Gesundheitswesen [JOURNAL]
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200 papers
[Contact-restricting measures in care facilities in the context of the COVID-19 pandemic and their impact on residents - a plea].
Heudorf U, Stalla K
Gesundheitswesen · 2025 May · PMID 40015326 · Publisher ↗
During the COVID-19 pandemic, residents of care homes for the elderly were at a particularly high risk of contracting the virus and dying from it. Strict protective measures were therefore taken, including bans on visits...
During the COVID-19 pandemic, residents of care homes for the elderly were at a particularly high risk of contracting the virus and dying from it. Strict protective measures were therefore taken, including bans on visits. However, the negative effects of these contact-restricting measures on the mental and physical health, quality of life, right to self-determination and ultimately the dignity of the residents soon became apparent and the question was raised as to whether isolation (confinement disease) was even more harmful to health than the disease itself. Statements on infection control measures in care facilities, studies with the views of those affected (residents, relatives, employees in care facilities) and interviews with residents of care facilities as well as reviews on adverse effects of the protective measures were researched. The search included both so-called "gray literature" and publications from PubMed. The residents suffered greatly from isolation and from the fact that decisions were made about them without consulting them. They complained about the loss of their autonomy and felt that their dignity was violated. The reviews showed that the residents generally experienced loneliness, anxiety, sadness and depression more frequently, and in some cases also physical deterioration. In future, care must be taken to achieve a good balance from a legal and health perspective between protection against infection and protection of the mental and physical health, well-being and quality of life of residents, respect for autonomy, the right to self-determination and the dignity of residents. This requires a broad social discussion in which not only experts from the fields of infectiology but also from the fields of geriatrics, nursing, public health, ethics and law, but in particular also those affected themselves or their representatives, their relatives, are heard and their arguments taken into account.
[Prevention of childhood obesity: participatory development of municipal strategies to increase community readiness].
Schröder M, Hassel H, Babitsch B
Gesundheitswesen · 2025 Dec · PMID 40010404 · Publisher ↗
Community readiness (CR) describes the degree to which a municipality is prepared to actively address a health problem. It is a central condition for successful and sustainable prevention efforts. The CR for childhood ob...
Community readiness (CR) describes the degree to which a municipality is prepared to actively address a health problem. It is a central condition for successful and sustainable prevention efforts. The CR for childhood obesity prevention is low in German municipalities, which makes it difficult to implement effective measures.The aim of this study was to develop strategies to increase CR for the prevention of childhood obesity in municipalities. In Bavarian municipalities, workshops (n=5) were conducted with municipal stakeholders after an initial CR assessment. Their specific results were analysed and based on this, strategies were developed in a participatory manner.The municipal strategies focused on three areas: (1) optimising resources for prevention efforts, (2) supporting knowledge about childhood obesity and prevention and (3) strengthening prioritisation of childhood obesity.The strategies offer practical approaches to promote CR and provide a basis for further development and implementation of effective prevention efforts. An evaluation of effectiveness can be made through follow-up measurements after implementation of the strategies.
[Generalisability of Phase III Clinical Trials Using the Example of Two German Multiple Sclerosis Registries].
Jalusic KO, Ellenberger D, Stahmann A … +1 more , Berger K
Gesundheitswesen · 2025 Dec · PMID 39954671 · Full text
Newly approved therapies usually have unknown adverse events, although the clinical trials that led to approval had already tested them for safety and efficacy. One reason for this is that the inclusion and exclusion cri...
