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Wildner M
Gesundheitswesen · 2025 Dec · PMID 41338236 · Publisher ↗
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[Evidence on Advance Care Planning for People with Dementia - A Systematic Review (2017-2023)].
Rühl J, Baumgartner A, Kolominsky-Rabas P
Gesundheitswesen · 2026 Jan · PMID 41309090 · Full text
Early involvement in care planning is essential for people with dementia. The concept of advance care planning (ACP) offers a promising opportunity to consider their individual wishes for care and treatment at the end of...
Early involvement in care planning is essential for people with dementia. The concept of advance care planning (ACP) offers a promising opportunity to consider their individual wishes for care and treatment at the end of life. Aim The aim of this review was to provide an overview of the current evidence on advance care planning for people with dementia.We conducted a systematic literature search in the databases Medline, PsycINFO, Scopus, CINAHL, and CENTRAL for articles published between January 2017 and April 2023. The study quality of the included studies was assessed using the Critical Appraisal Skills Programme (CASP).Seven studies were included in the qualitative analysis. The studies demonstrated positive effects of Advance Care Planning on various domains for individuals with dementia and their caregivers. However, the included RCTs exhibited significant heterogeneity in terms of methodology, quality, and measured outcomes.Videos and training can be effective tools for successfully implementing ACP for individuals with dementia and their caregivers. However, studies with stringent intervention criteria and standardized outcomes are needed to conclusively assess the effectiveness of Advance Care Planning.
[Treatment Gap 65+State of Mental Health Care among Elderly Patients in the Mainfranken Region (Germany)].
Majewski J, Gilles-Schulden M, Lang AS … +1 more , Vogel H
Gesundheitswesen · 2026 Jun · PMID 41309089 · Publisher ↗
OBJECTIVE: The present study aimed to gain insight into the psychotherapeutic care situation for people over the age of 65 in the cities and districts of Bad Kissingen, Haßberge, Rhön-Grabfeld, and Schweinfurt, Germany....
OBJECTIVE: The present study aimed to gain insight into the psychotherapeutic care situation for people over the age of 65 in the cities and districts of Bad Kissingen, Haßberge, Rhön-Grabfeld, and Schweinfurt, Germany. Additionally, it examined indicators and potential reasons for gaps in care and identified possible approaches to improving psychotherapeutic services for older adults. METHODOLOGY: For this purpose, surveys were conducted with n=31 licensed psychotherapists and employees of social psychiatric services, as well as n=12 general practitioners from the studied regions. Data were collected through questionnaires featuring open, semi-open, and closed questions, supplemented by additional interviews. RESULTS: The psychotherapeutic care for older adults in the region was largely assessed as inadequate. Furthermore, older adults were underrepresented in outpatient psychotherapy. Key barriers to accessing psychotherapy included lack of knowledge about mental illnesses and their treatment, as well as fears of stigmatization among older patients. General practitioners primarily faced time constraints and insufficient networking, while psychotherapists cited the lack of therapy slots and limited experience and knowledge in treating older patients as the greatest challenges. CONCLUSION: The study confirms the suspected discrepancy between the need for psychotherapy and its actual utilization among people over 65 in the Mainfranken region. The group of very old individuals over 85 seems to be particularly affected by this undersupply. To improve the care situation, both structural measures-such as expanding therapy capacities and creating low-threshold services-as well as information and networking initiatives should be implemented.
[Awareness, use and acceptance of digital health applications (DiGA) for mental health in the general adult population in Germany].
Christine Eicher S, Cohrdes C
Gesundheitswesen · 2026 May · PMID 41285397 · Publisher ↗
BACKGROUND: The Digital Healthcare Act introduced digital health applications (DiGA) as a supplement to standard care in Germany in 2019. These applications offer potentially scalable treatment options in the field of me...
