Gesundheitswesen [JOURNAL]
Sun
200 papers
Testing a model-based approach for planning and regional coordination of hospital service group offerings: A model project in the East Saxony healthcare cluster.
Glaubitz R, Harst L, Ehm F … +15 more , Tesch F, Barlinn J, Krause F, Schwarz R, Malzahn J, Werblow A, Sinz C, Randig I, Riedel T, Kutschker C, Fiebig S, Kubitza J, Cording M, Wolff J, Schmitt J
Gesundheitswesen · 2026 Mar · PMID 41850301 · Publisher ↗
The hospital reform passed in 2024 will lead to regional and nationwide changes in the German hospital landscape. A joint project to examine the effects of the hospital reform on health care structures in the East Saxony...
The hospital reform passed in 2024 will lead to regional and nationwide changes in the German hospital landscape. A joint project to examine the effects of the hospital reform on health care structures in the East Saxony region was initiated by the Center for Evidence-Based Health Care (ZEGV) at Dresden University Hospital, the regional health care coordinators of the four districts in the East Saxony care cluster and the city of Dresden, a statutory health insurance provider (AOK PLUS), and other regional stakeholders. In addition, the aim was to promote cooperation between the stakeholders for the purpose of future regionally coordinated planning for inpatient care. The project involved the application and validation of a model displaying a hospital's relevance for stationary care provision (care relevance model), which was developed in cooperation with the GKV-Spitzenverband (National Association of Statutory Health Insurance Funds) and is based on the performance data of German hospitals in accordance with § 21 KHEntgG (Hospital Remuneration Act). Thirty of the 36 hospital locations in the project region agreed to participate in the project. Both in a questionnaire-based self-assessment provided by the clinics and during a joint cluster conference, the tension between the need for cooperation and individual interests became clear. At this point, the care relevance model developed can scientifically support the dialogue between the stakeholders and thus support inpatient planning.Im Zuge der im Jahr 2024 verabschiedeten Krankenhausreform wird es zu regionalen und deutschlandweiten Veränderungen der Krankenhauslandschaft kommen. Vor diesem Hintergrund wurde ein gemeinsames Projekt des Zentrums für Evidenzbasierte Gesundheitsversorgung (ZEGV) der Hochschulmedizin Dresden mit den Regionalkoordinator:innen für Gesundheit der vier Landkreise im Versorgungscluster Ostsachsen und der Stadt Dresden, der AOK PLUS und weiteren regionalen Akteuren initiiert, um die Auswirkungen der Krankenhausreform auf die Versorgungsstrukturen in der Region Ostsachsen zu untersuchen. Zudem sollte die Kooperation zwischen den Akteuren zum Zweck einer zukünftigen regional abgestimmten Planung für die stationäre Versorgung gefördert werden. Im Projekt erfolgte die Anwendung und Validierung eines Versorgungsrelevanzmodells, welches in Kooperation mit dem GKV-Spitzenverband entwickelt wurde und auf den Leistungsdaten deutscher Krankenhäuser nach § 21 KHEntgG basiert. Dreißig von 36 Krankenhausstandorten in der Projektregion konnten für eine Teilnahme am Projekt gewonnen werden. Sowohl in einer fragebogengestützten Selbstauskunft der Kliniken als auch im Rahmen der zusammenführenden Clusterkonferenz wurde das Spannungsfeld zwischen Kooperationsnotwendigkeiten und Partikularinteressen deutlich. An dieser Stelle kann das entwickelte Versorgungsrelevanzmodell den Dialog zwischen den Akteuren wissenschaftlich begleiten und so die stationäre Planung unterstützen.
[Satisfaction with support provided by stroke case managers: Results of survey from the perspective of stroke survivors].
Voigt C, Miethe J, Pries R … +5 more , Franzisket C, Siebdrat A, Wagner M, Galle G, Brinkmeier M
Gesundheitswesen · 2026 May · PMID 41812682 · Publisher ↗
BACKGROUND: Many stroke patients are overwhelmed with the management and maintenance of their complex care and therapy during aftercare [1]. Stroke case managers provide support and coordination in the transition to afte...
