Das Gesundheitswesen
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Das Gesundheitswesen · Jun 2004
Comparative Study[Is there a voucher for the impact of quality assurance/-improvement methods in foreign countries?].
Internationally, the implementation of diagnosis-related group systems has underlined the importance of quality assurance and improvement in health care systems. Support is expected by various concepts based on different theories and traditions. Published experience and knowledge of other countries with long-standing DRG systems and data in literature are studied to see whether there is an evidence-based impact of quality assurance and quality improvement on health care systems. ⋯ None of the various tools for quality improvement in health care proves superior so far. It remains unclear which tool suits best for which intended improvement and in which context. Although quality improvement as a strategy meets with wide approval and appears to be a correct health policy, it remains doubtful whether it really improves clinical outcome and patient-centred health care. Public health research should address these questions. New concepts (e. g. integrating different tools of quality assurance and improvement or DMP systems) need evaluation prior to their broad implementation. Social medicine is called upon to mediate between the consented health care aims of society and medicine.
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Das Gesundheitswesen · Apr 2004
Comparative Study[Guidelines for the sociomedical assessment of performance in patients suffering from chronic obstructive lung diseases (COPD) and bronchial asthma].
The following guidelines were developed for the medical assessment services of the German Federal Insurance Institute for Salaried Employees (BfA). Starting from day-to-day practice, criteria and attributes to guide decisions for a systematization of the sociomedical assessment of performance in chronic obstructive pulmonary diseases (COPD) and bronchial asthma were compiled. ⋯ The guidelines summarise typical manifestations of chronic obstructive pulmonary diseases (COPD) and bronchial asthma and describe the necessary medical information for the sociomedical assessment of performance. Relevant assessment criteria for the medical history, clinical examination, and for diagnostic tests are illustrated.
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Das Gesundheitswesen · Apr 2004
Comparative Study[A security protocol for the exchange of personal medical data via Internet: monitoring treatment and drug effects].
We present a security protocol for the exchange of medical data via the Internet, based on the type/domain model. We discuss two applications of the protocol: in a system for the exchange of data for quality assurance, and in an on-line database of adverse reactions to drug use. We state that a type/domain security protocol can successfully comply with the complex requirements for data privacy and accessibility typical of such applications.
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Based on the different health status of women and men the advantages of gender-sensitive compared to gender-differentiated health reporting are pointed out. The main focus is on considerations how gender-sensitive perspectives can be implemented within health monitoring at federal level. Possible guidelines are suggested.