BACKGROUND: The Digital Healthcare Act introduced digital health applications (DiGA) as a supplement to standard care in Germany in 2019. These applications offer potentially scalable treatment options in the field of mental health, which could be particularly important in times of crisis. There is therefore a considerable need for research to investigate how well DiGAs are known, how frequently they are used and how open people are to their potential use as an addition to traditional care. The aim of the present study was to investigate the awareness, use and acceptance of DiGAs in the general adult population living in Germany. METHODS: Data collected were part of the COVID-19 Snapshot Monitoring Study in Germany in June 2021. The representative sample comprised n=1011 participants (n=506 women (50%), n=505 men (50%), mean age: 44.8 years, standard deviation:15.7). Using logistic and multiple regression models, associations between sociodemographic variables and awareness and use of DiGA as well as willingness to use DiGA were analyzed. Furthermore, reasons for non-use and sources of information about DiGA were analyzed. RESULTS: The majority of participants were not familiar with DiGA, and only a few had already used a DiGA. In principle, however, many participants were open to using DiGA. Age was the only significant predictor of awareness and use: older people were more likely to know and use DiGA. The willingness to use and preference of DiGA in comparison to face-to-face psychotherapy was influenced by education, health awareness and self-rated mental health. Higher education and better mental health reduced the willingness to use DiGA, while higher health awareness increased it. CONCLUSION: Overall, this study paints a complex picture of the potential and challenges of establishing DiGA in existing care provision. The goal should be to consider, develop, and implement appropriate age- and target group-specific formats for informing and educating people about DiGA, contributing to the enhancement of health literacy in the search for suitable healthcare services.
[Prescription of Benzodiazepines and Z-Drugs for Sleep Disorders in General Practice: A Qualitative Study].
Binder A, Gerlach I, Hiller R … +2 more , Pelzl MA, Sippel D
Gesundheitswesen · 2026 May · PMID 41285396 · Publisher ↗
INTRODUCTION: Sleep disorders, particularly insomnia, are a common reason for consultation in general practice. Among the approved treatment options are benzodiazepines (BZ) and benzodiazepine receptor agonists (BZRA). H...
INTRODUCTION: Sleep disorders, particularly insomnia, are a common reason for consultation in general practice. Among the approved treatment options are benzodiazepines (BZ) and benzodiazepine receptor agonists (BZRA). However, these medications carry a risk of dependence. The extent to which the risk of medication dependence influences the treatment decisions of general practitioners (GPs) is unclear. This study aimed to explore the spectrum of awareness regarding dependency potential of these drugs and prescribing practices. METHODS: As part of an exploratory qualitative interview study, 17 general practitioners from the districts of Tübingen, Reutlingen, and Zollernalb were interviewed. Data analysis was conducted using qualitative content analysis according to Kuckartz. A subsequent cross-analysis focused on addiction medicine aspects. RESULTS: Seven relevant dimensions with an addiction medicine focus emerged: (1) assessment of substances, (2) patient education, (3) prescribing in the context of expectations from patients, relatives, and caregivers, (4) prescription type, (5) older patients, (6) younger patients, (7) duration of prescription, and (8) assumption of responsibility. It became evident that dimensions 1-6 should be considered influencing factors for the assumption of responsibility. CONCLUSION: Clear differences in the assumption of responsibility regarding the prescription of BZ/BZRA for sleep disorders in general practice were observed. The influencing factors identified could serve as starting points for promoting responsibility in prescribing. In this context, information and training on addiction medicine aspects could play a crucial role.
[Impact of increasing half positions in psychotherapy practices on the capacity of providing care].
Hansen D, Jacobi M
Gesundheitswesen · 2026 Mar · PMID 41265891 · Publisher ↗
The division of practice licenses into two half positions has increased significantly, particularly in psychotherapeutic care mandates. So far, there has been no systematic investigation into the impact of dividing these...
The division of practice licenses into two half positions has increased significantly, particularly in psychotherapeutic care mandates. So far, there has been no systematic investigation into the impact of dividing these statutory health insurance seats on care capacities.An anonymous survey was conducted among 132 psychotherapeutic practices in Berlin. The weekly number of patient treatment hours was recorded, categorized into consultation hours, acute therapy, and guideline-based psychotherapy. Practices holding full licenses were compared with those operating under half licenses.A total of 40 practices with full licenses and 92 practices with half licenses participated in the study. Practices operating with two half licenses provided an average of 43.0 (SD=10.4) treatment hours per week, compared to 27.2 (SD=8.8) hours per week in practices with a full license - representing a 57% increase. When broken down by service type, practices with two half licenses offered 104% more consultation hours, 91% more acute therapy hours, and 60% more hours of guideline-based psychotherapy per week than full-license practices.The convergence of individual interests of practice owners, the difficulty in obtaining a license for providing care, and the increasing demand for psychotherapeutic services is leading, through the growing division of care mandates, to additional psychotherapeutic capacities that contribute to ensuring the provision of psychotherapeutic care.