BACKGROUND: Many stroke patients are overwhelmed with the management and maintenance of their complex care and therapy during aftercare [1]. Stroke case managers provide support and coordination in the transition to aftercare, acting as contact persons for patients for a minimum of six contact points over a period of 12 months following stroke. METHOD: A postal survey of stroke patients who were accompanied by case managers as part of a selective contract in accordance with §140 SGB V in Est Westphalia Lippe was conducted. The results of the current survey (n=101) and the overall results of all persons people surveyed to date (n=335), who were supported by a stroke case manager, are reported. RESULTS: The support provided by a stroke case managers was regarded as beneficial and valuable by stroke survivors. Cumulative satisfaction (agreement or full agreement on a four-point Likert scale) regarding frequency of contact (96%), accessibility (95%), and personal interaction with stroke survivors and, if applicable, relatives (98%) was rated very positively. A total of 82% of respondents indicated that the availability of a personal contact person constituted the most significant form of support. Furthermore, stroke survivors reported that the case managers had a positive impact on their awareness and the handling of risk and lifestyle factors. There was a notable level of satisfaction with the support provided, and based on their experiences, the respondents recommended the implementation of this intervention for all individuals who have experienced a stroke (99%). CONCLUSION: The intervention developed is well accepted by stroke survivors and provides relief for those affected and their relatives. A high level of acceptance on the part of stroke survivors and a needs-based organization of the stroke case manager activity is a central prerequisite for the nationwide establishment of case managers in standard care.
[Regional characteristics of diagnoses of unemployed people under socio-medical assessments by the Medical Service of the Federal Employment Agency].
Franke AG, Scherbaum N, Manz KM … +2 more , Pieper C, Lotz-Metz G
Gesundheitswesen · 2026 Apr · PMID 41812681 · Full text
There is a correlation between unemployment and health status of unemployed people. In Germany, there is a lack of current data on this relationship, particularly on the basis of medical diagnoses and regional characteri...
There is a correlation between unemployment and health status of unemployed people. In Germany, there is a lack of current data on this relationship, particularly on the basis of medical diagnoses and regional characteristics.All socio-medical assessments by the Medical Service of the Federal Employment Agency between 2016-2021 were analyzed nationwide with regard to diagnoses, results of performance assessment and regional characteristics.A total of 4,249,028 socio-medical assessments were analyzed. In 2021, an average of 1.4% of all unemployed were assessed, relatively most from the region of Berlin-Brandenburg (1.9%); in absolute terms, most in North Rhine-Westphalia (19.2%). Relative to the unemployment rate, most assessments took place in Baden-Württemberg. In all regions, F-diagnoses (mental disorders) led with the highest values among those who under the age of 25 (3/4) and living in Berlin-Brandenburg (62.4%), followed by M-diagnoses (musculoskeletal disorders) with the highest values (35.9%) in Lower Saxony-Bremen and I-diagnoses (circulatory disorders) with the highest values (14.8%) in Saxony-Anhalt and Thuringia. While the overall burden of disease was highest in North Rhine-Westphalia, Berlin-Brandenburg had the highest number of those being unable to work (40.7%). Overall, 33.9% of all assessed unemployed people were classified as being unable to work (<3 hours/day).Illnesses are an important obstacle to breaking through unemployment. Accordingly, treatment can help people to return to the labor market. The regional variations shown here indicate differences that are difficult to explain.
[Work-organizational Strategies and Measures for Pandemic Management in Inpatient Care: Findings from Scenario Workshops].
Zink M, Jansen N, Zurfluh F … +2 more , Vögler D, Melzer M
Gesundheitswesen · 2026 Mar · PMID 41771302 · Publisher ↗
The aim of this study was to develop suitable measures and strategies through a trans- and interdisciplinary discourse to improve pandemic management in (acute) inpatient care facilities (clinics, nursing homes) and ther...
The aim of this study was to develop suitable measures and strategies through a trans- and interdisciplinary discourse to improve pandemic management in (acute) inpatient care facilities (clinics, nursing homes) and thereby reduce the burden on nursing staff.Two scenario-based workshops were conducted-one focused on acute care and the other on long-term care. Following a collaborative, transdisciplinary approach, the workshops integrated perspectives from nursing practice, research, and relevant institutions. Using foresight methods such as the Futures Wheel and Ideation Canvas, participants co-developed potential solutions for optimizing pandemic preparedness and response. A total of 38 participants took part in the two-day workshops (acute care: 18; long-term care: 20).Participants developed outcomes at both structural and organizational levels, identifying short- and long-term effective strategies and interventions. Key findings addressed areas such as communication, internal organization, interface management, and the involvement of nursing practitioners. Examples include the (political) empowerment and increased participation of nurses, the development of digital and interdisciplinary structures, including skill-grade mix teams. Across both care settings, participants emphasized the need for formal nursing representation and clearly defined professional roles and responsibilities.Effective crisis management in inpatient care settings requires a systemic approach that integrates actions at the micro, meso, and macro levels. Coordinated collaboration between policy, science, and practice is essential to strengthen system resilience and sustainably improve working conditions in healthcare.