Newly approved therapies usually have unknown adverse events, although the clinical trials that led to approval had already tested them for safety and efficacy. One reason for this is that the inclusion and exclusion criteria of the trials often do not fully reflect the usually heterogeneous patient population in routine clinical care.The aim of the study was to analyse the extent to which patients with multiple sclerosis (MS) in routine clinical care fulfil the inclusion and exclusion criteria for the corresponding clinical phase III trial of the respective drug.Sociodemographic and clinical characteristics as well as (serious) adverse events ((S) AEs) were compared. Data were based on two national, prospective, observational, clinical, multicentre registries, the REGIMS registry and the DMSG MS registry.Patients (28%) in the REGIMS registry and 5% of the patients in the MS registry fulfilled the 4 predefined inclusion criteria and would therefore have been included in a phase III registration trial of the corresponding substance.Our results show a clear selection of patients by specific inclusion criteria in clinical trials of MS therapeutics compared to the patient population receiving this therapy after approval. However, this selection is not associated with a higher risk of AEs for those patients who would not have been included in the corresponding phase III clinical trial.
[Not Available].
Robra BP
Gesundheitswesen · 2025 Feb · PMID 39952257 · Full text
The German Society for Social Medicine and Prevention (DGSMP) is awarding the Salomon Neumann Medal 2024 to Prof. Dr. med. David Klemperer. He is a physician and still active in primary care today, a public health practi...
The German Society for Social Medicine and Prevention (DGSMP) is awarding the Salomon Neumann Medal 2024 to Prof. Dr. med. David Klemperer. He is a physician and still active in primary care today, a public health practitioner and - most importantly and effectively in terms of his public impact - an academic teacher. His work focuses on teaching in social medicine and public health, shared decision making, conflicts of interest in healthcare, and evidence-based medicine. With this medal, the DGSMP recognizes his outstanding services to teaching and evidence-based medicine, including his bringing together EbM and social medicine as well as medicine and public health.
[The Struggle for Human Resources in the Reforming Public Health Service].
Junius-Walker U, Feil F
Gesundheitswesen · 2025 Feb · PMID 39952256 · Full text
Abstract loading — click title to view on PubMed.
[Medication safety in German hospitals: An analysis of structured quality reports].
Kastirke N, Groß B
Gesundheitswesen · 2025 Mar · PMID 39938559 · Publisher ↗
Medication safety represents an increasingly pertinent aspect of quality and risk management in hospitals. However, little is known about the relevance of specific methods in controlling medication safety with respect to...
Medication safety represents an increasingly pertinent aspect of quality and risk management in hospitals. However, little is known about the relevance of specific methods in controlling medication safety with respect to medical care processes. The aim of this study, therefore, is to assess the implementation of medication safety measures and the significance of specific hospital characteristics.We analyzed data from 2018, comprising structured quality reports of 1987 sites that were the first to contain information on 13 medication safety tools and measures. Relative implementation rates were assessed both in general and for subgroups. The latter were formed based on site size, presence of specialized departments as well as university hospital affiliation. The relevance of corresponding differences between subgroups was examined using threshold analysis.Across all 13 medication safety measures, implementation rates varied highly (gapless medication safety after hospital release: 71.4%; SOP for good prescription practice: 23.5%). Rates also increased in relation to site size from 31.5% (<50 hospital beds) to 61.5% (>500 hospital beds). This pattern was especially prevalent for medication safety measures pertaining to electronics and IT. There were significant differences between eight measures based on the presence of specialized departments as well as university hospital affiliation. Two measures (medication safety training, description of optimal medication processes) did not vary with the hospital characteristics.Our results highlight the importance of standardized assessments of quality assurance data in hospital settings. The present data analysis enables the identification of those measures that have already been implemented. Implementation seems to be associated with hospital characteristics as well as regulatory guidelines. However, it is noteworthy that medication safety measures are not being implemented across the board. This might be explained by economic, social and technological barriers. These hurdles should be dealt with on a long-term basis and via adequate incentives.
[In times of crisis, utilization of medical services by mothers decreases - Are single mothers affected more?].
Erhart M, Müller D, O'Sullivan JL
Gesundheitswesen · 2026 Jan · PMID 39938558 · Publisher ↗
Accessing medical services requires resources, which can be particularly scarce for single parents. During times of crisis and the associated daily challenges, the threshold for seeking out medical care increases further...
