Das Gesundheitswesen
-
Das Gesundheitswesen · May 2007
Review[Detailed data collection regarding the utilization of medical services, morbidity, course of illness and outcomes by episode-based documentation in general practices within the CONTENT project].
Billing data for individual patients from General Practice surgeries can be used to analyse primary care utilisation. Making these data available for research and controlling purposes of the German health care system is vital for health services research. Due to the predominant billing purposes, German routine data are unlikely to yield a realistic and differentiated picture of primary care. ⋯ The resulting database has already yielded analyses that were impossible to achieve from German routine health care data. Further analyses will subsequently be based on the continuously expanding database and have the potential to shed light on complex epidemiological and health economics research questions. First results point in the direction that the new mode of data collection, in contrast to routinely entered data, features the potential for a more detailed assessment concerning utilisation of medical services, morbidity, course of illness and outcomes in the context of primary care.
-
Das Gesundheitswesen · Apr 2007
[Medical decision making in hospital--results of an exploratory study on the value of shared decision making from the physicians point of view].
The changes in the relationship between doctors and patients and the transfer of shared decision making into medical treatment has often been discussed. The role and the perspective of the patients are primarily described. The aim of our study is to examine the attitudes of physicians regarding the shared decision making concept, based on 15 interviews with clinical doctors. ⋯ The meaning of the concept of shared decision making for the physicians is in some respects different from the meaning of this concept for the patients. It is important to examine this concept more particularly with standardised instruments. It will be necessary to explore not only the role of patients and physicians in the medical decision making process but also the position of other relevant persons like the relatives of the patients or the nursing staff.
-
Twelve years after its introduction, long-term care insurance is back on the agenda and up for political reform. This paper shows why long-term care insurance needs to be reformed. ⋯ The principal conclusion is that, while there is a broad consensus about the structural improvement of long-term care insurance, opinions differ widely in the matter of its sustained financing. As a consequence, a coherent financing concept has yet to emerge.
-
Das Gesundheitswesen · Mar 2007
[Bedtime, television and computer habits of primary school children in Germany].
Pediatricians recommend daily sleep of at least ten hours for children aged 9 and 10 years. Sufficient sleep is necessary for maintaining the body's homeostasis, as well as for fixing memories and learning. Lack of sleep in children has been associated with a diminished school performance, reduced attention span, and obesity. Adulthood is influenced by childhood lifestyle habits. Data from 4th graders in 34 schools in Mainz and its surroundings were analysed in order to determine negative health lifestyle factors in German primary school children, such as lack of sleep and increased leisure time spent watching television and computer gaming. ⋯ Every fourth child does not obtain a sleep duration of 10 hours, under the assumption that primary schoolchildren need to be awake at 7 am on weekdays. Lifestyle factors that may negatively influence a child's development determine their actual and future habits. Sufficient sleep and less television and computer leisure times should be assertively emphasized to parents and carers of primary school students, in order to prevent the negative consequences of lack of sleep, such as diminished school performance. Developing sex-specific prevention programs, which take into account the complex lifestyles and habits of primary schoolchildren, seems to be relevant.
-
Das Gesundheitswesen · Jan 2007
[Health indicator-based cluster analysis of districts and urban districts in North Rhine-Westphalia].
North Rhine-Westphalia (NRW's) indicator set for health reporting activities comprises more than 70 regional health indicators, which means that these data are available for health reporting purposes for all 54 districts and urban districts. Morbidity and mortality indicators differ in part quite considerably and require further interpretation. With the help of selected indicators, the authors of the following article try to explain the relation between social status and health status. ⋯ Knowledge about socio-demographic differences in the health status of the population is particularly important for prevention measures in order to be able to react appropriately to health risks in districts and urban districts. The analysis shows that an intense regional accumulation of problems will have a negative influence on health status, an influence which is more significant than the positive influence of prosperous regions on the health status.