Gesundheitswesen
· 2026 Jun · PMID 42379230
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Social prescribing is an intervention approach developed in the United Kingdom that aims to bridge the gap between primary care and psychosocial and cultural services outside the healthcare system that can play an import...Social prescribing is an intervention approach developed in the United Kingdom that aims to bridge the gap between primary care and psychosocial and cultural services outside the healthcare system that can play an important role in maintaining and improving individual health 1 2. It is based on a bio-psycho-social understanding of health and the recognition that patients' social and emotional needs and resources, as well as social determinants of health (esp. housing, work, income), have an important influence on their health, but that these factors are often insufficiently addressed in healthcare. Social prescribing essentially comprises three components: the assessment of social needs of the patient as part of medical care, a "social prescription" as a formal referral to so-called link-workers, and counseling of patients by these link-workers, who determine the specific needs in more detail and provide more tailored care. Social prescribing is now being implemented in Austria, Scandinavia, the Netherlands, the USA, Canada, Japan, and Australia 3. The concept is also attracting considerable interest in Germany 4 5 6.
Gesundheitswesen
· 2026 Jun · PMID 42379229
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INTRODUCTION: The public health service (ÖGD) has had little presence in human medicine studies in Germany to date. As a result, students lack knowledge about its practical tasks, meaning that the ÖGD is rarely considere...INTRODUCTION: The public health service (ÖGD) has had little presence in human medicine studies in Germany to date. As a result, students lack knowledge about its practical tasks, meaning that the ÖGD is rarely considered when choosing a career. This situation contributes significantly to the shortage of young doctors in public health departments. Elective placements during the practical year are intended to attract students to the ÖGD; however, evaluations indicate that the offered places are not being filled, despite the positive assessment. Project description To promote interest in the ÖGD at an early stage and in a low-threshold manner, an extracurricular course was developed at Justus-Liebig-Universität Gießen as a supplementary elective in the interdisciplinary area of Health Economics, Health System, and Public Health. In the summer semester of 2025, a 90-minute bathing water inspection was held for the first time in cooperation with the Giessen Health Authority. The aim was to provide students with practical insights into the work of the ÖGD in the fields of water and environmental hygiene, while also establishing personal contact with the authorities' employees. RESULTS: Feedback from participants showed that the event was found to be enriching both professionally and in terms of career orientation. In contrast to clinical placements or PJ elective terms, the format allowed for very low-threshold access without requiring students to choose between other subject areas. CONCLUSION: Extracurricular elective courses such as bathing water inspections can serve as a complementary strategy to raise students' awareness of the ÖGD at an early stage and thus contribute to the long-term recruitment of young talent to public health service.
Fichter N, Wollenberg B, Scheufler F
… +1 more, Geraedts M
Gesundheitswesen
· 2026 Jun · PMID 42379228
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The occurrence of attention deficit hyperactivity disorder (ADHD) and ADHD-typical symptomatology in children is unevenly distributed depending on sociodemographic and regional factors. The aim of this study was to analy...The occurrence of attention deficit hyperactivity disorder (ADHD) and ADHD-typical symptomatology in children is unevenly distributed depending on sociodemographic and regional factors. The aim of this study was to analyze their distribution and their association with elevated hyperactivity. For this purpose, cross-sectional data were collected during the school entry examinations 2023/2024 using the Strengths and Difficulties Questionnaire (SDQ) in the Hessian districts of Marburg-Biedenkopf and Fulda (total n=2,832 children; total population of both districts: 465,088 [1]) and analyzed descriptively as well as using bivariate and multivariate methods with regard to sociodemographic and regional predictors of elevated hyperactivity. Overall, 7.2% of the children showed an elevated hyperactivity level; male sex, lower subjective socioeconomic status (SES), and urban residence were significantly associated with the occurrence of ADHD-typical symptomatology.
