Das Gesundheitswesen
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Das Gesundheitswesen · Jul 1993
[The medical service of compulsory health insurance--quo vadis? The law, responsibility and interests of those involved].
In contrast to all predictions and expectations the Medical Advisor of Health Insurance (MDK) still has to cope with an enormous quantity of medical examinations and reports. As long as the capacities of the MDK are completely absorbed by this task it cannot fulfill its legal commission as a medical consultant of the health insurance in an economical and highly qualified way. The present economical crisis of the health insurance can also be regarded as a challenge to overcome this situation.
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Das Gesundheitswesen · Jul 1993
[Development, organization and evaluation of a public health surveillance system].
Health professionals who set health policies and manage prevention and disease control programs are committed to the goals of reducing disease and injury related morbidity and mortality and improving the public's health and quality of life. To determine what health policies are needed and what specific actions should be taken and which epidemiological investigations should be carried out in order to identify lack of coverage of public health programs, decision makers need continuous information in order to tackle upcoming technical questions and to identify the most serious existing and emerging health problems of today's society. Both, political decision makers and health professionals have to ask themselves how those health problems can be prevented and which are the most cost-effective prevention and control strategies for this purpose. ⋯ Only a sophisticated public health surveillance system can give answers to all those issues. Surveillance is defined as the ongoing systematic collection, analysis and interpretation of date on specific health events for use in planning, implementation and evaluation of public health programs. Timely dissemination of these data to persons who need to know is essential to effective prevention and control.(ABSTRACT TRUNCATED AT 250 WORDS)
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Das Gesundheitswesen · Feb 1993
[Asthma attacks in general practice--epidemiologic markers and seasonal patterns in longitudinal observation].
The continuous registration of asthmatic attacks by the Swiss Sentinel Network "Sentinella" since November 1988 has been preceded by a pilot study which tested the methods of data collection and analysis. The original aim was (a) to use the incidence of asthmatic attacks as a possible indicator for the adverse effects of rising concentrations of air pollutants, and (b) to create a set of baseline data for future research in this field, i.e. data of asthmatic attacks for retrospective analysis of periods with increased levels of air pollution. Here, morbidity characteristics and seasonal patterns of asthmatic attacks as registered from November 1988 to May 1991, will be presented only. ⋯ Thus, it can be inferred that asthma, while a major problem in the hospital, is dealt with successfully by practitioners in the primary care setting. This is to the contrary of international trends which show an increasing referral rate for asthma. A differential analysis of workload from asthmatic attacks for general practitioners, internists and paediatricians is directing toward a rising incidence of asthma.(ABSTRACT TRUNCATED AT 250 WORDS)
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Das Gesundheitswesen · Jan 1993
[The concept of environmental pollution for emission control in regulating carcinogenic air pollutants in outdoor air].
The Conference of Ministers for the Environment commissioned a working group of the Länder Committee for Immission Protection to develop a concept of guidelines for the concentration of carcinogenic pollutants in the atmospheric aerosol. Of the large number of substances which have been identified as carcinogenic, seven were selected (arsenic, asbestos, benzene, cadmium, diesel exhaust, polynuclear aromatic hydrocarbons and 2,3,7,8-tetrachlorodibenzo-(p)-dioxin). These substances are emitted into the environment by amounts that are quantitatively of special importance for immission control. ⋯ The quantitative risk assessment by the working group was based on the WHO's "unit risk" model. It was decided that for evolving the guidelines the total cancer risk for all carcinogenic air pollutants be limited while at the same time the possible risk attributed to each individual substance should be reduced according to its contribution to the actual total cancer risk. The synthetic model developed by the working group is explained in detail and the resulting guidelines for an acceptable total cancer risk of 1:1000, 1:2500 und 1:5000 are stated.
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Das Gesundheitswesen · Jan 1993
[Experience with preventive measles, mumps and rubella vaccination in unified Germany].
Considerable immunity gaps in respect of mumps and rubella (German measles) of up to 30% among pupils of the prepuberty age are the requisite arguments in favour of the need for vaccination measures. Combined protective vaccination with live attenuated measles-mumps-rubella vaccine without preceding laboratory tests is recommended for practical reasons and economy. ⋯ A booster effect can be demonstrated in vaccinated persons with low or borderline antibody levels. Revaccination from the 6th year of life onwards is recommended and advocated to close existing vaccination and immunity gaps.