[Utilisation of Speech/Language and Occupational Therapy in Dementia and Mild Cognitive Impairment: Insights from German Routine Healthcare Data].
Dörr F, Holle D, Morouj B … +4 more , Obermüller D, Sommer S, Wübbeler M, Bilda K
Gesundheitswesen · 2026 Mar · PMID 41771301 · Publisher ↗
Non-pharmacological therapies such as speech/ language and occupational therapy are considered essential components in the care of people with dementia and mild cognitive impairment. However, data on the actual utilisati...
Non-pharmacological therapies such as speech/ language and occupational therapy are considered essential components in the care of people with dementia and mild cognitive impairment. However, data on the actual utilisation of these services in routine care are lacking. This study aimed to examine the utilisation of these services using routine data.Based on routine data from the research database of the Institute for Applied Health Research Berlin (2017-2022), annual utilisation densities of speech/ language therapy and occupational therapy were calculated in relation to the annual prevalence of dementia/mild cognitive impairment and analysed by federal state. In addition, all individuals with an initial diagnosis in 2017 were followed over a five-year period as part of a longitudinal study to examine the use of therapeutic services.The six-year prevalence was 5.1%, with an annual average of n=85,496 individuals identified with dementia/mild cognitive impairment. The mean annual utilisation densities were 2.5% for speech/language therapy and 7.0% for occupational therapy. North Rhine-Westphalia had the highest, Bremen the lowest utilisation density. In the longitudinal analysis, 9.4% of affected individuals (n=13,746) received at least one therapy prescription. Utilisation decreased with disease duration, while home visits became more frequent.Despite established guideline recommendations, speech/language and occupational therapy remain underutilised in the care of people with dementia or mild cognitive impairment in Germany. To address these care gaps, targeted information strategies for stakeholders and the implementation of interdisciplinary care pathways in routine practice are needed.
[E-cigarettes - a pitfall in rewarding smoking cessation during pregnancy?].
Ulbricht S, Vitzthum K
Gesundheitswesen · 2026 Mar · PMID 41771300 · Publisher ↗
The pilot project, entitled "Rewards for Smoking Cessation during Pregnancy" is testing an intervention involving rewards and psychosocial support for women who smoke from the 15 week of pregnancy onwards. A reward of € ...
The pilot project, entitled "Rewards for Smoking Cessation during Pregnancy" is testing an intervention involving rewards and psychosocial support for women who smoke from the 15 week of pregnancy onwards. A reward of € 25 is given if carbon monoxide in the exhaled air is found to be at or below 4 parts per million on two days of the week. However, the case study of Ms T. shows that CO is not suitable for validating self-reported data, as there is a risk of switching to tobacco and nicotine products without combustion, such as e-cigarettes. In the context of alternative methodologies, detecting cotinine, a nicotine breakdown product, in saliva or urine is a viable option. However, research is needed to establish the extent to which these methods are accepted by those affected by it, as well as by those who use it. Updating the methods used to verify self-reported smoking habits during pregnancy, as well as in the context of smoking cessation in general, is essential in order to keep up with new developments in the field. This is necessary to avoid creating false incentives, as we can see from the case of Ms T., and to ensure reliable monitoring of smoking status during smoking cessation.
[Closure of child care centers and SARS-CoV-2 spread: A regional analysis of lockdown measures].
Klebe J, Standl F, Stich H
Gesundheitswesen · 2026 May · PMID 41760283 · Publisher ↗
BACKGROUND: On 11 March 2020, the World Health Organization (WHO) declared SARS-CoV-2 a pandemic. In the absence of specific vaccines or effective antiviral therapies at the beginning of the pandemic, non-pharmaceutical...
BACKGROUND: On 11 March 2020, the World Health Organization (WHO) declared SARS-CoV-2 a pandemic. In the absence of specific vaccines or effective antiviral therapies at the beginning of the pandemic, non-pharmaceutical interventions (NPIs) were widely implemented, including temporary closures of day-care centers (Kitas). METHODS: Using routinely reported case data from the Landshut Health Authority, we analyzed the period from November 2020 to February 2021. SARS-CoV-2 incidence before and after Kita closures was assessed for children aged 0-5 years and for the general population using an interrupted time series analysis (ITSA) with a negative binomial regression model. RESULTS: Following Kita closures, reported SARS-CoV-2 infections decreased in both children aged 0-5 years (IRR: 0.96; 95% CI: 0.92-0.99) and the general population (IRR: 0.97; 95% CI: 0.95-0.98). CONCLUSION: These findings suggest that temporary Kita closures were associated with a reduction in reported SARS-CoV-2 infections and may have influenced pandemic transmission dynamics. However, potential socio-psychological impacts of Kita closures on children should be considered when evaluating NPIs and incorporated - without presupposing direction of effect - into preparedness planning for future pandemic events.