[Pharmacists' use of embryotox.de in routine healthcare].
Wahliß A, Müller A, Beck E … +6 more , Harms E, Breuning M, Holmberg C, Schaefer C, Onken M, Dathe K
Gesundheitswesen · 2025 Nov · PMID 41260353 · Publisher ↗
Embryotox.de offers evidence-based information on drug safety during pregnancy and lactation free of charge and independent from pharmaceutical industry. There are more than five million users per year. Utilization of em...
Embryotox.de offers evidence-based information on drug safety during pregnancy and lactation free of charge and independent from pharmaceutical industry. There are more than five million users per year. Utilization of embryotox.de in routine healthcare was investigated in a mixed-methods study funded by the G-BA Innovation Fund. The following sub-analysis focuses on the use by pharmacists.User feedback was obtained by two different online questionnaires (multiple choice options or ratings on a Likert Scale ranging from 0 "not at all" to 10 "completely"). Questionnaire 1 included questions on user characteristics, clinical circumstances, comprehensibility and consequences of use, while questionnaire 2 asked about typical situations of use and applications of retrieved information. For this analysis, all questionnaires answered by pharmacists were evaluated using descriptive statistics.A total of 550 pharmacists completed online questionnaire 1, 87.3% of whom (n=480/550) worked in community pharmacies. Medication for cough and cold symptoms (19.3%, n=106/550) and non-opioid analgesics (16.9%, n=93/550) were most frequently inquired. 57.1% (n=314/550) reported that their risk perception of a given drug had changed after reading the respective fact sheet. Pharmacists' mean rating of fact sheet comprehensibility was 9.25 (Likert scale from 0 to 10). 79 pharmacists completed online questionnaire 2. 93.7% (n=74/79) considered embryotox.de helpful for informing and, if necessary, reassuring worried patients. They also used embryotox.de to pass on selected information to patients (79.7%, n=63/79), to check prescription drugs before dispensing (57.0%, n=45/79) and to consult with prescribing doctors in cases of critical medications (58.2%, n=46/79).Community pharmacists obtain relevant information from embryotox.de on risk and safety of OTC and prescription drugs in pregnancy and lactation. Embryotox.de thus supports pharmacists in counselling pregnant and breastfeeding patients and ensuring safe and rational drug treatment.
Medical Training on Climate Change and Health: Evaluation of an Online Learning Format for Outpatient Care.
Stark S, Klanke M, Quitmann C … +9 more , Nieder J, Herrmann A, Lindenthal J, Shimada D, Wambach V, Alvarez F, Kaspar-Ott I, Hertig E, Hueber S
Gesundheitswesen · 2026 Feb · PMID 41253286 · Publisher ↗
Climate change increasingly affects public health and presents new challenges for outpatient care. Physicians require specific training opportunities to address these developments. As part of the project AdaptNet ("Adapt...
Climate change increasingly affects public health and presents new challenges for outpatient care. Physicians require specific training opportunities to address these developments. As part of the project AdaptNet ("Adapting primary and specialised outpatient care to the health impacts of climate change"), an online training course on climate change and health was developed to provide essential foundational knowledge on climate-related health risks and adaptation strategies for medical practice. The aim of this study was to evaluate the training in terms of comprehensibility, applicability, and its relevance to medical practice.The training was provided as an online learning format. The evaluation followed a mixed-methods approach involving 23 general practitioners and specialised physicians from the Northern Bavaria region (Germany). Data collection included a standardised online questionnaire as well as structured group discussions. The analysis was guided by the Consolidated Framework for Implementation Research, with data being evaluated using qualitative content analysis and quantitative descriptive methods.The quantitative analysis showed that the training was perceived as comprehensible, practically relevant, and well-structured. Participants considered the scope and duration of the training to be appropriate. The multimedia design was particularly positively highlighted. The qualitative results indicated increased awareness of climate-related health risks and a high perceived added value for medical practice. The training generated great interest among participants and was considered relevant for outpatient care. The flexible integration of the online format into daily work routines was seen as advantageous. Critical feedback referred to the lack of opportunities for interactive exchange and a desire for additional regional adaptation of the training content.Climate change and adaptation are recognised as relevant topics in medical practice and can be effectively and practically communicated in the outpatient sector through the online training developed specially for this purpose. Regional customisation of the training content appears sensible in order to address climate and health challenges more specifically. Online formats may prove to be suitable tools for effective knowledge transfer.
