Pub Date : 2025-02-01DOI: 10.1016/j.zefq.2024.11.011
Can Alpagut , Christian Volberg , Michael Hertl , Lisa Krönig , Martin Gschnell
Introduction
Diagnosis in dermatology is primarily based on the assessment and description of the clinical appearance of the skin. The German medical literature focuses almost exclusively on white skin, so it is questionable whether this one-sided training is sufficient to do justice to all patients since the diversity of skin types increases.
Methods
Online survey among German dermatologists regarding training and experience in the diagnosis of dark skin, difficulties in recognizing dermatoses and the desire for training and further education in skin diseases of “skin of color”.
Results
A total of 236 responses were received. 65 % of participants felt unsure to very unsure about recognizing skin conditions in people with dark skin. Training in the recognition of skin types IV–VI was rated as poor to very poor by 76 %, and 73 % rated the current literature on the diagnosis of dark skin as poor to very poor. 89 % reported that they have difficulties in diagnosing skin diseases in dark skin in their daily practice.
Conclusion
There is uncertainty among German dermatologists in the diagnosis of skin diseases in people with dark skin. This diagnostic uncertainty may lead to poorer treatment outcomes. More training opportunities should be offered to improve skills in the diagnosis and treatment of skin diseases in skin of color and the associated care.
{"title":"Dermatologische Diagnostik bei Patient*innen mit „skin of color“ – Wie sicher fühlen sich deutsche Dermatolog*innen?","authors":"Can Alpagut , Christian Volberg , Michael Hertl , Lisa Krönig , Martin Gschnell","doi":"10.1016/j.zefq.2024.11.011","DOIUrl":"10.1016/j.zefq.2024.11.011","url":null,"abstract":"<div><h3>Introduction</h3><div>Diagnosis in dermatology is primarily based on the assessment and description of the clinical appearance of the skin. The German medical literature focuses almost exclusively on white skin, so it is questionable whether this one-sided training is sufficient to do justice to all patients since the diversity of skin types increases.</div></div><div><h3>Methods</h3><div>Online survey among German dermatologists regarding training and experience in the diagnosis of dark skin, difficulties in recognizing dermatoses and the desire for training and further education in skin diseases of “skin of color”.</div></div><div><h3>Results</h3><div>A total of 236 responses were received. 65 % of participants felt unsure to very unsure about recognizing skin conditions in people with dark skin. Training in the recognition of skin types IV–VI was rated as poor to very poor by 76 %, and 73 % rated the current literature on the diagnosis of dark skin as poor to very poor. 89 % reported that they have difficulties in diagnosing skin diseases in dark skin in their daily practice.</div></div><div><h3>Conclusion</h3><div>There is uncertainty among German dermatologists in the diagnosis of skin diseases in people with dark skin. This diagnostic uncertainty may lead to poorer treatment outcomes. More training opportunities should be offered to improve skills in the diagnosis and treatment of skin diseases in skin of color and the associated care.</div></div>","PeriodicalId":46628,"journal":{"name":"Zeitschrift fur Evidenz Fortbildung und Qualitaet im Gesundheitswesen","volume":"192 ","pages":"Pages 28-35"},"PeriodicalIF":1.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142915910","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-01DOI: 10.1016/j.zefq.2024.10.008
Katrin Spohn , Daniela Aufermann , Philipp Gregor Albert , Narmin Dzhabbarova , Christin Frühling , Antonina Jakob , Timo Neunaber , Felix Hoffmann
Introduction
The main objective of the present study was to analyze the new job profile “Chief Digital Officer (CDO) in German hospitals”. Here, best practices for the introduction of the job profile should be determined and the need for a CDO position to execute the digital transformation should be evaluated.
Methods
A standardized three-stage online Delphi process (expert consensus finding) followed by a roundtable discussion was performed, including 16 experts.
Results
The survey showed that most CDOs have been employed as CDOs in a hospital for a maximum of two years. Just over half of these hospitals already have a digitization strategy. Lack of human resources, underfunding of projects, lack of willingness to change among operational staff and management as well as legal hurdles have been reported as the primary problems in digital transformation. In addition to project management skills, CDOs should also have change management expertise and the ability to abstract and simplify complex processes. They should have a high level of knowledge about everyday work and technical content of interdisciplinary health professions. A CDO can be considered as the fourth pillar of responsibility, in addition to the business, medical and nursing director at the management level, and should be responsible in this role for the implementation of digital transformation.
Discussion
This study was able to show which activities CDOs are involved in and which coping strategies they use to handle the hurdles.