Accessing medical services requires resources, which can be particularly scarce for single parents. During times of crisis and the associated daily challenges, the threshold for seeking out medical care increases further. This study is based on data on 6,155 mothers from the Socioeconomic panel (SOEP) survey waves of 2019 and 2021. The COVID-19 pandemic is used here as an example of a crisis. The results suggest that single parents have an overall higher need for medical care, reflected by poorer health and more medical diagnoses. During the COVID-19 pandemic, a decline in the utilization of healthcare services was observed, especially among single mothers. It is important to create support opportunities for (single) mothers to improve and maintain their health during times of crisis.
[Determinants of the utilization of general health check-up among older adults in Saxony-Anhalt: What is the influence of access to health services?].
Kubat D, Epping J, Stallmann C … +2 more , March S, Swart E
Gesundheitswesen · 2025 Feb · PMID 39919824 · Publisher ↗
Due to the nature of demographic developmens, there is an increasing need for prevention measures in healthcare. In Germany, people with statutory health insurance have a legal right to general health check-ups for early...
Due to the nature of demographic developmens, there is an increasing need for prevention measures in healthcare. In Germany, people with statutory health insurance have a legal right to general health check-ups for early detection of diseases that are significant in terms of population medicine. However, the older population has thus far made inadequate use of these services, resulting in significant losses of prevention potential. This paper examines the impact of objective and subjectively perceived access to health services on the use of general health check-up among citizens aged 55 years and older in the state of Saxony-Anhalt, Germany.The study uses data from a written cross-sectional survey of residents from four major and minor cities in Saxony-Anhalt. Bivariate logistic regression models were used for the statistical analysis of data to evaluate the relation between access parameters to health services and utilization.In all, 953 questionnaires were included in the analyses; 59.7% of the respondents used the general health check-up in the recommended time interval. In the multivariate analyses, the study showed that neither subjective satisfaction with access nor self-reported travel times to family doctors were significant factors affecting the utilization. On the other hand, being a member of statutory health insurance funds and the use of a private car increased the likelihood of utilization. Other determinants that had an influence on the use of general health checks were net household income and need for long-term care.The results of this study indicate potential for increasing utilization of general health check-up among older people. However, increased use of free health check-ups by this section of the population cannot be achieved primarily by improving accessibility, but must be addressed by other factors, such as attitudes towards health checks, which requires further analysis.
Enrichment of health insurance claims data with official death certificate information from three German cancer registries: Proportions of successful linkages and differences by region, year, and age.
Heinze F, Langner I, Bartholomäus S … +4 more , Meyer M, Kieschke J, Maaser K, Czwikla J
Gesundheitswesen · 2025 Nov · PMID 39900106 · Publisher ↗
Evaluating breast cancer mortality in the German mammography screening program with health insurance claims data requires the availability of claims data with information on causes of death. This work aimed to determine...
Evaluating breast cancer mortality in the German mammography screening program with health insurance claims data requires the availability of claims data with information on causes of death. This work aimed to determine the proportions of successful cause-of-death linkages between the second-largest German statutory health insurance fund and three federal cancer registries and to investigate whether linked proportions differed by region, year, and age. Women aged 40-90 years whose insurance was terminated between 2006 and 2018 were included. Proportions successfully linked to the official death certificate databases of all individuals (available in one registry) and of registered cancer cases (available in three registries) were calculated. Of 150,369 women whose insurance was terminated due to death, 90.0% were linked to the database including all deceased women. Regarding the databases including only registered cancer cases, 35.9% of 150,369, 38.6% of 47,472, and 20.1% of 65,893 deceased women were linked. Linked proportions increased from 2006 to 2018 and peaked in age group 60-69 years. The data will be used for the evaluation of the German Mammography screening program. Since causes of death were not linked for all deceased women and the proportions of linkages differed by region, year, and age, claims-based algorithms will also be considered to complement claims data with causes of death.