[Subjective Care Needs after Tracheostomy: A Qualitative Study with Patients and Proxy-Interviewed Relatives].
Brehmer N, Klähn AK, Püschner F … +5 more , Gartner LM, Oberste M, Buhl I, Rudack C, Beule AG
Gesundheitswesen · 2026 May · PMID 41213611 · Publisher ↗
INTRODUCTION: Diseases that impair breathing through the mouth and nose often necessitate the creation of a tracheostoma. This procedure is linked to complex care requirements. The present study investigates deficits in...
INTRODUCTION: Diseases that impair breathing through the mouth and nose often necessitate the creation of a tracheostoma. This procedure is linked to complex care requirements. The present study investigates deficits in care as perceived subjectively by patients with a tracheostoma. METHODS: A qualitative study design was employed, utilizing semi-structured interviews. Participants were recruited from a single center using theoretical and maximum variation sampling. For speech-limited and pediatric patients, their relatives were also interviewed. The interviews took place in the second quarter of 2024 and were recorded. The transcripts were then coded using thematic analysis, and the results were summarized into main themes. RESULTS: A total of 33 individuals participated in the study (24 patients, including 2 pediatric patients, and 9 relatives). The subjective care deficits identified can be categorized into several themes: impairments related to the tracheostoma, lack of information about the tracheostoma, the desire for autonomy in self-care, social participation, provision of medical supplies, and navigation within the healthcare system. CONCLUSION: The identified care deficits mainly pertained to the need for information, the challenge of finding tracheostoma-competent physicians and nurses, and issues related to social participation. In contrast, medical aspects of tracheostoma care were discussed less in the interviews compared to organizational and psychosocial challenges.
[Extremism in medical treatment: Results of an e-learning training course for prevention].
Rau T, Mayer S, Stickel M … +2 more , Fegert JM, Allroggen M
Gesundheitswesen · 2025 Nov · PMID 41183550 · Publisher ↗
Initial studies showed that healthcare professionals are confronted with patients with extremist attitudes and do not feel safe when dealing with these patients. With this in mind, an e-learning training programme on ext...
Initial studies showed that healthcare professionals are confronted with patients with extremist attitudes and do not feel safe when dealing with these patients. With this in mind, an e-learning training programme on extremism was designed for healthcare professionals. The paper deals with the results of the accompanying research on this training programme.The data comes from a pre- and post-survey to evaluate the e-learning training course entitled 'Extremist attitudes in medical and psychotherapeutic treatment', which was designed for physicians and psychological psychotherapists. The data analyses include questions on knowledge and skills.A total of 2,971 professionals took part in the pre- and post-survey. The findings showed a significant increase in learning among participants in the training programme in all eight areas of competence (confidentiality, areas of phenomena, legal principles, etc.). In addition, concerns and worries about dealing with potential threats were reduced and the participants felt more confident in dealing with potential patients from the extremist milieu after the training programme. However, there were still uncertainties, especially in dealing with dangerous situations.Training on the topic of extremism is effective in ensuring greater safety for medical professionals in dealing with these issues. Networking with experts in the field is recommended for certain issues.
[Evaluation of possible applications of text-generative artificial intelligence in statutory accident insurance using ChatGPT].
Kekeritz T, Hoffmann FR
Gesundheitswesen · 2025 Nov · PMID 41183549 · Publisher ↗
This study examined the extent to which generative artificial intelligence can be used for analyzing reports from the statutory accident insurance system. To this end, medical documents were evaluated using targeted prom...