{"title":"Delphi-Studie: Evaluation des neuen Berufsbildes „Chief Digital Officer” in deutschen Krankenhäusern","authors":"Katrin Spohn , Daniela Aufermann , Philipp Gregor Albert , Narmin Dzhabbarova , Christin Frühling , Antonina Jakob , Timo Neunaber , Felix Hoffmann","doi":"10.1016/j.zefq.2024.10.008","DOIUrl":"10.1016/j.zefq.2024.10.008","url":null,"abstract":"<div><h3>Introduction</h3><div>The main objective of the present study was to analyze the new job profile “Chief Digital Officer (CDO) in German hospitals”. Here, best practices for the introduction of the job profile should be determined and the need for a CDO position to execute the digital transformation should be evaluated.</div></div><div><h3>Methods</h3><div>A standardized three-stage online Delphi process (expert consensus finding) followed by a roundtable discussion was performed, including 16 experts.</div></div><div><h3>Results</h3><div>The survey showed that most CDOs have been employed as CDOs in a hospital for a maximum of two years. Just over half of these hospitals already have a digitization strategy. Lack of human resources, underfunding of projects, lack of willingness to change among operational staff and management as well as legal hurdles have been reported as the primary problems in digital transformation. In addition to project management skills, CDOs should also have change management expertise and the ability to abstract and simplify complex processes. They should have a high level of knowledge about everyday work and technical content of interdisciplinary health professions. A CDO can be considered as the fourth pillar of responsibility, in addition to the business, medical and nursing director at the management level, and should be responsible in this role for the implementation of digital transformation.</div></div><div><h3>Discussion</h3><div>This study was able to show which activities CDOs are involved in and which coping strategies they use to handle the hurdles.</div></div>","PeriodicalId":46628,"journal":{"name":"Zeitschrift fur Evidenz Fortbildung und Qualitaet im Gesundheitswesen","volume":"192 ","pages":"Pages 49-56"},"PeriodicalIF":1.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142910987","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-01DOI: 10.1016/j.zefq.2024.11.006
Mirhelen Mendes de Abreu , Melanie Noël Maia , Alexandre Oliveira Telles , Renata Oliveira Maciel dos Santos , Maria Katia Gomes , Ana Luisa Rocha Mallet , Lúcia Maria Soares de Azevedo
Clinical practice in Brazil has rapidly transformed. Doctor-patient relationships are the focus of these transformations, either within health policies or in the context of medical training. The Brazilian Curriculum Guidelines have emphasized the doctor-patient relationship as part of medical skills and competences, based on patient-centered care. In this article, we present the political advances in patient-centered care. In addition, we address an overview of the Brazilian status quo of decision support tools. Finally, we share experiences in curriculum reform for the advances of communication skills and the interfaces with narrative medicine and the arts in curricular medical training as a means to advance towards the practice of shared decision making.
{"title":"Advances in Shared Decision Making in Brazil: The role of patient autonomy in curriculum reform, health system and clinical care","authors":"Mirhelen Mendes de Abreu , Melanie Noël Maia , Alexandre Oliveira Telles , Renata Oliveira Maciel dos Santos , Maria Katia Gomes , Ana Luisa Rocha Mallet , Lúcia Maria Soares de Azevedo","doi":"10.1016/j.zefq.2024.11.006","DOIUrl":"10.1016/j.zefq.2024.11.006","url":null,"abstract":"<div><div>Clinical practice in Brazil has rapidly transformed. Doctor-patient relationships are the focus of these transformations, either within health policies or in the context of medical training. The Brazilian Curriculum Guidelines have emphasized the doctor-patient relationship as part of medical skills and competences, based on patient-centered care. In this article, we present the political advances in patient-centered care. In addition, we address an overview of the Brazilian <em>status quo</em> of decision support tools. Finally, we share experiences in curriculum reform for the advances of communication skills and the interfaces with narrative medicine and the arts in curricular medical training as a means to advance towards the practice of shared decision making.</div></div>","PeriodicalId":46628,"journal":{"name":"Zeitschrift fur Evidenz Fortbildung und Qualitaet im Gesundheitswesen","volume":"192 ","pages":"Pages 90-93"},"PeriodicalIF":1.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142819420","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Body temperature measurement is a fundamental requirement for clinical decisions in nursing care, medical diagnosis, and treatment. Therefore, it is pivotal that body temperature measurements are accurate and precise.
Aims
To test the diagnostic accuracy of an ear temperature screening procedure among adult hospitalized patients. Further aims were to test the precision of the measurements being carried out by trained registered nurses compared with daily routine practice and to investigate patients’ preferences for different measurement methods.
