Das Gesundheitswesen
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Improvement of Children's Immunisation Coverage: Only the branches for infants, children and adolescents in the public health departments carry out regular data collections concerning the protection given by vaccination of children and adolescents. These immunisation records as well as selected studies show a lack of vaccination and immunisation in these age groups. The analysis of these immunisation records by the public health departments shows specific vaccination deficits which are basic for specific strategies that must be taken to improve the immunisation coverage. ⋯ All these persons together have to develop strategies to improve the immunisation coverage in the short as well as in the long run. The public health department coordinate these strategies, validate coverage data and and evaluate them. The central points of such a concept are here presented.
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Das Gesundheitswesen · Apr 1997
[Health promotion by the public health service--problem areas and perspectives].
For more than ten years policy makers and researchers in the field of health policy have been requesting the local health departments in Germany to focus primarily on population-oriented and structural strategies in health promotion. Based on empirical findings of a study carried out in Berlin, this article argues that several structural and organizational factors in practice influence the implementation of these strategies by the local health departments. ⋯ More than ever, the definition of their tasks and targets needs to be linked to questions of organizational change and personnel. Moreover, the local health departments should define their role more clearly in relation to the other institutions in the sector of public health and in relation to the citizens.
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Das Gesundheitswesen · Apr 1997
[Misuse of inpatient care--background, indicators and evaluation parameters].
17a of the German hospital financing law constitutes the basis for the evaluation of not justified hospital admission. It demands not to admit patients into hospital who do not need inpatient treatment or, treat them in an inpatient-setting longer than medical required. Unjustified inpatient treatment results from faulty decision with regard to admission, to adequate intensity of medical care or duration of stay. ⋯ Testing parameters are, among others, occasion of admission, severity of illness, indication for complete in-patient treatment, utilisation of alternatives to medical care (outpatient, pre-, post-, partial inpatient treatment), adequacy of diagnostic or therapeutic intervention with regard to the disease, intensity, respectively chronological sequence of medical procedures, efficiency of organizational processes, transfer or discharge in time. The evaluation of unjustified admission to inpatient treatment should be conducted with a systematic approach including standardised methods and an adequate sample size on the basis of the individual medical report. In 1995 an outline as to testing of unjustified hospital admission as already presented by Bundes-Arbeltsgemeinschaft der Medizinischen Dienste der Krankenversicherung.