[Mothers with migration background have significantly less knowledge of ante- and postnatal support services than mothers without migration background: cross-sectional survey in two maternity hospitals].
Selbertinger B, Rothfuß D, Hatzipanagiotou M … +4 more , Köninger A, Apfelbacher C, Kabesch M, Brandstetter S
Gesundheitswesen · 2025 Dec · PMID 39900100 · Publisher ↗
The aim of this study was to describe and analyse knowledge of women in childbed with and without a migration background about ante- and postnatal support services.Questionnaires were provided in 26 languages. In a cross...
The aim of this study was to describe and analyse knowledge of women in childbed with and without a migration background about ante- and postnatal support services.Questionnaires were provided in 26 languages. In a cross-sectional survey, 641 women answered questions about their knowledge of 11 different regional support services, and information sources for these and other support service providers. Median split was used to derive mothers with good and poor knowledge.German was not the mother tongue of 30% of the participants (n=194) and were therefore defined as "mothers with migration background". Of these, 83% (n=161) were aware of services offered by midwives and<40% knew of other support services. Women with migration background were significantly less likely to know the support services (OR 0.16, 95% CI 0.11 to 0.23), even after controlling for other sociodemographic variables. Furthermore, they obtained significantly less frequently information about relevant services from gynaecologists, midwives, relatives/acquaintances or by themselves.Especially for mothers with migration background, knowledge about ante- and postnatal support services must be made more accessible. In this, midwives could play a decisive role.
[Correction: Access to and use of Data for better Healthcare: A Plea for a cooperative data and Research Infrastructure of Statutory and Private Health Insurers and the Network University Medicine (NUM)].
Schmitt J, Ihle P, Schoffer O … +15 more , Reese JP, Ortmann S, Swart E, Hanß S, Hoffmann F, Stallmann C, Kraus M, Semler SC, Heyder R, Vehreschild JJ, Heuschmann P, Krefting D, Sedlmayr M, Hoffmann W, und die gemeinsame Arbeitsgruppe „Externe Daten“ des Netzwerks Universitätsmedizin (NUM) und der Medizininformatik-Initiative*
Gesundheitswesen · 2025 Nov · PMID 39889728 · Publisher ↗
Abstract loading — click title to view on PubMed.
[Characteristics of the "Behavioural and cultural insights (BCI)" approach in Public Health - a consensus paper of the network "Behavioural Science Connect"].
Loss J, Betsch C, Ellermann C … +9 more , Ewert B, Grill E, Jenny MA, Jordan S, Kubiak T, Mata J, Rebitschek FG, Rehfuess EA, Sniehotta F
Gesundheitswesen · 2025 Apr · PMID 39880008 · Publisher ↗
Public health interventions are often intended to make it easier for people to adopt health-related behaviours, e. g., by changing the social environment and material living conditions. With the concept of "Behavioral an...
Public health interventions are often intended to make it easier for people to adopt health-related behaviours, e. g., by changing the social environment and material living conditions. With the concept of "Behavioral and Cultural Insights" (BCI), the World Health Organization (WHO) has established an approach that aims at a better understanding of health-related behaviours, in order to be able to develop corresponding public health interventions in a more targeted manner. The focus is on the empirical identification of individuals as well as cultural, social and environmental barriers to and facilitators of health behaviour.The BCI approach can be used to plan preventive measures in a more evidence-based and needs-oriented manner. To this end, the current article outlines some basic features of BCI which should be taken into account for integrating the concept into a contemporary understanding of "new public health". This includes social and individual factors influencing health as well as social inequalities in health.First, the article distinguishes the BCI concept from the approach of behavioural economics (e. g., nudging). To illustrate its potential for population health and health equity, the article then explains that BCI-based measures that (a) focus on both behaviour and environment, (b) aim at health equity, (c) are developed and implemented in a participatory manner, and (d) follow the logic of the well-established Public Health Action Cycle. For BCI, it is crucial to systematically identify and analyse the factors influencing human behaviour in everyday life. BCI-based interventions must also consider the characteristics of complex interventions and be tailored to local conditions and the cultural diversity of specific population groups.The BCI approach has many similarities with other approaches of quality-assured and needs-oriented prevention measures. The focus on a systematic identification of barriers and facilitators offers an important added value in the planning of public health measures. Research into BCI and their use in prevention should be expanded in Germany.
