Das Gesundheitswesen
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Das Gesundheitswesen · Oct 2012
[Is the needs-based planning mechanism effectively needs-based? An analysis of the regional distribution of outpatient care providers].
Since the 1990s licenses for opening a medical practice in Germany are granted based on a needs-based planning system which regulates the regional allocation of physicians in primary care. This study aims at an analysis of the distribution of physicians (and hence the effects of the planning system) with regard to the overarching objective of primary care supply: the safeguarding of "needs-based and evenly distributed health care provision" (Section 70 para 1 German Social Code V). ⋯ The initiated reforms of the planning mechanism should progress and be further deepened. Especially today's quota-based allocation of practice licenses requires fundamental changes taking into account the relevant factors approximating local health care needs, re-assessing the adequate spatial planning level and expanding opportunities for introducing innovative and more flexible health care services models.
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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 · 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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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.