[Impact of the amendment to the AMNOG guidelines by the GKV-FinStG on the benefit assessments of the G-BA].
Hammerschmidt T, Nitzl T, Robert S
Gesundheitswesen · 2026 Apr · PMID 41748107 · Publisher ↗
The central aim of the study was to analyze possible changes in the benefit assessment by the Federal Joint Committee (G-BA) following the GKV Financial Stabilization Act (GKV-FinStG) by examining whether the tightening...
The central aim of the study was to analyze possible changes in the benefit assessment by the Federal Joint Committee (G-BA) following the GKV Financial Stabilization Act (GKV-FinStG) by examining whether the tightening of AMNOG guardrails has led to more restrictive assessment practices. This was operationalized through a comparative analysis of German and French benefit assessments before and after the GKV-FinStG. Two central research questions were pursued: (1) Can statistically significant changes in the G-BA's additional benefit assessments be demonstrated? (2) Can observed changes be causally attributed to the tightening of AMNOG guidelines?A quasi-experimental difference-in-difference (DiD) design was employed to analyze changes in benefit assessment. Germany served as the intervention group, France as the control group. German benefit assessments were captured via the AMNOG Monitor for the period 2020-2024, French assessments via the Haute Autorité de Santé (HAS). Separate analyses were conducted according to patent protection status of the appropriate comparator therapy (ACT).The study provides the first empirical evidence of a potential influence of tightened AMNOG guidelines on G-BA assessment behavior. The statistically significant difference-in-difference effect of -9.74% (p=0.028) shows that the proportion of at least considerable additional benefit assessments in Germany declined by nearly 10 percentage points more strongly than in France after the reform. For procedures with patent-protected ACT, the strongest effect of -14.56% was observed, while for generic ACT, no relevant effect (0.88%) occurred as expected.The tightening of AMNOG guardrails has led to a systematic reduction in the proportion of at least considerable additional benefit assessments. The observed change could be attributed to unconscious cognitive adaptations or conscious strategic considerations to limit GKV expenditures. The findings suggest that savings arise not only through direct price effects but also through more restrictive assessment practices.
[Need for Improvement in Healthcare Provision for Rare Endocrinological Diseases in Germany Using the Example Endogenous Cushing's Syndrome].
Haberbosch L, Fassnacht M, Reincke M … +6 more , Kabilka A, Effenberger T, Hupp T, Tuckermann J, Petersenn S, Kreitschmann-Andermahr I
Gesundheitswesen · 2026 Feb · PMID 41730278 · Publisher ↗
The care of patients with rare diseases in Germany poses a challenge; endogenous Cushing's syndrome highlights this issue. An analysis of the care situation aims to identify areas for improvement. A systematic literature...
The care of patients with rare diseases in Germany poses a challenge; endogenous Cushing's syndrome highlights this issue. An analysis of the care situation aims to identify areas for improvement. A systematic literature search on the care situation was compared with prescription data from Germany and France as well as physician statistics from various European countries. In Germany, there is a low density of endocrinologists, a lower treatment prevalence than in France and a longer time to diagnosis than in other countries with well-developed healthcare systems. In order to guarantee need-based care for rare diseases, investments in the training and further education of specialists, such as endocrinologists, and in new, cross-sectoral forms of care are necessary.
Integration of Real-World Data into Clinical Trials: An Interdisciplinary Discussion from Regulatory and Practical Perspectives.
Köppe J, Schiel A, Gerlinger C … +3 more , Götte H, Edelmann D, Erdmann S
Gesundheitswesen · 2026 Feb · PMID 41730277 · Publisher ↗
Increasing efforts are required to integrate the growing volume of so-called real-world data (also named routine practice data), which are data generated outside of randomized controlled trials, into regulatory studies....