This study examined the extent to which generative artificial intelligence can be used for analyzing reports from the statutory accident insurance system. To this end, medical documents were evaluated using targeted prompts with both ChatGPT and a specially customized CustomGPT model. The results showed that simple tasks, such as extracting basic personal data or identifying missing causal links, were performed with high accuracy and a low error rate. However, when it came to more complex legal issues or the interpretation of contextual information, the models demonstrated limited reliability. The use of a tailored CustomGPT model did not yield a significant improvement in response quality compared to the standard version. In its current stage of development, the technology is not suitable for practical use in evaluating reports from the statutory accident insurance system. Future research should investigate newer versions of ChatGPT as well as alternative AI systems. It is expected that generative AI will soon be reliably applicable to the use cases explored in this study.
Inpatient Endometriosis Care in Germany: Hospital Caseloads and their Spatial Distribution.
Brauer L, Ji L, Geraedts M
Gesundheitswesen · 2025 Nov · PMID 41183548 · Publisher ↗
Endometriosis is a chronic gynaecological disease with an estimated prevalence of 10-15%. The German guideline provides evidence-based recommendations for diagnosis and treatment, but care provided is inadequate care due...
Endometriosis is a chronic gynaecological disease with an estimated prevalence of 10-15%. The German guideline provides evidence-based recommendations for diagnosis and treatment, but care provided is inadequate care due to long diagnostic pathways. Recent German research focused on regional variations in outpatient care, however research on inpatient endometriosis care is still lacking.The aim of the study was to examine inpatient endometriosis care - hospital locations and their caseloads. Spatial coverage, caseload distribution patterns and possible clusters, including certified endometriosis centres (CEC) and non-certified hospitals nationwide were analysed.German hospital quality report data from 2021 was used as data source. The location, certification status and caseload, meaning coded ICD-10 N80 Endometriosis cases, were collected for all hospitals. Then, 20-, 40- and 60-minutes' drive radius of CEC and non-certified hospitals were determined. Global and Local Moran's I was calculated to assess spatial clusters in caseload.A CEC 60-minutes' drive radius covers 78.15% of the area in Germany. Including all hospital locations that coded endometriosis, a maximum driving time of 40-minutes provides almost nationwide coverage. High caseload clusters appeared in urban areas and low caseload clusters especially in eastern Germany.The results indicate spatial clusters in providers caseload and difficulties in access to CEC for patients depending on location. Further research with patient-level data is needed to investigate the spatial distribution of patients and precise travel time for inpatient care.
["Strong together": Preparedness in German ports from the perspective of the stakeholders involved in the context of infection events].
Frese M, Bäßler J, Boldt M … +5 more , Dirksen-Fischer M, Ehlers L, Gueye SN, Harth V, Heidrich J
Gesundheitswesen · 2026 Jan · PMID 41167598 · Publisher ↗
Ports are the first interface with the local population in the event of infections on board ships. In addition to the health authorities, other stakeholders are also involved in the management of disease outbreaks or are...
Ports are the first interface with the local population in the event of infections on board ships. In addition to the health authorities, other stakeholders are also involved in the management of disease outbreaks or are affected by them through their activities at the port. An effective approach to outbreak prevention and management that takes all stakeholders into account is therefore crucial. This qualitative sub-study of the 'GESA - Healthy Ports, Strong Together' project analyses the needs of the stakeholders involved.As part of the GESA study, qualitative interviews were conducted with port medical services, port authorities, fire services, terminal operators, pilots and other relevant stakeholders in order to record structures and processes in five major German ports. Among other things, optimisation opportunities and fields of action were identified. The interviews were analyzed using a qualitative content analysis according to Mayring.A total of 34 interviews were conducted, covering 13 different stakeholders. The needs were primarily expressed in the areas of emergency planning, interdisciplinary exchange, digitalisation, interfaces and information requirements in operations as well as training and further education.The GESA project makes an important contribution to disease prevention and management at ports, as the needs identified are directly incorporated into the development of an idealised process for infection management in German ports. The results will also be taken into account in the development of a training concept for the public health service.