Methods
In Aalborg University Hospital, 274 patients were included in a cross-sectional comparative study. Each patient had four temperature measurements and responded to a survey regarding their preference for measurement. Bland–Altman analysis was used to evaluate the difference between ear- and rectal measurements. Sensitivity and specificity were evaluated at different cut-off points.
Results
The ear temperature was 0.1 to 0.2 °C lower than rectal temperature. At a cut-off point at 37.5 °C an ear thermometer is accurate and can be used for screening, while higher cut-off points risk missing patients with fever. There was no significant difference in the mean temperature measured by a trained registered nurse or other staff members and patients. Patients preferred ear measurements to rectal measurements.
Conclusion
The tested ear thermometer is accurate for screening fever in an adult population during hospital admission. Using ear measurement as a screening tool can contribute to a less resource-demanding care activity and a more convenient alternative to rectal measurements in hospitalised patients.
{"title":"Measurement of non-invasive rectal and ear temperature in inpatients ≥ 18 years old: A cross-sectional comparative study","authors":"Lone Jørgensen , Birgitte Boll , Kristina Fischer Rosenkilde , Niels Henrik Bruun , Preben Ulrich Pedersen , Marianne Wetendorff Nørgaard","doi":"10.1016/j.zefq.2024.11.005","DOIUrl":"10.1016/j.zefq.2024.11.005","url":null,"abstract":"<div><h3>Introduction</h3><div>Body temperature measurement is a fundamental requirement for clinical decisions in nursing care, medical diagnosis, and treatment. Therefore, it is pivotal that body temperature measurements are accurate and precise.</div></div><div><h3>Aims</h3><div>To test the diagnostic accuracy of an ear temperature screening procedure among adult hospitalized patients. Further aims were to test the precision of the measurements being carried out by trained registered nurses compared with daily routine practice and to investigate patients’ preferences for different measurement methods.</div></div><div><h3>Methods</h3><div>In Aalborg University Hospital, 274 patients were included in a cross-sectional comparative study. Each patient had four temperature measurements and responded to a survey regarding their preference for measurement. Bland–Altman analysis was used to evaluate the difference between ear- and rectal measurements. Sensitivity and specificity were evaluated at different cut-off points.</div></div><div><h3>Results</h3><div>The ear temperature was 0.1 to 0.2 °C lower than rectal temperature. At a cut-off point at 37.5 °C an ear thermometer is accurate and can be used for screening, while higher cut-off points risk missing patients with fever. There was no significant difference in the mean temperature measured by a trained registered nurse or other staff members and patients. Patients preferred ear measurements to rectal measurements.</div></div><div><h3>Conclusion</h3><div>The tested ear thermometer is accurate for screening fever in an adult population during hospital admission. Using ear measurement as a screening tool can contribute to a less resource-demanding care activity and a more convenient alternative to rectal measurements in hospitalised patients.</div></div>","PeriodicalId":46628,"journal":{"name":"Zeitschrift fur Evidenz Fortbildung und Qualitaet im Gesundheitswesen","volume":"192 ","pages":"Pages 36-41"},"PeriodicalIF":1.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142824691","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-01DOI: 10.1016/j.zefq.2024.11.012
Anne Kis, Christina Sorbe, Matthias Augustin, Marina Otten, Jobst Augustin
Background
Telemedicine applications are perceived as having great potential to address regional health service deficits. However, it is unclear to what extent telemedicine can actually contribute to ensuring care in medically underserved regions. The aim of this study is to prospectively identify underserved regions and to investigate the potential of telemedicine applications using teledermatology as an example.
Methods
Well-served regions were identified using selected indicators. Points were awarded for each indicator and added up to form two scores. The results were analyzed for spatial autocorrelation (Moran’s I), and visualized as a bivariate choropleth map. Data on broadband availability (BMVI) and descriptive statistics (Spearman’s Rho, Beeswarm plots) were used to analyze the potential for telemedicine applications. All analyses were carried out at county level.
Results
Out of 401 counties, 159 can be classified as vulnerable because of their supply situation. They are mainly located in the north-west part of Germany. Locally, there are infrastructure deficits, i. e. insufficient bandwidth for telemedicine applications. Spearman’s Rho shows negative correlations between broadband availability and the scores obtained (ρ: –0.654/–0.229, p < 0.001).
Conclusions
The results indicate a consolidation of regional disparities. If the identified regions are inhabited by patients with limited mobility and by socially disadvantaged patients, there is a risk of “double gaps in care”. In the context of an increasing demand and workload, barriers to telemedicine should be removed, especially in the identified areas, and alternative care models should be implemented.