Increasing efforts are required to integrate the growing volume of so-called real-world data (also named routine practice data), which are data generated outside of randomized controlled trials, into regulatory studies. Various stakeholders anticipate that such integration could save time and financial resources during the approval process of new therapies, and ethical considerations also partially support such an approach. The aim of this manuscript is to provide an overview of the methodological, ethical, and regulatory considerations when integrating routine practice data into randomized controlled trials. It targets clinical researchers, biostatisticians, regulators, and decision-makers involved in evidence generation and trial design.The inclusion of real-world data in randomized controlled trials can be meaningful from both ethical and economic perspectives. However, implementing this requires addressing various and sometimes significant limitations of the data, which need to be methodologically addressed. Therefore, it is essential to carefully weigh the risks and benefits of incorporating real world data into clinical studies.Randomized trials remain the gold standard for evaluating the efficacy of new therapies. Nevertheless, real-world data have the potential to improve the complex and costly process of drug development. The assessment of the potential for a specific clinical study should be made in collaboration with all relevant stakeholders. Apart from that, real-world data have a substantial potential to expand the evidence from randomized trials after post-market approval, thereby ensuring the safety of all patients.
[Correction: DNVF Memorandum Participatory Health Services Research (Part 1)].
Brütt AL, Borgmann S, Buchholz E … +23 more , Burggraf L, Engler J, Fischer F, Holetzek T, Houwaart S, Icks A, Jagoda F, Kernebeck S, Kersting C, Krieger T, Kugler C, Kuske S, Lander J, Messer M, Muche-Borowski C, Münte C, Röper AL, Salm S, Schindel D, Schreiter S, Teupen S, von Peter S, Farin-Glattacker E
Gesundheitswesen · 2026 May · PMID 41707680 · Full text
Abstract loading — click title to view on PubMed.
[Utilisation Of Dental And Medical Care Among Children And Adolescents With And Without Special Support Needs].
Krause L, Seeling S, Schmidt P … +1 more , Prütz F
Gesundheitswesen · 2026 Feb · PMID 41662871 · Full text
Children and adolescents with special support needs, i. e. with disabilities, special educational needs and impairments, are a heterogeneous group with different health situations and needs. This article examines to what...
Children and adolescents with special support needs, i. e. with disabilities, special educational needs and impairments, are a heterogeneous group with different health situations and needs. This article examines to what extent these health-related needs are reflected in the self-reported utilisation of dental and medical care, also in comparison to children and adolescents without special support needs.The database for this work is the German Health Interview and Examination Survey for Children and Adolescents (KiGGS Wave 2, 2014-2017). The following utilisation indicators were used for the analyses: dental check-up, orthodontic treatment, dental services overall, pediatrics, internal medicine, ophthalmology, otolaryngology, orthopedics, as well as psychiatric, psychotherapeutic and psychological services. Prevalences, univariable and multivariable prevalence ratios were calculated, which were controlled for sex, age and socioeconomic status of the family, as well as -values from Poisson regressions.The analyses were based on data of 779 children and adolescents with and 9,943 children and adolescents without special support needs. Children and adolescents with special support needs showed lower utilisation of dental services compared to children and adolescents without special support needs (e. g. dental check-ups: 72.8% and 79.4%, respectively; univariable =0.011), although the differences did not persist in the multivariable model (>0.05). In contrast, children and adolescents with special support needs were significantly more likely to receive specialist somatic (e. g. ophthalmology: 43,6% and 32.1%, respectively), psychiatric (18.7% and 4.2%, respectively) and psychological care (13.0% and 2.5%, respectively) compared to children and adolescents without special support needs (<0.001).Among children and adolescents with special support needs, the utilisation of medical care was significantly higher than among children and adolescents without special support needs, while there were hardly any differences in the utilisation of dental services. In order to improve the oral health of children and adolescents with special support needs, target group-specific health care and support services in close interdisciplinary co-operation seem to be necessary.
[Challenges, expectations and wishes in the use of colorectal cancer screening: a qualitative study of people with a Turkish and Afghan migration history].
Allak A, Wahidie D, Yilmaz-Aslan Y … +1 more , Brzoska P
Gesundheitswesen · 2026 Apr · PMID 41651010 · Publisher ↗
OBJECTIVE: The aim of the present study was to examine the challenges and needs of people with a Turkish and Afghan migration history when using colorectal cancer screening. METHODS: Semi-structured interviews were condu...
