Das Gesundheitswesen
-
Das Gesundheitswesen · Aug 2009
[The role of next of kin in medical decision-making--empirical findings from haemato-oncological diseases].
Models of shared decision making in the patient-doctor relationship are attracting increasing attention. A recent study focuses on the so far inadequate attention paid to the role of next of kin. It was examined in which decision areas next of kin of haematological cancer patients were included, further what support next of kin could provided and finally which factors encouraged the participation of next of kin in that process. ⋯ It is clear that family members, especially spouses and partners, consider it meaningful to participate in medical decisions affecting their loved ones, and that they want to be able to do this in the clinical context. One limitation that must be mentioned is that due to the small size of the sample and an approach that focused on initial exploration, the results should be interpreted as a point of orientation. Further studies should look in more detail at how inner family structures play a role in patient-doctor shared decision-making, as well as the concrete conditions and implications that play a role in family members' participation in this process, i.e., adherence to "doctor's orders" and possible decision-making conflicts on the part of the patient.
-
Das Gesundheitswesen · Jun 2009
Review[Prevention and control of infectious diseases with pandemic potential: the EU-project SARSControl].
The influenza pandemics of the 20th century, the SARS epidemic in 2002/03 and the growing number of human cases infected with the H5N1 avian influenza virus clearly demonstrate that the threat of new pandemics is very real. These events have intensified pandemic prevention and control activities worldwide. "SARSControl" is a three-year project funded by the European Commission with the objective to aid European member states in the public health management of new emerging infections. This article summarises the main research results and recommendations arising from this project. ⋯ The basic prerequisites of an efficient pandemic management are operationalisable pandemic plans, subjected to regular exercises, backed by adequate resources and a sound health-care infrastructure. At international level cross-border co-operation and information exchange on infection control is the key to pandemic mitigation and containment. Strengthening surveillance systems at the international level, to allow the timely monitoring of infectious agents and outbreaks is essential. Transferring such outbreak information in real time into mathematical models and the resulting essential epidemiological information to policy makers would facilitate a more efficient use of scarce resources. Involvement of the public in decisions regarding the implementation of restrictive control measures which often curtail individual liberty is necessary for the acceptance and ultimate success of pandemic control.
-
Das Gesundheitswesen · May 2009
[Prevalence and incidence of dementia in Germany--a study based on data from the public sick funds in 2002].
So far all calculations of the number of demented people are based on rates from meta-analyses, mean rates of meta-analyses or spatial analyses. This article presents age- and gender-specific prevalence and incidence rates of dementia that are based on a large sample of the German Sick Funds (Stichprobendaten von Versicherten der gesetzlichen Krankenversicherung (GKV)) with 2.3 million people from the year 2002. Prevalence rates increase from 0.8% and 0.6% for 60-64 year old men and women to 30% and 43% for men and women aged 100 or older, respectively. ⋯ Our results confirm rates from earlier studies on the basis of meta-analyses. Regional differences show for the first time that higher prevalence rates exist for East German women and men above age 85. In 2007 about 1.07 million moderately or severely demented people live in Germany of which about 244 000 are incident cases when we extrapolate our rates to the population of this year.
-
Das Gesundheitswesen · Mar 2009
Multicenter Study[The quality assurance programme of the statutory health insurance funds in medical rehabilitation: results and further developments].
This study reports on the results of the quality assurance programme of the statutory health insurance funds in medical rehabilitation (QS Reha programme) and on the further development of the programme in 2007 to 2008. By October 2008, a total of 240 rehabilitation centres with 283 specialised departments were participating in the QS-Reha programme. ⋯ The preliminary results of the programme provide a comprehensive view of the quality of medical rehabilitation. Limitations exist concerning evidence-based structural quality criteria, methodological problems of patient-reported outcomes and the occurrence of non-responders and dropouts. The reworking of the QS Reha programme pursued the goal of improving the cost-benefit ratio of compiling data without impairing the methodological soundness of the programme. The new concept is scheduled to be implemented routinely beginning in 2009.