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Zeitschrift fur Evidenz Fortbildung und Qualitaet im Gesundheitswesen最新文献

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Liste der Affiliierten Institute und Fachgesellschaften / List of Affiliations 附属机构名单
IF 1.7 Q4 HEALTH POLICY & SERVICES Pub Date : 2025-09-01 Epub Date: 2025-09-11 DOI: 10.1016/S1865-9217(25)00192-8
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引用次数: 0
Erhebung der Arbeitsbelastung in der hausärztlichen Versorgung während der SARS-CoV-2-Pandemie – eine „Proof-of-Concept“-Studie [SARS-CoV-2大流行期间初级保健医生工作量调查:一项概念验证研究]。
IF 1.7 Q4 HEALTH POLICY & SERVICES Pub Date : 2025-09-01 Epub Date: 2025-08-26 DOI: 10.1016/j.zefq.2025.07.003
Thomas Kloppe , Jan Hendrik Oltrogge-Abiry , Maren Ehrhardt, Dagmar Lühmann, Thomas Zimmermann, Martin Scherer

Objective

One of the conclusions from the experience with the SARS-CoV-2 pandemic of 2020 to 2022 was the requirement for data on primary care/ambulatory care to assess the severity of the pandemic in a timely manner. Since most patients with COVID-19 in Germany had been primarily cared for by general practitioners, the question arose whether the incidence course of a pandemic can be mapped by means of a regular evaluation of GP workload and number of patients.

Methods

From January 2021 to June 2021, 12 replicative, internet-based cross-sectional surveys were conducted fortnightly. Invitations were sent out to all members of the German Society of General Practice/Family Medicine (DEGAM) and selected federal/regional member organizations of the German Association of General Practitioners. They were asked about increases in personal workload, number of patients with COVID-19, and other conditions of patient care.

Results

On average, 697 general practitioners (GPs) participated in each survey and completed a total of 8,369 questionnaires. The composition of participants remained consistent across the 12 survey periods, with 82.9–87.2 % being practice owners and 32.0–40.7 % working in group practices. Over time, the proportion of physicians reporting an increased workload reached a minimum of 24.2 % in February 2021; from March 2021 onward, there was a trend reversal with a peak (88.1 %) in May 2021. The change in the GPs’ workload developed in phases that ran parallel to the official RKI reporting data on the COVID-19 incidence. The reported increase in the care deficit for patients with chronic diseases or social problems did not show a temporal dynamic comparable to the reported incidence trend.