OBJECTIVE: The aim of the present study was to examine the challenges and needs of people with a Turkish and Afghan migration history when using colorectal cancer screening. METHODS: Semi-structured interviews were conducted with 18 people with a Turkish and Afghan migration history aged between 42 and 75 years. The participants were selected based on various socio-demographic characteristics to ensure a heterogeneous sample. The interviews were conducted in German and, if necessary, in Turkish or Dari, transcribed and analyzed using qualitative content analysis according to Kuckartz and structured according to Bronfenbrenner's socio-ecological model. RESULTS: Lack of knowledge, inadequate medical education, cultural and religious beliefs, language barriers and low risk perception were the main barriers to participation in colorectal cancer screening. Women and people with a low educational status were less informed about screening options and were less likely to utilize them. The respondents reported mostly positive experiences with previous screenings but would like to see more comprehensive and culturally sensitive information. CONCLUSIONS: Diversity-sensitive educational measures, nationwide dissemination of information, multilingual information and targeted information events are necessary to promote informed decision-making about participation in colorectal cancer screening among people with Turkish and Afghan migration history. General practitioners, as key information providers and confidants, play a crucial role in this context. Further research is needed to develop specific strategies to improve colorectal cancer screening.
[Psychological psychotherapists' and physicians' perspective on perceived need for and prescription of digital health applications for mental disorders].
Engesser D, Stalujanis E, Kemmerer P … +6 more , Dotzauer L, Salm S, Scheibe S, Mergenthal K, Voigt K, Singer S
Gesundheitswesen · 2026 Feb · PMID 41651000 · Publisher ↗
Since 2020, psychotherapists and physicians have been allowed to prescribe digital health applications for mental disorders (DHA-MD). The aim of the study was to examine the actual relevance of DHA-MD for mental health c...
Since 2020, psychotherapists and physicians have been allowed to prescribe digital health applications for mental disorders (DHA-MD). The aim of the study was to examine the actual relevance of DHA-MD for mental health care by asking psychotherapists and physicians for their opinion on the need for DHA-MD and how often they actually prescribe them. Moreover, we wanted to identify reasons for (not) prescribing DHA-MD.In spring 2024, 1000 psychological psychotherapists and physicians registered by the National Association of Statutory Health Insurance Physicians in Germany were selected stratified by region and community size. They received a self-developed questionnaire by post, which was additionally published online by, for instance, expert associations. Additionally, we conducted semi-structured interviews with selected participants. Questionnaires were analysed both descriptively and via Spearman's Rank Correlation Test. A qualitative content analysis according to Mayring was done for the interviews.In total, 321 participants filled out the questionnaires, and 16 were interviewed. The need for DHA-MD on a scale of 0-10 was rated≤2 (median 2) by 61% (n=198) of the participants. The median of DHA-MD prescriptions in a regular calender quarter was 0 with a range up to 20. The share of participants prescribing at least one PsyDiGA was slightly higher (n=23, 29%) among physicians compared to psychological psychotherapists (n=60, 25%). There was no difference in the assessment of need for DHA-MD between the two professions. According to the interviews, requirements for confidence in and prescription of DHA-MD comprised guaranteed data protection, sufficient proof of concept, and knowledge about the contents of DHA-MD.Reasons for the low number of prescriptions and perceived need for DHA-MD may be less experience with DHA-MD or a lack of perceived necessity in participants' practice routine. The demand for transparency concerning data protection, proof of concept, and content of DHA-MD show mental health professionals' expectations of high quality concerning DHA-MD.
[Gender-Specific Lethality in Myocardial Infarction: A Regional and Temporal Analysis].
Dunkel T, Seeland U
Gesundheitswesen · 2026 Mar · PMID 41633405 · Publisher ↗
Epidemiological indicators form the statistical basis for medical research questions and influence how the relevance of a research topic is perceived. Temporal, financial, and human resources are invested to improve heal...
Epidemiological indicators form the statistical basis for medical research questions and influence how the relevance of a research topic is perceived. Temporal, financial, and human resources are invested to improve healthcare based on empirical evidence. While indicators such as morbidity and mortality are widely reported and describe the number of disease and death cases in relation to the total population, lethality - defined as the proportion of deaths among those actually affected - receives far less attention. From a gender-sensitive perspective, knowledge of the 30-day lethality rate is essential to assess treatment outcomes in women and men. This raises the question of whether current data in Germany are sufficient to enable regional and temporal analyses of lethality among women and men following myocardial infarction.A systematic PubMed search (PRISMA, 28 January 2025) identified publications (2017-2025) reporting sex-specific 28-day lethality after acute myocardial infarction (AMI). Evidence was assessed using the GRADE system. In addition, a secondary analysis of publicly available datasets (Destatis, MONICA/KORA, RHESA, GBE-Bund) was conducted. AMI cases were defined via ICD-10 I21.0-I21.9 (first infarctions). Results The search identified 18 relevant publications. Three studies of high methodological quality (AOK, MONICA/KORA, GBE-Bund) consistently showed higher 28-day lethality in women (RR 1.12-1.30), especially in individuals under 60 years; in older age groups, differences diminished. Marked regional disparities were observed, with higher lethality rates in eastern German states (e. g., Brandenburg 19%, Berlin 12%).These findings reveal a rudimentary data landscape regarding 30-day mortality after acute coronary syndrome or myocardial infarction. Known factors, such as earlier diagnosis in men, differences in risk profiles, and treatment disparities, can partly explain the observed trends. However, robust, evidence-based analyses and datasets enabling sex- and age-specific evaluations are lacking. Consistent inclusion of post-discharge follow-up data is essential to fully capture care quality and to develop targeted, gender-sensitive prevention and treatment strategies.
