Das Gesundheitswesen
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Das Gesundheitswesen · May 2010
[Transfer of the AGnES concept to the regular German health-care system: legal evaluation, reimbursement, qualification].
According to an amendment of German social security legislation, the AGnES concept of delegation of certain tasks of medical care, especially house calls, by general practitioners (GPs) to qualified practice employees (AGnES employees), will be transferred into the regular German health care system from January 2009 onward. The concept was developed to support GPs in regions with imminent gaps in primary care. ⋯ A successful transfer of the AGnES concept with a high standard of quality into regular health-care depends on several factors. Of particular importance is the specific qualification of the practice employees, which is a central legal condition for the delegation of medical tasks from GPs to AGnEs employees. A second determining factor is also an adequate reimbursement within the catalogus of the statutory health insurances.
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Das Gesundheitswesen · Feb 2010
[Gender specific differences in the frequency of admission to intensive care units, duration of stay and the application of intensive medical care measures in men and women aged 75 years and above in an Austrian region].
It was the aim of this study to evaluate the frequency of admission to intensive care units, duration of stay and application of intensive care treatments in patients aged 75 years and above and to analyse possible gender specific differences. ⋯ In the aged there are marked gender specific differences in the application of intensive care treatments, especially in the end-of-life state in Austria. The reasons for these differences should be subject of future research.
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Das Gesundheitswesen · Feb 2010
[Off-label prescription of drugs in the statutory health insurance].
Prescribing a medication for a condition not described in the label approved by national and international regulatory bodies (in Europe the EMEA, European Medicines Agency) is a medical necessity recognised by law. In many clinical fields, studies allowing approval of drugs are lacking. ⋯ Due to the various aspects concerning social and drug law, civil and even criminal law on the one hand and requirements for therapy and diagnostic guidelines and criteria set by evidence-based medicine on the other, the subject matter becomes complex and intricate. The legal and medical facts are described and practical advice is presented for dealing with the issue in hospital and general practice.
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Das Gesundheitswesen · Jan 2010
[Promoting instead of controlling health--lessons learned, lessons to learn].
Health promotion, as laid down in the Ottawa Charta by the World Health Organisation, embraces the call for self-responsibility. Self-responsibility, however, is not merely directed towards apparently personal risk factors. The Ottawa Charta clearly puts health in a wider societal context and follows the line of early social medicine, which, as Virchow put it, understood politics as medicine on a large scale. ⋯ At the same time a resurgence of expert-led prevention strategies could be observed. Recently, however, the discussion on self-responsibility appears to be regaining societal aspects. The task on hand is, to support this societal approach to health whilst at the same time to ensure the field of health promotion does not overstretch itself.