背景：远程医疗应用被认为具有解决区域卫生服务不足的巨大潜力。然而，目前尚不清楚远程医疗在多大程度上能够真正有助于确保医疗服务不足地区的护理。本研究的目的是前瞻性地确定服务不足的地区，并以远程皮肤科为例调查远程医疗应用的潜力。方法：使用选定的指标确定服务良好的地区。每个指标都有分数，加起来就是两个分数。对结果进行空间自相关分析（Moran’s I），并将其可视化为双变量样面图。宽带可用性数据（BMVI）和描述性统计数据（Spearman’s Rho， Beeswarm图）用于分析远程医疗应用的潜力。所有分析均在县一级进行。结果：在401个县中，159个县因其供应状况可被列为易危县。它们主要位于德国的西北部。在当地，存在基础设施不足，即远程医疗应用的带宽不足。Spearman's Rho显示宽带可用性与获得的分数之间呈负相关（ρ: -0.654/-0.229, p < 0.001）。结论：研究结果表明，区域差异正在巩固。如果确定的地区居住着行动不便的患者和社会处境不利的患者，则存在“护理方面的双重差距”的风险。在需求和工作量不断增加的背景下，应消除远程医疗的障碍，特别是在已确定的领域，并应实施替代护理模式。
{"title":"Potenzial telemedizinischer Anwendungen zur Verbesserung einer flächendeckenden Gesundheitsversorgung am Beispiel der Teledermatologie","authors":"Anne Kis, Christina Sorbe, Matthias Augustin, Marina Otten, Jobst Augustin","doi":"10.1016/j.zefq.2024.11.012","DOIUrl":"10.1016/j.zefq.2024.11.012","url":null,"abstract":"<div><h3>Background</h3><div>Telemedicine applications are perceived as having great potential to address regional health service deficits. However, it is unclear to what extent telemedicine can actually contribute to ensuring care in medically underserved regions. The aim of this study is to prospectively identify underserved regions and to investigate the potential of telemedicine applications using teledermatology as an example.</div></div><div><h3>Methods</h3><div>Well-served regions were identified using selected indicators. Points were awarded for each indicator and added up to form two scores. The results were analyzed for spatial autocorrelation (Moran’s I), and visualized as a bivariate choropleth map. Data on broadband availability (BMVI) and descriptive statistics (Spearman’s Rho, Beeswarm plots) were used to analyze the potential for telemedicine applications. All analyses were carried out at county level.</div></div><div><h3>Results</h3><div>Out of 401 counties, 159 can be classified as vulnerable because of their supply situation. They are mainly located in the north-west part of Germany. Locally, there are infrastructure deficits, i. e. insufficient bandwidth for telemedicine applications. Spearman’s Rho shows negative correlations between broadband availability and the scores obtained (ρ: –0.654/–0.229, p < 0.001).</div></div><div><h3>Conclusions</h3><div>The results indicate a consolidation of regional disparities. If the identified regions are inhabited by patients with limited mobility and by socially disadvantaged patients, there is a risk of “double gaps in care”. In the context of an increasing demand and workload, barriers to telemedicine should be removed, especially in the identified areas, and alternative care models should be implemented.</div></div>","PeriodicalId":46628,"journal":{"name":"Zeitschrift fur Evidenz Fortbildung und Qualitaet im Gesundheitswesen","volume":"192 ","pages":"Pages 11-18"},"PeriodicalIF":1.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142915883","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-01DOI: 10.1016/S1865-9217(25)00040-6
{"title":"Liste der Affiliierten Institute und Fachgesellschaften / List of Affiliations","authors":"","doi":"10.1016/S1865-9217(25)00040-6","DOIUrl":"10.1016/S1865-9217(25)00040-6","url":null,"abstract":"","PeriodicalId":46628,"journal":{"name":"Zeitschrift fur Evidenz Fortbildung und Qualitaet im Gesundheitswesen","volume":"192 ","pages":"Page OBC"},"PeriodicalIF":1.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143436950","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-01DOI: 10.1016/S1865-9217(25)00037-6
{"title":"Inhaltsverzeichnis / Table of Contents","authors":"","doi":"10.1016/S1865-9217(25)00037-6","DOIUrl":"10.1016/S1865-9217(25)00037-6","url":null,"abstract":"","PeriodicalId":46628,"journal":{"name":"Zeitschrift fur Evidenz Fortbildung und Qualitaet im Gesundheitswesen","volume":"192 ","pages":"Pages iii-iv"},"PeriodicalIF":1.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143437067","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-01DOI: 10.1016/j.zefq.2024.11.008
Alessia Dehnen , Benjamin Borchardt , Philip Schillen , Jürgen in der Schmitten , Christine Kersting , Angela Fuchs , Nino Chikhradze , Dorothea Dehnen
Background
Strategies to counteract the impending and in some places already existing shortage of general practitioners (GPs) are being discussed in Germany. One approach could be to establish interprofessional teams in GP practices by integrating physician assistants (PAs).