[From functional status to level of care: The Barthel Index as an approximation to level of care needs].
Ivanova M, Rosenbusch ML, Neumann J … +3 more , Arndt R, Landgraf I, Müller D
Gesundheitswesen · 2026 Mar · PMID 41633379 · Full text
Based on anonymized inpatient service data from 2023 using the InEK-DatenBrowser (according to § 21 KHEntgG), the correlation between restrictions in the activities of daily living - measured with the Barthel Index - and...
Based on anonymized inpatient service data from 2023 using the InEK-DatenBrowser (according to § 21 KHEntgG), the correlation between restrictions in the activities of daily living - measured with the Barthel Index - and the assigned level of care was examined. The aim was to demonstrate that the Barthel Index can be used as a practical tool for assessing the need for care in everyday medical practice. The results show that a lower Barthel Index is significantly associated with a higher level of care. Using ordinal logistic regression analyses (OR for level of care>1 are between 1.40 and 14.52) and the Kendall correlation test (τ=0.32; p<0.001; Cohen's d=1.10) we were able to demonstrate a statistically significant correlation. Thus, the Barthel Index can be used as an indicator for care needs - especially in cases where no formal level of care has yet been assigned. These findings can support medical decision-making and contribute to more needs-based care. Additionally, they could potentially ease physicians' daily routines by enabling the early identification of a need for long-term care.
[Mobility services in primary care: An overview of existing types of services and potentials for the German healthcare system].
Legler O, Ratschker N, Maier V … +3 more , Hofmann J, Ewert T, Geuter G
Gesundheitswesen · 2026 Jun · PMID 41628651 · Publisher ↗
BACKGROUND: Current developments in Germany are leading to concentration processes of primary care services, which can result in longer distances or travel times, especially in rural areas. So far, there are only recomme...
BACKGROUND: Current developments in Germany are leading to concentration processes of primary care services, which can result in longer distances or travel times, especially in rural areas. So far, there are only recommendations regarding the reasonableness of the effort to reach them. Nevertheless, there are increasing calls for efforts, for example, for people with limited mobility and chronic illnesses, to reduce potential access barriers. One discussion thread in recent years has been the further development of proactive and outreach primary care services. This includes discussions about mobile GP practices as well as specific transportation offers for patients to complement public transport and individual travel. However, the needs and significance of such offerings in the German healthcare system have hardly been investigated so far. The aim of this paper was to provide an overview of existing types of offerings, discuss them and highlight their potential for the German healthcare system. METHODS: In addition to searching data banks to identify scientific publications, an internet search was conducted. Both national and international results were taken into consideration. RESULTS: The identified approaches from the 21 included publications were clustered according to their types of offerings. The four clusters "Independent mobile doctor's practice", "Mobile branch practice", "Specific transportation offers for patients as a complement to local transport" and "Brokerage services for patient transportation" were identified. A closely coordinated approach of relevant actors with a participatory approach to consider different perspectives was proved to be beneficial in conception and implementation. In addition to legal hurdles, non-cost-covering economic aspects, often associated with the rather low use of the offers, proved to be inhibiting. CONCLUSION: Mobile doctor's offices and offers to supplement existing mobility options for patients can potentially reduce access barriers to local primary care, especially if they are part of an overall concept for multidisciplinary primary care and take into account the respective needs. To concretize the potential, scientific evaluation of pilot projects is recommended. Regional needs and requirements should be consistently taken into account.
[When non-kin caregivers provide home care: additional burden or personal benefit for friends, neighbours, and acquaintances? - Findings from an exploratory cross-sectional study].
Lauer N, Heckel M, Bösl S … +4 more , Schmidt J, Kratzer A, Gräßel E, Pendergrass A
Gesundheitswesen · 2026 Jun · PMID 41628636 · Full text
BACKGROUND: Although the proportion of non-kin caregivers providing home care for friends, neighbours, and acquaintances is steadily increasing, there is a lack of research that goes beyond the general characteristics of...