[Challenges for Patients and Staff in Mother-/Father-Child Prevention and Rehabilitation Clinics during the COVID-19 Pandemic from the Perspective of Senior Clinic Representatives].
Habermann J, Kirsch C, Noeres D … +2 more , Hauser D, Förster M
Gesundheitswesen · 2026 Mar · PMID 41145119 · Publisher ↗
The COVID-19 pandemic and its containment significantly affected the provision of inpatient care for mother/father-child, and implementation of rehabilitation and preventive measures. Under these conditions, the question...
The COVID-19 pandemic and its containment significantly affected the provision of inpatient care for mother/father-child, and implementation of rehabilitation and preventive measures. Under these conditions, the question of the challenges faced by patients and staff in inpatient mother/father-child prevention care and rehabilitation clinics during the pandemic from the perspective of senior clinic representatives was explored. The aim was to describe the daily routine under pandemic conditions and to derive possible recommendations for future exceptional situations.(Senior) staff, clinic management and representatives as well as individual representatives of clinic associations of the Family Health Research Association, had telephone conferences for mutual consultation over a period of three years. The resulting protocols were analysed using qualitative content analysis according to Kuckartz.The results, based on the views of the senior clinic representatives, show that, on the patient side, the measures were threatened by cancellations or disruptions and marked by changing arrival modalities, interventions to prevent infections and changes in the therapeutic offer. For staff, there were periods when it was not possible to carry out their work. Their work was characterised by staff absences and modified procedures. Clinic representatives described the mood in both groups as being affected by these circumstances. The challenges faced by the various people affected were mutually dependent.Ongoing challenges for staff and the cancellation or disruption of a mother/father-child measure for patients meant an increased health burden for those affected. Actions were taken specifically for mother/father-child clinics, such as adjusted arrival procedures or personal contact with patients in advance. For future exceptional situations, steps such as strict adherence to interventions to prevent infections and the creation of a waiting list for short-term cancellations should be derived. Due to the dedicated efforts of the staff, patients were still able to benefit from the measures with a wide range of treatments available.
[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 41145118 · Full text
Patients, as central actors in healthcare, should be enabled to actively participate in health services research processes. In addition, other stakeholders, such as professionals from healthcare practice, are also essent...
Patients, as central actors in healthcare, should be enabled to actively participate in health services research processes. In addition, other stakeholders, such as professionals from healthcare practice, are also essential for a comprehensive participatory approach. This DNVF memorandum focuses on participatory approaches in the context of health services research. It begins by outlining the key characteristics of participatory health services research and describing its current development and institutionalization in Germany. The DNVF memorandum also highlights the potential and benefits of participatory research. Finally, it addresses two cross-cutting topics that are particularly relevant for further development in this field: the theoretical and conceptual foundations, and the investigation of effects and effectiveness of participatory approaches.
[Relevance of eHealth Literacy (eHL) for Health Services Research and Practice - Part I].
Sinha M, Fischer F, Giehl C … +17 more , Harst L, Härter M, Häupl T, Jerke K, Kernebeck S, Merkel S, Mewes JS, Neugebauer E, Otte I, Redaèlli M, Richter JG, Scheibe M, Strotbaum V, Timpel P, Welzel F, Busse TS, Vollmar HC
Gesundheitswesen · 2026 Feb · PMID 41022114 · Full text
As digitization progresses, citizens, patients and providers increasingly encounter digital or hybrid prevention or care services and digitally supported health information. Under these circumstances, electronic health l...
As digitization progresses, citizens, patients and providers increasingly encounter digital or hybrid prevention or care services and digitally supported health information. Under these circumstances, electronic health literacy (eHL) as an extension of health literacy (HL) is a crucial skill that entails searching, finding, understanding, evaluating and applying health information based on digital sources when encountering challenges to health. There are currently multiple definitions that do not take into account newer digital applications in particular. The aim of part I of this article by the members of the Digital Health working group of the German Network for Health Services Research (DNVF) is to derive a working definition of eHL which is founded on known definitions of (e-)health literacy and on dimensions of relevant framework models and theories. Particular attention is paid to the delimitation and similarities between HL and eHL. Also, this article looks at the operationalization of eHL in the context of internationally proven approaches. Here, eHL is viewed as a relational construct that can be approached via multidimensional operationalization at the individual, interaction-related and system levels.
