Das Gesundheitswesen
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One of the common features of the five Public Health Research Centres of Germany lies in quality assurance and quality improvement of their research activities. The institutionalisation of systems of quality improvement of Public Health Research has to be regarded as innovative, hitherto unparalleled, in the German context. The article deals with the demands on quality improvement confronting empirical research, the possibilities of coming to terms with this challenge, and still unresolved problems of implementation. ⋯ The concept of quality improvement, developed in the Munich Public Health Research Centre, applies two basic strategies to meet these demands: enhancement of the transparency of the research process, and the training of research staff. Instruments for quality improvement are introduced: some of them may be applied by the research team itself (such as study protocol, research diary, team discussion) some of them have to be realised by external staff, especially responsible for the process of quality improvement, in cooperation with the research team (quality circles, training, compilation of written material). In conclusion, the implementation of instruments of this kind is discussed, concentrating on the problematic cooperation between research team and external staff.
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Das Gesundheitswesen · Dec 1996
[Experiences in realization of guidelines of the nursing care insurance regulation--outcome in home care service after expert assessment by medical service personnel].
The German Pflegeversicherung is a new kind of insurance system for dependence on nursing care (Nursing Care Insurance). Grading into groups according to the intensity of help required, effected by physicians and nurses of the Medical Service of the statutory insurance bodies, as well as the grading system itself have been subjected to severe criticism. However, the emotions in this regard have recently calmed down considerably. ⋯ We observed major deficits in the counselling of patients or their relatives; there were mostly no courses in nursing care for relatives. Patients and their care-providing relatives usually were satisfied by the benefits provided; relatives felt the financial benefits as an acknowledgement of their engagement. In summary, most care-providing relatives were satisfied by the benefits, but the lack of nonfinancial services (counselling, courses in nursing care, payments for social security) showed up major deficiencies.
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Das Gesundheitswesen · Dec 1996
[Educational and occupational expectations of tomorrow's generation of physicians].
As a result of increased competition on the market for young doctors and the continuing debate on the kind and extent of reforms planned for university courses, it is becoming increasingly difficult for students of human medicine to plan their occupational future. Against this background, the aim of this study was to evaluate the expectations regarding training and occupation of students embarking on their course and to carry out extensive analysis of the results taking socio-demographic variables into consideration. The study was designed as a survey using standardised, anonymous questionnaires, which took place at the beginning of two terms (summer term 95 and winter term 95/96) and was carried out with students attending the lectures on "Occupational opportunities". ⋯ Qualified teaching with personal contact with the lecturers is regarded as particularly important despite the general complaint of mass teaching and anonymity. Bearing this in mind, future reforms should, in particular, aim at strengthening personnel and financial resources. With recognisable occupational flexibility already apparent at the beginning of medical studies, more information should be provided on training for alternative medical occupations.
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In a state of the art paper a four step approach is made in order to investigate the question why public health research is necessary at all. 1. Expectations concerning public health research: The classical topics of public health research will continue to be relevant. Additionally, health promotion especially for low income and other risk groups should become important. ⋯ Expectations to public health research concern the transfer of public health into other areas of science, the establishment of new institutions and teaching programmes and its inter-disciplinarity. Deficits exist in the selection of relevant topics and in the innovative power of projects. 4. Proposals for further public health actions refer to politically dominant issues which are to be defined by consensus conferences.