BACKGROUND: Although the proportion of non-kin caregivers providing home care for friends, neighbours, and acquaintances is steadily increasing, there is a lack of research that goes beyond the general characteristics of this subgroup. The aim of this exploratory study is to provide the first in-depth examination of the non-kin caregiver population and highlight differences between non-kin and family caregivers in terms of the burden and perceived benefits of informal care. METHODS: The data are based on a representative sample (n=2927) of non-kin and family caregivers of statutorily insured care recipients, surveyed in a cross-sectional study in cooperation with MD Bayern. The general characteristics, burden, and perceived benefits of non-kin caregivers (n=71) were examined. The main focus was on comparative analyses with family caregivers (n=2856) using χ²-tests and independent samples t-tests, or corresponding non-parametric tests. RESULTS: Non-kin and family caregivers did not differ in terms of general characteristics. Despite having the same objective burden (t(74.45)=1.80, p=0.077), non-kin caregivers perceived the caregiving situation as significantly less burdensome (t(72.56)=2.57, p=0.012), experienced significantly more benefits from informal care (t(2925)=-3.37, p<0.001), and rated their mental health significantly more positively (t(72.84)=-2.52, p=0.014). CONCLUSION: Non-kin caregivers are less likely to experience high levels of subjective burden and often derive greater personal benefit from the support, care, or assistance of someone from their neighborhood, social circle, or acquaintances. As such, they represent a valuable resource that could help strengthen informal care in the future.
[Motivations, Challenges And Values Of Developers In Diga And Health App Start-Ups: A Qualitative Interview Study In Germany].
Jansky B, Wild V
Gesundheitswesen · 2026 Jan · PMID 41554279 · Publisher ↗
In Germany, a wide range of health apps is now available, supported by the Digital Healthcare Act (DVG), which has been in effect since 2020. These digital applications raise hopes for more equitable access to healthcare...
In Germany, a wide range of health apps is now available, supported by the Digital Healthcare Act (DVG), which has been in effect since 2020. These digital applications raise hopes for more equitable access to healthcare, particularly for people in rural areas. While previous studies have primarily focused on users and healthcare professionals, there is little empirical research on the perspectives of stakeholders involved in app development. This paper is based on a qualitative interview study with 16 actors from the field of health app and DiGA development. The data were analysed using reflexive thematic analysis. Three main, partially overlapping motivations for engaging in this field were identified: personal experiences as a patient, a professional background in healthcare, or economic interest. Regardless of their motivation, the interviewees agreed that health is a special good that carries certain moral obligations. At the same time, they cited legal ambiguity and bureaucratic obstacles as main challenges. The findings show that digital health innovations operate within a tension between economic growth and the social mandate of healthcare. We argue that understanding the motivations, challenges experienced, and values guiding stakeholders in health app development is particularly relevant, as their actions and values shape the technologies that are increasingly becoming part of the healthcare system.
[Interdisciplinarity and co-creative paradigms of applied social medicine].
Gaertner T, Sammer C, von Hardenberg S … +5 more , Behrens J, Herold-Majumdar A, Darchinger B, Zorn I, Schunda P
Gesundheitswesen · 2026 Jan · PMID 41554278 · Publisher ↗
Social medicine, as practiced in the Federal Republic of Germany, is based on an interdisciplinary foundation. Within the multifaceted range of tasks assigned to it by the social insurance system, it implements both part...
Social medicine, as practiced in the Federal Republic of Germany, is based on an interdisciplinary foundation. Within the multifaceted range of tasks assigned to it by the social insurance system, it implements both participatory and transformative processes through multiprofessional cooperation and co-creation. A symposium organized by the DGSMP's "Practical Social Medicine and Rehabilitation" department with significant participation of its Working Group on Nursing at the 60th annual conference of the German Society for Social Medicine and Rehabilitation (DGSMP) on September 19, 2025, at the Charité hospital, was dedicated to the theoretical and practical complexity of social medicine. It was conceived as a catalyst for defining a contemporary profile for social medicine and for fostering constructive discourse in the future. Six individual presentations addressed key concepts constituting social medicine and social legislation for categorizing social medicine's multiprofessional practice. The interdisciplinary agenda included selected topics from epistemological, historical, legal, health science, nursing science, and medical perspectives.
About
- Frequency
- Sun
- Papers found
- 200
- RSS feed
- Subscribe