[Relevance of eHealth Literacy (eHL) for health services research and practice - Part II].
Sinha M, Fischer F, Giehl C … +17 more , Harst L, Härter M, Häupl T, Jerke K, Kernebeck S, Merkel S, Mewes JS, Neugebauer E, Otte I, Redaèlli M, Richter JG, Scheibe M, Strotbaum V, Timpel P, Vollmar HC, Welzel F, Busse TS
Gesundheitswesen · 2026 Feb · PMID 41022113 · Full text
Not all individuals or population groups can participate equally in digital transformation due to varying levels of (e)HL and their socioeconomic conditions. This disparity is known as the "digital divide." A lower socio...
Not all individuals or population groups can participate equally in digital transformation due to varying levels of (e)HL and their socioeconomic conditions. This disparity is known as the "digital divide." A lower socioeconomic status and older age appear to be associated with lower eHL. In the interest of reducing health inequalities, targeted efforts to promote dGK among disadvantaged groups should be pursued. This paper by the members of the working group Digital Health of the German Network for Health Services Research (Deutsches Netzwerk Versorgungsforschung e.V. (DNVF)) therefore addresses the importance of eHealth Literacy (eHL) for health services research and practice in Germany, with an emphasis on measures to enhance eHL. Building on a theory-based definition of eHL established in the first publication (Relevance of eHealth Literacy (eHL) for health services research and practice - Part I), the current state of eHL in Germany and the effects of low eHL are examined. Guided by the Delphi study conducted by the DNVF working group Digital Health and the guidelines of the German Advisory Council on Health and Care (Sachverständigenrat zur Begutachtung der Entwicklung im Gesundheitswesen und in der Pflege (SVR)), the digital divide is addressed and analyzed. Specific proposals for enhancing eHL are presented, with a focus on theory-driven interventions co-developed with users. Evaluation and implementation aspects of such interventions are also considered.
[Impact of the hospital structural reform and socio-economic deprivation in North Rhine-Westphalia (NRW) on the accessibility of specialized inpatient palliative care].
von Sass C, Wedding U, Bergmann J … +5 more , Fink L, Adelstein J, van Oorschot B, Muehlensiepen F, Kamp MA
Gesundheitswesen · 2026 Apr · PMID 40997822 · Publisher ↗
Palliative care aims to improve the quality of life for patients with potentially life-threatening illnesses and their families by early identification and treatment of physical, psychosocial, and spiritual suffering and...
Palliative care aims to improve the quality of life for patients with potentially life-threatening illnesses and their families by early identification and treatment of physical, psychosocial, and spiritual suffering and symptoms. The aim of this study was to examine the impact of the hospital structural reform in North Rhine-Westphalia (NRW, 01.04.2025) on the accessibility of facilities offering specialized inpatient palliative care.Hospitals providing specialized inpatient palliative care were identified through the Palliative Care Registry and the §136b data submitted to the Joint Federal Committee (G-BA). The average weighted travel times to these facilities were calculated and compared with the future locations proposed under the NRW hospital structural reform in service group 29, "Palliative Care." Accessibility was correlated with socio-economic deprivation (German Index of Socioeconomic Deprivation, GISD) at the municipal level.A total of 162 hospitals in NRW offering specialized palliative care were identified. In 2022, the average weighted travel time to these hospitals was 11.4 minutes, with 53% of the population able to reach a hospital within 10 minutes and 97% within 30 minutes. No significant correlation was found between the accessibility of specialized inpatient palliative care facilities and socio-economic deprivation. Under the planned hospital structural reform, the average travel time is expected to increase to 12.2 minutes; 48% of the population will be able to reach a palliative care facility within just under 10 minutes, and 96% within 30 minutes.The results suggest that the planned reform will have only a marginal impact on the accessibility of specialized palliative care in NRW. Although average travel times are expected to increase slightly, access will still remain feasible for the majority of the population within a short timeframe.
[Insured-Specific Outpatient Claims Data in Private Health Insurance - Part 2: Data Origin and Data Flow].