Discussion

A replicative survey among GPs conducted between January 2021 and June 2021 revealed changes in the workload of general practitioners under pandemic conditions. The progression of the SARS-CoV-2 pandemic during the same period and the observed change in workload developed in parallel. The methodology used (an internet-based, replicative survey among GPs) could therefore be a low-threshold, resource-saving approach to assessing the course of a pandemic. Despite the increasing workload during the different waves of the pandemic, the care for chronically ill patients reported by the GPs was not subject to any pandemic-related dynamics.
目的:从2020年至2022年SARS-CoV-2大流行的经验中得出的结论之一是需要初级保健/门诊护理数据,以便及时评估大流行的严重程度。由于德国大多数COVID-19患者主要由全科医生照顾,因此出现了一个问题,即是否可以通过定期评估全科医生的工作量和患者数量来绘制大流行的发病过程。方法:2021年1月至2021年6月,每两周进行12项基于互联网的重复性横断面调查。邀请已向德国全科医师/家庭医学协会(DEGAM)的所有成员和德国全科医师协会选定的联邦/区域成员组织发出。他们被问及个人工作量增加、COVID-19患者人数以及患者护理的其他情况。结果:平均每场调查有697名全科医生参与,共填写问卷8369份。参与者的组成在12个调查期间保持一致,82.9-87.2 %是实践所有者,32.0-40.7 %在团队实践中工作。随着时间的推移,报告工作量增加的医生比例在2021年2月达到最低24.2% %;从2021年3月开始,趋势逆转,在2021年5月达到峰值(88.1 %)。全科医生工作量的变化分阶段发展,与RKI官方报告的COVID-19发病率数据并行。报告的慢性病或社会问题患者护理赤字的增加没有显示出与报告的发病率趋势相当的时间动态。讨论:2021年1月至2021年6月期间对全科医生进行的一项重复性调查揭示了大流行条件下全科医生工作量的变化。在同一时期,SARS-CoV-2大流行的进展与观察到的工作量变化是平行发展的。因此,所使用的方法(在全科医生中进行基于互联网的重复性调查)可能是评估大流行进程的低门槛、节约资源的方法。尽管在大流行的不同浪潮期间工作量不断增加,但全科医生报告的对慢性病患者的护理不受任何大流行相关动态的影响。
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引用次数: 0
Inhaltsverzeichnis / Table of Contents 吸入物/目录
IF 1.7 Q4 HEALTH POLICY & SERVICES Pub Date : 2025-09-01 Epub Date: 2025-09-11 DOI: 10.1016/S1865-9217(25)00184-9
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引用次数: 0
Taking a look behind the scenes: Updating health information on Gesundheitsinformation.de 在gesundheitinformation .de上更新健康信息。
IF 1.7 Q4 HEALTH POLICY & SERVICES Pub Date : 2025-09-01 Epub Date: 2025-05-14 DOI: 10.1016/j.zefq.2025.04.002
Milly Schröer-Günther, Klaus Koch, Inger Scheike
The website Gesundheitsinformation.de and its English sister website InformedHealth.org are a service of the Institute for Quality and Efficiency in Health Care (IQWiG). IQWiG has the legal mandate to provide all citizens with independent and scientifically proven free health information. The website currently comprises information on more than 300 diseases and health issues (“topics”). Evidence-based medicine (EBM) forms the base of Gesundheitsinformation.de. Regular updates are therefore an important quality criterion. Usually, the information is updated every three years. The paper will describe a major update process of the individual topics on Gesundheitsinformation.de. The major process includes 10 steps (e.g., evidence search, medical writing, editorial revisions, and translation). The updating process is currently being reviewed to see whether the effort required for individual tasks can be reduced. The aim is to update/produce more health information with the same resources and without any loss of quality.
gesundheitinformation .de网站及其英文姊妹网站InformedHealth.org是卫生保健质量和效率研究所(IQWiG)的一项服务。IQWiG的法律任务是向所有公民提供独立和经科学证明的免费健康信息。该网站目前包含300多种疾病和健康问题(“专题”)的信息。循证医学(EBM)构成了gesundheitinformationde的基础。因此,定期更新是一个重要的质量标准。通常,信息每三年更新一次。本文将描述gesundheitinformation .de上单个主题的主要更新过程。主要过程包括10个步骤(例如,证据检索、医学写作、编辑修订和翻译)。然而,许多更新在原因或范围上都很小。对于那些较小的更新,可以省略某些步骤以限制资源和时间。
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引用次数: 0
Gut und kosteneffektiv palliativ versorgt in Westfalen-Lippe – aber warum? Ergebnisse einer Mixed-Methods Studie [威斯特伐利亚-利佩的良好且具有成本效益的姑息治疗-但为什么?]混合方法研究的结果]。
IF 1.7 Q4 HEALTH POLICY & SERVICES Pub Date : 2025-09-01 Epub Date: 2025-07-14 DOI: 10.1016/j.zefq.2025.06.001
Anastasia Suslow , Nino Chikhradze , Bianka Ditscheid , Chantal Giehl , Horst Christian Vollmar , Antje Freytag , Ina Carola Otte