Gesundheitswesen
· 2026 Jun · PMID 42331011
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BACKGROUND: Despite laws for non-discriminatory medical care, people with disabilities often perceive their primary care as insufficient. They report barriers to access and uncertainties among medical staff. The aim of t...BACKGROUND: Despite laws for non-discriminatory medical care, people with disabilities often perceive their primary care as insufficient. They report barriers to access and uncertainties among medical staff. The aim of this study was to examine the primary care situation for people with disabilities in Munich. METHODS: In this cross-sectional study, between August and October 2024, people with disabilities in Munich were surveyed about their primary care experience using a questionnaire. No exclusion criteria were applied. The survey was conducted both online and in written form, using plain- and easy-to-read language. Data were analyzed using descriptive statistics, and bivariate analyses were conducted to examine associations. Logistic regression analysis was used to calculate predictors for the likelihood of having or having had difficulties in finding a general practitioner. RESULTS: A total of 306 people participated in the survey; 95% (n=291) reported having a GP, and over 80% were satisfied with medical (n=253) and practice staff (n=252). Nevertheless, 39% (n=111) reported difficulties in finding a GP, and 33% (n=91) had been refused by a practice at least once. Differences in care were observed regarding the utilization of appointments, the need to visit a GP due to disability, difficulties in finding a medical practice, freedom of choice of physician, and acceptance into a GP practice, depending on gender, living situation, and type of disability, as well as with regard to the need for home visits. In addition, multivariate analyses showed that people with disabilities had a significantly higher risk of experiencing difficulties in finding a GP if they had previously been refused by a practice, were restricted during medical visits, or needed home visits. CONCLUSION: The study shows that, from the perspective of people with disabilities, primary care was rated as satisfactory; however, access problems persist due to structural, communication and social barriers. The results can help provide stakeholders with practical arguments to improve the care situation.
Sponsel S, Pfaller L, Karrer L
… +3 more, Schöffski O, Beckmann MW, Mocker A
Gesundheitswesen
· 2026 Jun · PMID 42320585
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BACKGROUND: Since 2020, midwifery has been the first health profession in Germany to be fully transferred into academic education. However, it remains unclear whether midwifery students acquire the professional health li...BACKGROUND: Since 2020, midwifery has been the first health profession in Germany to be fully transferred into academic education. However, it remains unclear whether midwifery students acquire the professional health literacy required to meet the increasing challenges of the healthcare system, such as the substantial growth in available specialized knowledge and the evolving expectations of patients regarding care and participation in decision-making. Whether and how future midwives possess the necessary competencies to respond to these new challenges is reflected in their level of professional health literacy. The aim of this study is therefore to assess the current status of professional health literacy among students of midwifery science. METHODS: Data collection was conducted as part of the HELPER study. A total of 140 midwifery students from Bavaria were included. Professional health literacy was measured using the PROF-HL-Q instrument, which comprises 34 items covering four domains. Results are presented descriptively. Correlation analyses were performed to identify potential associations with sociodemographic characteristics and study-related parameters. RESULTS: On average, students rated their professional health literacy positively, achieving scores between 51.4 and 78.7 out of 100 across the four domains. Patient-centered communication was perceived as the easiest domain, whereas professional digital health literacy was rated the most challenging. In particular, students reported difficulties in interpreting statistical results, dealing with misinformed patients, and supporting patients in finding digital health information. Overall, only weak correlations were observed with the variables examined. CONCLUSION: The findings indicate specific areas in which midwifery students' competencies require further strengthening and thus provide implications for curriculum development, particularly in light of ongoing digitalization and the continued professionalization of midwifery.
Braun A, Grobe TG, Tsatsaronis C
… +11 more, Reschke P, Kinder K, Klemt M, Wende D, Schulte C, Focke K, Steiger E, Schulz M, Czihal T, Quentin W, Busse R
Gesundheitswesen
· 2026 Jun · PMID 42320584
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OBJECTIVE: Population-based classification systems are used in various countries to assess and present healthcare needs. The PopGroup project aimed to develop such a classification system for the German healthcare contex...OBJECTIVE: Population-based classification systems are used in various countries to assess and present healthcare needs. The PopGroup project aimed to develop such a classification system for the German healthcare context. Version 1.0 of the PopGrouper is now available and assigns each person to exactly one PopGroup (PG). This article builds on a previous publication on the grouping of diseases with assignments of severity levels and explains the next steps for the mutually exclusive grouping of all insured persons across several levels, thus completing the methodological description of the grouper. METHODOLOGY: For the development of version 1.0, training and test data from a total of 8.8 million insured persons of the BARMER health insurance fund for the year 2022 were used in a ratio of 4 to 1. After an initial content and clinically oriented grouping, further splits were carried out algorithmically using decision lists and regression trees. This resulted in a set of rules that can be used also for grouping of other populations. RESULTS: All individuals were assigned to exactly one of 10, 427, or 610 groups and finally into 776 PGs across 4 hierarchical levels. PGs explained 38.8% of the variance in insurance-related documented health care costs in test data. After applying the grouping rules to data from 2021 and 2023, the results were similar, with explained variance shares across all grouping levels tending to be higher in 2023 than in 2022. CONCLUSION: The PopGrouper 1.0 is the first population-based grouper adapted for statutory health insurance data in Germany that is comprehensively documented and free to use. The grouper has proven useful for data from the years 2021 to 2023, for which complete grouping rules already exist. The grouper should be updated for future years, while also examining to what extent simplifications of the grouper and its maintenance are possible without loss of quality.