[Legal requirements for information and their influence on patient satisfaction].
Briegel W, Lopez de Miguel P
Gesundheitswesen · 2025 Jul · PMID 39875123 · Publisher ↗
The German Patientenrechtegesetz defines, among other things, medical obligations in connection with the provision of information. To date, the extent to which these legal requirements also influence patient satisfaction...
The German Patientenrechtegesetz defines, among other things, medical obligations in connection with the provision of information. To date, the extent to which these legal requirements also influence patient satisfaction with information has not been investigated in Germany.The study employed an anonymized patient survey on satisfaction with information, which was recorded using a validated 10-item questionnaire.189 consultations (n=105 female, n=84 male patients) were included in the analysis. 87.8% (n=166) of the patients were undergoing inpatient treatment, 12.2% (n=23) were treated as outpatients. The patients were on average 53.2 years old (standard deviation: 20.3 years, range: 15 to 97 years) and were distributed across the following treatment areas: Anesthesia: n=68; Surgery: n=60; Internal Medicine: n=56; Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy: n=5 patients. Overall, there was a high level of satisfaction with the information provided, which did not differ significantly between the genders. However, patients were more satisfied if they were informed by doctors with German as their mother tongue (p=0.005; d=0.214) or by specialists (p<0.001; d=0.288). The duration of the consultation was significantly positively correlated with patient satisfaction (p=0.002, r=0.211). It was also shown that the physician's level of training (specialist: yes/no) was the most important factor (adjusted odds ratio: 4.48).The requirements of the Patientenrechtegesetz with regard to the comprehensibility and thoroughness of the information conveyed, as well as the proficiency of the medical practitioner, have been demonstrated to foster patient satisfaction. It is thus imperative that sufficient professional competence is always ensured. For medical practitioners whose native language is not German, the utilization of translation programs, pictorial or video-based supplementary materials is recommended to facilitate comprehension and minimize any potential language barriers. Moreover, the duration of the consultation should be tailored to the specific needs of the individual patient in order to optimize satisfaction. In order to achieve this, it would be prudent to ascertain from patients in advance the level of detail they would prefer the consultation to encompass.
[The burnout dimension emotional exhaustion and impairment of work participation: A prospective study of 2308 employees subject to social security contributions in Germany].
Rose U, Buchallik F, Burr H … +1 more , Kersten N
Gesundheitswesen · 2025 Oct · PMID 39855257 · Full text
The present study examines the relationship between the burnout dimension emotional exhaustion and subsequent events of work nonparticipation (long-term sickness absence, unemployment, early retirement) and their duratio...
The present study examines the relationship between the burnout dimension emotional exhaustion and subsequent events of work nonparticipation (long-term sickness absence, unemployment, early retirement) and their duration.The data basis was the Study on Mental Health at Work (S-MGA); a follow-up study based on a random sample of n=4511 employees subject to social security contributions aged 31-60 years at baseline and their follow-up after 5 years (n=2460). Burnout symptoms were measured at the time of the baseline survey by means of a questionnaire, while the employment and sickness absence history was recorded at follow-up by means of an interview. Associations between the burnout scale at T1 and subsequent events of inactivity were analysed using a two-part model: i. e., events were predicted using logistic regression, and their duration was predicted using generalised linear regression models (GLM).The burnout scale was associated with the events and duration of long-term sickness absence; among men with an odds ratio [OR]=1.72 (95% CI=1.31; 2.27) and among women with an OR=2.23 (95% CI=1.73; 2.88) per scale point for the occurrence of an event. Among those who experienced long-term sickness absence, the duration (in months) increased by a factor of Exp(β)=1.44 (95% CI=1.23; 1.69) for men and Exp(β)=1.29 (95% CI=1.09; 1.52) for women for each scale point on the burnout scale.From a clinical and health economic point of view, it is a relevant finding that the burnout dimension of emotional exhaustion is associated with events and duration of work nonparticipation.