Question
Can GPs imagine employing a PA in their practice and if so, under what conditions?
Methods
In March/April 2023, about 5,000 GPs in North Rhine-Westphalia (NRW), who work in a region with a care level of < 100 %, and about 1,000 GPs from Saxony-Anhalt were asked to take part in an online-based survey. Simultaneously, semi-structured preliminary interviews (one online focus group with four participants, seven individual interviews) were conducted with GPs from NRW.
Results
290 GPs participated in the survey (response rate approx. 5 %). Of these, 46.3 % expressed interest in employing a PA in their practice. A majority of 60 % considered assignments such as conducting an open consultation for uncomplicated respiratory tract infections or vaccination consultations to be delegable. As many as 21.9 % would be willing to pay a PA more than 3,500 euro gross monthly salary (based on a full-time position) (8.7 % more than 4,000 euro), while 38.4 % stated that they could not currently afford the cost of employing a PA. The qualitative results underline these findings. One of the respondents’ conditions for the employment of a PA was to abolish the quarterly budget limits for GPs.
Discussion
Many GPs already express their interest and willingness to both employ PAs and to delegate medical tasks to them – in spite of unanswered questions and, possibly, by necessity. About a fifth of the participants can even imagine paying from their own budget the same gross salary that PAs employed by hospitals are paid. Reliable clarification of feasibility, safety and cost-effectiveness of the use of PAs as well as effects on the quality of treatment in primary care should be a priority for health policy actors.
Take-home message
From the GP’s point of view, the integration of PAs into GP-centred care in terms of an interprofessional team practice has got potential. At the same time, the question of financial feasibility is still unsettled.
{"title":"Integration von Physician Assistants in die hausärztliche Versorgung: Akzeptanz und Bedenken von Hausärzt*innen","authors":"Alessia Dehnen , Benjamin Borchardt , Philip Schillen , Jürgen in der Schmitten , Christine Kersting , Angela Fuchs , Nino Chikhradze , Dorothea Dehnen","doi":"10.1016/j.zefq.2024.11.008","DOIUrl":"10.1016/j.zefq.2024.11.008","url":null,"abstract":"<div><h3>Background</h3><div>Strategies to counteract the impending and in some places already existing shortage of general practitioners (GPs) are being discussed in Germany. One approach could be to establish interprofessional teams in GP practices by integrating physician assistants (PAs).</div></div><div><h3>Question</h3><div>Can GPs imagine employing a PA in their practice and if so, under what conditions?</div></div><div><h3>Methods</h3><div>In March/April 2023, about 5,000 GPs in North Rhine-Westphalia (NRW), who work in a region with a care level of < 100 %, and about 1,000 GPs from Saxony-Anhalt were asked to take part in an online-based survey. Simultaneously, semi-structured preliminary interviews (one online focus group with four participants, seven individual interviews) were conducted with GPs from NRW.</div></div><div><h3>Results</h3><div>290 GPs participated in the survey (response rate approx. 5 %). Of these, 46.3 % expressed interest in employing a PA in their practice. A majority of 60 % considered assignments such as conducting an open consultation for uncomplicated respiratory tract infections or vaccination consultations to be delegable. As many as 21.9 % would be willing to pay a PA more than 3,500 euro gross monthly salary (based on a full-time position) (8.7 % more than 4,000 euro), while 38.4 % stated that they could not currently afford the cost of employing a PA. The qualitative results underline these findings. One of the respondents’ conditions for the employment of a PA was to abolish the quarterly budget limits for GPs.</div></div><div><h3>Discussion</h3><div>Many GPs already express their interest and willingness to both employ PAs and to delegate medical tasks to them – in spite of unanswered questions and, possibly, by necessity. About a fifth of the participants can even imagine paying from their own budget the same gross salary that PAs employed by hospitals are paid. Reliable clarification of feasibility, safety and cost-effectiveness of the use of PAs as well as effects on the quality of treatment in primary care should be a priority for health policy actors.</div></div><div><h3>Take-home message</h3><div>From the GP’s point of view, the integration of PAs into GP-centred care in terms of an interprofessional team practice has got potential. At the same time, the question of financial feasibility is still unsettled.</div></div>","PeriodicalId":46628,"journal":{"name":"Zeitschrift fur Evidenz Fortbildung und Qualitaet im Gesundheitswesen","volume":"192 ","pages":"Pages 66-76"},"PeriodicalIF":1.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142915913","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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