Stallmann C, Achstetter K, Goldhahn L … +7 more , Hengel P, Kortmann M, Köppen J, Ramm P, Schaarschmidt J, Gothe H, Jacke C
Gesundheitswesen · 2025 Nov · PMID 40997821 · Publisher ↗
Scientific research with claims data provided by private health insurance companies (PHI companies) requires a basic understanding of the regulatory processes of the utilisation of health-related services by persons with...
Scientific research with claims data provided by private health insurance companies (PHI companies) requires a basic understanding of the regulatory processes of the utilisation of health-related services by persons with private health insurance, the submission of invoices for healthcare services rendered/prescriptions redeemed to a PHI company, their billing and storage of data. Previous research projects have shown that, with knowledge of the special features of data from PHI companies, these can be used in projects involving claims data in a similar way to data from statutory health insurers. This second part of the series of articles on the scientific utilisation of private health insurance claims data focuses on the creation and flow of insured person and associated billing data in the private health insurance system for the sector of outpatient medical care, including medication. Using an exemplary data flow model for the sectors mentioned, processes and special features in the private health insurance system are systematically illustrated. Taking into account the process-related particularities of data generation and the associated content-related consequences, this article is intended to provide a basic understanding of these data. The information gathered can help decision-makers when planning a study with PHI data. The description of the data flow should support data analysts to consider the administrative and data content challenges in data preparation and evaluation. It is also essential for data analysts to be familiar with the data flow as well as with certain administrative and data content-related challenges. The evaluation of data availability and quality is necessary on an individual basis for each PHI company due to the divergent IT infrastructures and insurance rates. Future research projects with health-related claims data from individual or several PHI companies will expand expertise and empirical knowledge. The use of linkage methods is of particular importance here. The additional use of primary or survey data from privately insured persons will allow the realisation of validation studies that are designed, for instance, to examine the plausibility of recorded diagnoses. The increasing digitalisation of the healthcare system, for example through electronic invoicing and electronic prescriptions, can contribute to improving data content and availability in the future.
[The municipal teaching and research health department - an inter-municipal position paper by experts the public health service].
Yilmaz M, Gleich S, Ehehalt S … +4 more , Lampl BM, Graf M, Savaskan N, Tinnemann P
Gesundheitswesen · 2026 Apr · PMID 40972639 · Publisher ↗
The corona pandemic has exposed numerous existing weaknesses in the Public Health Service (PHS). This clearly pointed out that the PHS requires modernization. In the future scientific methods will become even more crucia...
The corona pandemic has exposed numerous existing weaknesses in the Public Health Service (PHS). This clearly pointed out that the PHS requires modernization. In the future scientific methods will become even more crucial within the PHS. The aim of this article, among other things, is to formulate a clear definition, of a municipal teaching and research health department (TRHD). We also desire to precisely define the scope of the tasks and the necessary requirements for the establishment and further development of a TRHD.On December 11, 2024, the Hanover Region hosted an inter-municipal conference including participants who also attended the conference remotely. Within the focus groups questions regarding our goals were adressed. Based on these results, an article was formulated and circulated among the participants. The authors agreed upon and accepted the final version of this paper on February 20, 2025.A municipal TRHD is defined as a health department that represents an innovative interface between practical efforts on the one hand and university-level teaching and research on the other hand. That means, its task is to combine the two. For example, it offers internships and electives during the last year of medical school. The qualification and further development of employees is another central concern. TRHD municipalities work together to ensure and control their own quality. The ideal prerequisite for a TRHD is contractual cooperation with an university medical faculty and various other faculties. Valuable here would be the establishment of "bridging professorships" and connecting the TRHD with the university as an affiliated institute. Ultimately, a TRHD requires a solid structural foundation in order to establish itself in the scientific field. This also includes connecting with a regionally important health department or a network of health departments.The development of a TRHD strengthens every local health department by developing local solutions and addressing the diversity of regional challenges. This will also increase diversity in the applied scientific approach. With a regionaly-oriented implementation the future of a TRHD will gain innovative strength and significantly greater self-sufficiency in scientific research. This will also prove to be indispensable for the wellbeing of our population in the future.
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