[Health Economic Benefit Analysis of ENT Centers: Simulation-based analysis of centralization in laryngeal surgery using population data from Schleswig-Holstein, exemplified by laryngeal carcinoma].
Bettin S, Müller M, Weinhold I … +3 more , Zetzsch L, Bruchhage KL, Elsner C
Gesundheitswesen · 2025 Dec · PMID 39842464 · Publisher ↗
The health economic impacts of centralization in the German healthcare system, particularly in the field of ENT, are insufficiently researched. Therefore, this study investigates the potential benefits of a head and neck...
The health economic impacts of centralization in the German healthcare system, particularly in the field of ENT, are insufficiently researched. Therefore, this study investigates the potential benefits of a head and neck tumor center using the example of surgical care for laryngeal carcinoma in Schleswig-Holstein.A systematic literature review was conducted using the PRISMA search schema to examine the correlation between a hospital's treatment volume and mortality rates for laryngeal carcinomas. Subsequently, an 8-year Markov model simulation was employed to demonstrate the effects of establishing centers. This was supplemented by a cost analysis based on data from the PROGNOS study.The simulation shows the hypothetical impact on patient care for the existing head and neck tumor center in Schleswig-Holstein over an 8-year period. Maintaining the center in Schleswig-Holstein over eight years would save 113 lives and gain 1,333 life years (equivalent to 933.1 QALYs), corresponding to costs of 12,866 euros per QALY.The results suggest that centralizing care has medical and economic effectiveness in the ENT sector. They provide important insights for current political discussions and decision-making processes in healthcare. Future research should expand the focus to include other ENT cancers to gain a more comprehensive understanding of the impacts of centralization.
[Between Hippocrates and the Oath of Office: Tensions between legal, moral and role expectations with regard to Public Health Service Physician assessments of (future) public servants].
Schröder-Bäck P, Brixius K
Gesundheitswesen · 2025 Apr · PMID 39842448 · Publisher ↗
Assessments in the German Public Health Service take place, among other things, in the recruitment and incapacity assessment of civil servants. This may lead to conflicts of values and norms for assessing doctors, as the...
Assessments in the German Public Health Service take place, among other things, in the recruitment and incapacity assessment of civil servants. This may lead to conflicts of values and norms for assessing doctors, as they have to make decisions that are not necessarily in the interests of the person being assessed. Legally, the expectations of assessing doctors in public administration are largely defined. For public health service physicians, individual normative role conflicts still appear, and questions arise as to whether conscientious decisions of physicians adhere to legal requirements.
[Description of the characteristics of invasive home mechanical ventilated patients in Bavaria using routine data from the MD Bavaria].
Brandstetter LS, Schutzmeier M, Grau A … +9 more , Ahnert J, Klingshirn H, Reuschenbach B, Kippnich M, Skazel T, Wurmb T, Lehmann K, Heuschmann PU, Haas K
Gesundheitswesen · 2026 Mar · PMID 39842447 · Publisher ↗
The number of patients with invasive home mechanical ventilation (IHMV) in Germany is vastly increasing. Currently, only limited data is available on the characteristics of these patients. The aim of the present study wa...