Piontek D, Schoffer O, Datzmann T
… +10 more, Boehme H, Distler M, Fritzmann J, Hempel S, Oehme F, Radulova-Mauersberger O, Ubbelohde U, Bornhaeuser M, Weitz J, Schmitt J
Gesundheitswesen
· 2026 Jun · PMID 42285169
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INTRODUCTION: Colorectal and pancreatic cancers impose profound physical, psychological, and social challenges on patients, underscoring the need for comprehensive assessments of their impact on health-related quality of...INTRODUCTION: Colorectal and pancreatic cancers impose profound physical, psychological, and social challenges on patients, underscoring the need for comprehensive assessments of their impact on health-related quality of life (HRQoL). This study aimed to evaluate HRQoL levels in colorectal and pancreatic cancer patients, including the comparison to the general population and the assessment of sociodemographic as well as disease- and treatment-related predictors. METHODS: The analyses are based on data from a clinical registry of the NCT/UCC Dresden. Patients were recruited during consultation hours between August 2020 and December 2024. Baseline quality of life data and routine data from the tumor documentation system were used. The final analytical sample comprised n=417 patients in the colorectal study group and n=193 patients in the pancreatic study group. Multivariable linear regression analyses were calculated, with results presented as regression coefficients (b) and 95% confidence intervals (CI). RESULTS: Colorectal and pancreatic cancer patients exhibited significantly lower HRQoL compared to the general population, with large differences in social function and medium differences in role function and global health. Pancreatic cancer patients reported lower HRQoL across most domains compared to colorectal cancer patients. In the colorectal study group, statutory health insurance (b=-14.10, CI=-22.54; -5.66), living in rural counties with some urbanization (b=-5.34, CI=-10.51; -0.17) and recent chemotherapy (b=-9.10, CI=-16.36; -1.85) predicted worse global health. With regard to pancreatic cancers, residence in rural counties with some urbanization (b=-10.26, CI=-18.93; -1.59) was associated with worse global health, whereas longer time since diagnosis (b=0.06, CI=0.01; 0.12) was associated with better global health. CONCLUSIONS: Sociodemographic factors were the most consistent predictors of HRQoL in patients with pancreatic and colorectal cancer. These findings suggest social disparities, particularly for patients in rural areas and those with lower socioeconomic status. Efforts to improve access to healthcare, provide psychosocial support, and manage symptom burden are critical to enhancing the quality of life for these patients.
Gesundheitswesen
· 2026 Jun · PMID 42269699
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Discharge management and transitional care are key interfaces within the German healthcare system. Nevertheless, there remain significant gaps in the transition of patients from hospital to post-discharge care. In the pr...Discharge management and transitional care are key interfaces within the German healthcare system. Nevertheless, there remain significant gaps in the transition of patients from hospital to post-discharge care. In the project "ÜberPflege - Care-centred transitional care in hospital to reduce post-discharge bottlenecks following inpatient treatment within the framework of discharge management", eleven guideline-based interviews were conducted with representatives of post-discharge care facilities and analysed using Kuckartz's content analysis method. The results reveal clear shortcomings in the quality of information, communication and cross-sectoral coordination. Information relevant to nursing is frequently missing or transmitted late, and digital structures are scarcely established. Transition care is regarded as fundamentally beneficial, but is used only to a limited extent in practice. Successful transitions depend largely on nursing-led coordination and interface competence. The findings underscore the need to involve nursing staff more closely in discharge and handover processes.
