Das Gesundheitswesen
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Das Gesundheitswesen · Jan 2011
[Hospital referrals from the general practitioner's perspective - a descriptive analysis based on the CONTENT morbidity register].
Hospital referrals cause high costs in the health-care system. Information on hospital referrals from general practices in Germany is sparse. As a starting point for further research we describe the characteristics of hospital referrals and referred patients. ⋯ Patients referred to hospital from general practice are older and have a higher morbidity than patients not referred. Hospital referrals to rule out diseases with a potentially dangerous course as a means of managing uncertainty seem to be the most effective field under control of general practitioners to reduce hospital referrals.
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Das Gesundheitswesen · Jan 2011
[Introduction of the electronic health card in Germany: influence of interest positions and sector membership on the establishment of an implementation network].
This article raises the question as to which mode of governance has been established for the implementation of the electronic health card (eHC) in Germany and which coordination problems have emerged. It will be shown that the amalgamation of two different policy domains - namely health-care and innovation policy - leads to a novel governance configuration in which information exchange (hence governance) is affected by sector membership and interest similarity as opposed to anticipated financial burdens or influence reputation in the newly established policy domain. The study is based on a standardised survey of 29 organisations that are involved in the implementation of the eHC. The analysis is carried out using quantitative methods such as social network analysis.
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Das Gesundheitswesen · Nov 2010
[Mutual communication is often lacking--interviews with professional care givers on ambulatory palliative care].
Within the study "possibilities and borders of ambulatory palliative care" interviews with employees of the outpatient care service were carried out. Thereby the subjective view of the professional care givers was the maintaining of interest. The focus was on problems in palliative home care, co-operation with other professionals and family caregivers as well as the conditions of their work. ⋯ An efficient implementation of specialised ambulatory care models (SAPV) is imperative in order to ensure an interdisciplinary and cooperative care for palliative patients and to afford an effective working field for professional care givers.
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Das Gesundheitswesen · Aug 2010
Review[Do primary care physicians acting as gatekeepers really improve health outcomes and decrease costs? A systematic review of the concept gatekeeping].
The aim of this systematic review was to analyse the effects of gatekeeping where primary care physicians (PCP) control access to specialist care. ⋯ International evidence on effects of gatekeeping is limited by the low internal validity of studies and applicability to other contexts. It suggests that gatekeeping by PCP decreases utilization of specialist care and health care costs. Based on very few studies health outcomes and patient quality of life in gatekeeping models might be comparable with those in open access models. Evidence is inconsistent or not available concerning the quality of care, patient or provider satisfaction.
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Das Gesundheitswesen · Aug 2010
Comparative Study[Pain and pain management for children in Greifswald and East Pomerania: comparison with the results of the German Health Interview and Examination Survey for Children and Adolescents (KiGGS)].
Pain in children and adolescents in Germany is a common health problem which has a high socioeconomic impact. There have been no studies allowing a reliable estimation of the prevalence of pain in children in the 5 (th) grade (age range 9-13 years) in schools in the region of the city of Greifswald and the administrative district East Pomerania. This population-based cross-sectional study examined the prevalence of pain in children, the treatment of pain and compared these data with the results of the German Health Interview and Examination Survey for Children and Adolescents (KiGGS). ⋯ Compared to other epidemiological studies, pain is also a common health problem for children in the city of Greifswald and the administrative district East Pomerania. The data base enables comprehensive conclusions on the health-related state of students in Greifswald/East Pomerania. Further studies should examine additional factors on medication and the degree of doctor?s visits, e. g., parental attitudes towards medication and parental motivation towards the degree of visiting a doctor.