfaction in qualitative and quantitative form. This information should support other patients in the search for a suitable physician and can serve as a form of anonymous feedback for physicians. Medical association representatives are often concerned that such reviews primarily aim at defamation. Furthermore, there are various aspects of medical work that cannot be adequately evaluated solely through the patients. In the United States of America, the majority of such previous reviews were shown to be positive. It has yet to be examined in the German and English speaking regions where distinct criteria presently allow patients to express their satisfaction through PRS. ⋯ The various PRS vary significantly in the selection and explanation of criteria for the evaluation of medical quality and, respectively, patient satisfaction. The specific selection and explanation of certain evaluation criteria could have a lasting effect on the understanding of physician quality and patient self-conception in the case of increased utilisation of PRS. The lack of standards for medical evaluation for PRS as well as poorly differentiated reviews, since reviews were usually positive, generally speak for the need for full text comments on PRS. This would enable peer-to-peer communication amongst users, especially regarding the practical relevance of evaluation criteria. Through this interaction between PRS users, user-oriented standards can be established and the advanced use of physician rating sites can be promoted.
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Das Gesundheitswesen · Jul 2012
[Teaching health economics, health-care system and public health at German medical faculties].
On 1 October 2003 the 9th Medical Practice Act came into effect and implemented the teaching subjects "health economics, health-care system, public health" in the medical curriculum. The purpose of the study was to define the content of teaching. ⋯ With the teaching of the subject, medical students become sensitised to efficiency and other topics beyond the natural sciences. The collaboration between physicians and other professionals promotes the ability to be critical in an economic and public health context. Implementing the subject students expand their knowledge of the health-care system thereby contributing to professionalism of the medical profession.
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Das Gesundheitswesen · May 2012
[Structural differences between health insurance funds and their impact on health services research: results from the Bertelsmann Health-Care Monitor].
Claims data of health insurance companies are an important database for health services research. We investigated if there are differences in baseline characteristics and prevalence of chronic diseases between members of several health insurance funds in Germany, and if so, whether adjusting for age and sex could explain these differences. ⋯ We found considerable differences in the prevalence of chronic diseases between German health insurance funds that remained after controlling for age and sex, and even after adjustment for further health-related variables. Further methodological studies are urgently needed to assess strengths and weaknesses of German claim data.