The number of patients with invasive home mechanical ventilation (IHMV) in Germany is vastly increasing. Currently, only limited data is available on the characteristics of these patients. The aim of the present study was to describe the health care situation of IHMV patients living in Bavaria using routinely collected data within the project OVER BEAS.The routine data were derived from the care assessment of the Medical Service (MD) in Bavaria (years 2017-2020). In this dataset, IHMV patients were identified using specific filter variables. Patients were analysed regarding sociodemographic characteristics, diagnosis, mobility, therapeutic measures, and need for care.The dataset comprised 536 adult IHMV patients (34.5% female, median age 68, IQR 58 75); 13.1% lived in nursing homes (NH), 22.2% in home care (HC), and 64.2% in shared living communities (SLC). From 2017 to 2020 a trend in proportionally more patients living in SLC was observed. Differences between the living situations were seen in the frequency of physical (NH 91.4%; HC 76.5%; SLC 90.4%; p<0.001) and occupational therapy (NH 47.1%, HC 58.8%, SLC 69.8%, p<0.001). 69.4% of IHMV patients were classified as having the highest need for care.The routine data from the MD Bavaria could be successfully used to describe the characteristics of patients in the highly complex setting of IHMV. In order to facilitate regular monitoring of the care situation, it would be advantageous to implement more precise recording of IHMV in routine data.
[Cross-sector Management of Medical Treatment and Integrated Forms of Therapy for Post-COVID-19 Patients with Fatigue and Sensorimotor Instability].
Urban T, Reinhardt F, Lohse P … +2 more , Spitzer SG, Reichmann H
Gesundheitswesen · 2025 May · PMID 39832786 · Publisher ↗
For the medical treatment of post-COVID-19 syndrome, only a few cross-sector medical treatment networks, such as the Post-COVIDLMU CONCEPT [1], are currently being implemented. However, no causal therapy can be reliably...
For the medical treatment of post-COVID-19 syndrome, only a few cross-sector medical treatment networks, such as the Post-COVIDLMU CONCEPT [1], are currently being implemented. However, no causal therapy can be reliably recommended based on evidence-based criteria. A cross-sector, doctor-led treatment management will be inaugurated for post-COVID-19, initially focusing on the syndrome of fatigue/immunometabolic depression (as a target for precision medicine) and sensorimotor instability as a cognitive parameter. The corresponding parameters will be recorded and analyzed in real time and at the same time become an important environmentally stable training object. The use of internet and mobile-based interventions represents an essential component here.Changes in the leading syndromes of fatigue and sensorimotor instability through stress-controlled standardized training therapy, intensified cognitive behavioral therapy and the process design of interdisciplinary therapy management in compliance with the guidelines of the Federal Joint Committee (G-BA) for cross-professional and cross-sector care for post-COVID-19 patients were the overarching goals of an intervention study at the post-COVID-19-Center Lausitz over a 3-year period (Q1-2021-Q2-2024). The results of a stress-controlled intervention study were integrated into the derivation, design and evaluation of a cross-sector management process. The outcome and management of the training therapy were assessed based on the post-COVID-19 key symptoms and motor fatigue parameters. A secondary psychosomatic syndrome that emerged during treatment was examined using cognitive fatigue parameters.With the stress-controlled sensorimotor intervention integrated into the designed management process as well as intensified cognitive behavioral therapy, improvements in post-COVID-19 key symptoms as well as in the parameters of motor and cognitive fatigability were achieved. The timing of the start of the process stages of the overall management had an influence on the outcome of the treatment path. Intensification of cognitive behavioral therapy also had positive effects, resulting in an increasing level of activity and self control in patients.
[Access to and Transitions within the Medical Care Process of Persons with Down Syndrome and Dementia: A Qualitative Analysis].
Walendzik A, Weitzel M, Giebel GD … +10 more , Raszke P, Wasem J, Levin J, Wagemann O, Wlasich E, Nübling G, Pantel J, Tesky VA, Schall A, Hüer T
Gesundheitswesen · 2025 Oct · PMID 39824222 · Full text
Compared to the general population, individuals with Down syndrome carry a much higher genetic risk of developing early onset Alzheimer's dementia. This leads to unique challenges and the need for a targeted patient jour...