Gesundheitswesen
· 2026 Jun · PMID 42259391
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BACKGROUND: Survival and motor functional outcomes after aneurysmal subarachnoid hemorrhage (aSAH) have improved substantially in recent years. At the same time, cognitive impairment and socio-medical consequences are ga...BACKGROUND: Survival and motor functional outcomes after aneurysmal subarachnoid hemorrhage (aSAH) have improved substantially in recent years. At the same time, cognitive impairment and socio-medical consequences are gaining increasing relevance. With evolving rehabilitation care structures, early neurological rehabilitation has assumed a more central role in initiating timely socio-medical decision-making. OBJECTIVE: To analyze the discrepancy between functional recovery and socio-medical participation capacity in patients after aSAH across the rehabilitation continuum, from early neurological rehabilitation to subsequent levels of care. METHODS: Retrospective longitudinal analysis of patients with aSAH treated in an early neurological rehabilitation setting in North Rhine-Westphalia, Germany. Data included functional measures (Barthel Index including the early rehabilitation component), provision of neuropsychological co-treatment, rehabilitation pathways, German long-term care grades (Pflegegrade), and socio-medical discharge recommendations. Analyses were descriptive and supplemented by a subgroup analysis of working-age patients (<65 years). RESULTS: Despite partially moderate to good motor recovery, a relevant proportion of patients showed persistent socio-medically significant limitations. Discharge with documented work incapacity, assignment of long-term care grades, and lack of neuropsychological follow-up occurred even among patients with favorable motor functional scores. Early neurological rehabilitation emerged as a key interface for socio-medical decision-making. CONCLUSION: Isolated consideration of functional scores is insufficient in a socio-medical context. A multidimensional assessment integrating cognitive status and rehabilitation-structural factors should be implemented early within early neurological rehabilitation, including Rehabilitation Phase B.
Giebel G, Höfer K, Raszke P
… +9 more, Wasem J, Bußmann A, Schlierenkamp S, Minor M, Volland C, Schneider U, Maaß E, Katzmann J, Abels C
Gesundheitswesen
· 2026 Jun · PMID 42235549
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INTRODUCTION: In Germany, Digital Health Applications (DiGA) can be prescribed for mental illnesses since 2020. Patients with statutory health insurance can access DiGA in two different ways. They can either be prescribe...INTRODUCTION: In Germany, Digital Health Applications (DiGA) can be prescribed for mental illnesses since 2020. Patients with statutory health insurance can access DiGA in two different ways. They can either be prescribed by a physician or psychotherapist or patients can request them directly from their health insurance company. The aim of the present study was to shed light on the different ways of access especially with regard to their actual implementation. METHODS: Semistructured interviews were conducted with experts to investigate the current care situation with DiGA in the context of mental illnesses. The experts were representatives of patients, physicians and psychotherapists, statutory health insurance companies and DiGA manufacturers. The interviews were conducted online, recorded and transcribed. A qualitative content analysis according to Kuckartz was performed with MAXQDA. RESULTS: A total of 13 expert interviews were conducted. Content analysis revealed three main topics: 1) relevance of direct authorization by the health insurance company, 2) implementation of direct authorization by the health insurance company, and 3) advantages and disadvantages of direct access. While direct access via the health insurance company played a minor role quantitatively, it has potential advantages such as a low threshold access or a greater patient autonomy. Disadvantages were seen in the transfer of therapeutic sovereignty from physicians and psychotherapists towards the health insurance companies. Problems were also seen in the lack of comprehensive therapy monitoring, inadequate diagnosis without or with inadequate consideration of contraindications, and additional effort on the part of health insurance companies. CONCLUSION: The direct application for statutory health insurance-funded services from health insurance companies marks a new approach in the German health care system. While there are good arguments for and against patient self-referral, the current implementation needs to be scrutinized. Because of the need for a current indication and the possible exclusion of contraindications, patients usually have to visit a doctor or psychotherapist anyway, which significantly limits the benefits. Under the current conditions, the way of prescription is usually associated with fewer problems.