Compared to the general population, individuals with Down syndrome carry a much higher genetic risk of developing early onset Alzheimer's dementia. This leads to unique challenges and the need for a targeted patient journey.In a qualitative interview study with medical professionals, patient organisations and formal and informal care persons, we assessed barriers within the medical care process of this patient group as well as current approaches to overcome these problems. The study is one module of a multi-method project founded by the Innovation Fund of the German Joint Commission. The results presented here focus on access to and transitions within the medical care process. 14 guided interviews were conducted by a team of moderators by video conference, recorded and transcribed. The analysis of the results was carried out as a qualitative content analysis based on the methods of Mayring.Given the varying degree of premorbid intellectual disability, difficulties recognizing dementia symptoms were reported leading to delays in initiating the diagnostic process. Limited knowledge of the special disease risk and symptom manifestation in routine medical care as well as the lack of specialized medical institutions were identified as additional hurdles. Insufficient dissemination of information about existing specialised institutions to regular physicians and caregivers was criticized. All stakeholder groups drew attention to limitations in access to occupational and speech therapy because of the inadequate number of specialized therapists. Improvements suggested by the interview partners focussed on topics such as the implementation of guidance of the patient journey to and within the medical care process by one institution, easily accessible information for patients and caregivers as well as optimised training for physicians in routine care.Barriers such as insufficient availability of specialised service providers and information deficits about the specific disease risks and symptoms of the population have also been identified in international literatur; in addition, management and coordination deficits in the fragmented German health care system represent well known additional barriers. Approaches to improve the situation can be seen, on the one hand, in improved information and training offers for caregivers and service providers, and, on the other hand, in the expansion of the range of specialized service providers, in particular the Medical Centres for Adults with Disabilities. Informed by these study results and the results of other project modules, health policy recommendations for the improvement of the patient journey of patients with Down syndrome and dementia will be developed in the last project module.
[Primary care physicians' perspectives on the referral of patients with social problems to non-medical services - a cross-sectional survey].
Evers S, Kloppe T, Gerhardus A
Gesundheitswesen · 2025 Nov · PMID 39821752 · Publisher ↗
Physicians in primary care practices encounter social problems among their patients on a daily basis. Physicians can refer these patients to social services to improve their health and reduce pressure on the health care...
Physicians in primary care practices encounter social problems among their patients on a daily basis. Physicians can refer these patients to social services to improve their health and reduce pressure on the health care system. Open questions remain about how these referral practices are carried out and what areas have potential for improvement.An online survey with 21 closed or open-ended questions was conducted among primary care physicians (general practitioners and paediatricians) in Bremen, Germany. Data from closed questions were analysed for frequency distributions, while responses to open-ended questions were coded and interpreted using qualitative content analysis.Out of 580 primary care physicians in Bremen, 45 (8%) participated in the survey. Most of the respondents considered it important to be able to refer patients to support services outside the medical care system. Physicians referred a median of 10% of patients for whom they identified a need for social support. The most common reasons for not referring patients included a lack of knowledge about available services or the absence of such services, as well as time constraints. A total of 33 physicians (73%) reported feeling highly burdened when unable to refer patients. Furthermore, 34 respondents (76%) anticipated that a central contact point for social issues would greatly improve their job satisfaction. More general practitioners than paediatricians considered support services related to finances, unemployment, and housing to be important, while paediatricians were more open to providing external social support services in their own practices or using a "Gesundheitskiosk" (health kiosk).This is the first study to compare general practitioners and paediatricians regarding social issues in patient care. Given the low response rate, the results should be interpreted with caution. Notably, physicians reported that they did not refer most patients with identified social needs and experienced this as a burden. The majority indicated that, if available, they would use various forms of collaboration with social services.
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