<div><h3>Background</h3><div>The organization of palliative care in Germany varies from region to region. Previous studies show that palliative care in Westphalia-Lippe (WL) – measured by quality and cost indicators – performs better than in other regions. The Westphalian model for outpatient care emphasizes a close cooperation between general practitioners (GPs) and palliative care consultation services (PCS). The basis is a contractual regulation of general and specialized care within a joint outpatient palliative care contract according to Sect. 140a SGB V. The VESPAL study (on the <em>Quality of care in outpatient palliative care based on the example of Westphalia-Lippe</em>), which was funded by the Professional Association of Palliative Care Physicians in Westfalen-Lippe (Berufsverband der Palliativmediziner in Westfalen-Lippe e.V.) and the Association of Statutory Health Insurance Physicians (Kassenärztliche Vereinigung Westfalen-Lippe e.V.), was conducted between 02/2022 and 07/2023 and examined which characteristics of outpatient palliative care in WL could be identified from the correlation of quantitative key figures with qualitative interview quotes that might contribute to high-quality care and cost-effectiveness.</div></div><div><h3>Methods</h3><div>A complex mixed-methods design was applied. Quantitative and qualitative data were collected and analyzed simultaneously, were used as a basis for further qualitative research, and then merged (QUAL+QUAN → QUAL). The quantitative data were derived from a routine data analysis on the utilization and quality of palliative care from data of deceased patients who had been covered by the BARMER health insurance, while qualitative data were obtained using five non-participant observations, interviews with 50 care providers (general practitioners, palliative care physicians, coordinators, nurses), and three focus groups. Both data sets were analyzed independently, with the quantitative results being complemented by qualitative insights to provide a more comprehensive understanding of the WL care model.</div></div><div><h3>Results</h3><div>The quantitative parameters used to measure the quality of care included, in particular: the hospital as place of death, the number of hospital cases, and the number of ambulance call-outs in the last 30 days of life. The qualitative study results show that these parameters can be improved by a close cooperation and specific arrangements with emergency services and nursing homes. According to the interviewees, the typical Westphalian organization of cooperation between doctors and PCS enables providers to respond quickly and provide care which is focused on the needs of patients and their relatives and can be flexibly “ramped up and down”. Providers emphasized the flexibility of the model, the close cooperation, and the lack of competitive pressure from each other as reasons for the high quality of care perceived.</div></div><div><h3>Conclusions</h3><div>The r
背景:在德国,姑息治疗的组织因地区而异。以前的研究表明,威斯特伐利亚-利佩(WL)的姑息治疗——以质量和成本指标衡量——比其他地区表现更好。威斯特伐利亚模式的门诊护理强调全科医生(全科医生)和姑息治疗咨询服务(PCS)之间的密切合作。其基础是根据SGB V. 140a节,在联合门诊姑息治疗合同中对一般护理和专科护理的合同规定。VESPAL研究(基于威斯特伐利亚-利佩的门诊姑息治疗的护理质量)。由威斯特法伦-利普姑息治疗医师专业协会(Berufsverband der Palliativmediziner in Westfalen-Lippe e.v.)和法定健康保险医师协会(Kassenärztliche Vereinigung Westfalen-Lippe e.v.)资助,在2022年2月至2023年7月期间进行了一项研究,研究了从定量关键数据与定性访谈引用的相关性中可以识别出WL门诊姑息治疗的哪些特征,这些特征可能有助于提供高质量的护理和成本效益。方法:采用复杂的混合方法设计。定量和定性数据同时收集和分析,作为进一步定性研究的基础,然后合并(QUAL+QUAN→QUAL)。定量数据来自BARMER健康保险覆盖的已故患者数据中关于姑息治疗的利用和质量的常规数据分析,而定性数据通过5次非参与性观察、对50名护理提供者(全科医生、姑息治疗医生、协调员、护士)和3个焦点小组的访谈获得。两个数据集都被独立分析,定量结果与定性见解相辅相成,以提供对WL护理模式更全面的了解。结果:用于衡量护理质量的定量参数包括,特别是:医院作为死亡地点,医院病例数和生命最后30天的救护车呼叫次数。定性研究结果表明,通过与急救服务和养老院的密切合作和具体安排,这些参数可以得到改善。根据受访者的说法,典型的威斯特伐利亚式医生和PCS之间的合作组织使提供者能够快速响应,并提供专注于患者及其亲属需求的护理,并且可以灵活地“上下起伏”。提供者强调了模式的灵活性,密切合作,以及彼此之间缺乏竞争压力,这些都是高质量护理的原因。结论:结果提供了在广泛的WL门诊模式中有效的潜在机制的具体指示,这可能解释了高质量的护理和成本效益。今后的研究应解决可转移到其他区域的问题。
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引用次数: 0
Herausgeberkollegium / Editorial Board Herausgeberkollegium编委会
IF 1.7 Q4 HEALTH POLICY & SERVICES Pub Date : 2025-09-01 Epub Date: 2025-09-11 DOI: 10.1016/S1865-9217(25)00183-7
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引用次数: 0
Abschlusseditorial Abschlusseditorial .
IF 1.7 Q4 HEALTH POLICY & SERVICES Pub Date : 2025-09-01 Epub Date: 2025-07-30 DOI: 10.1016/j.zefq.2025.06.006
Waldemar Siemens , Claudia Breuer , Jörg J. Meerpohl
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引用次数: 0
Liste der Affiliierten Institute und Fachgesellschaften / List of Affiliations 附属机构名单
IF 1.4 Q4 HEALTH POLICY & SERVICES Pub Date : 2025-07-01 Epub Date: 2025-07-09 DOI: 10.1016/S1865-9217(25)00171-0
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引用次数: 0
Kommunikation, Kooperation und Austausch mit Psychotherapeut*innen aus der Sicht von Primärversorger*innen – Befragungsergebnisse im Rahmen des Projekts „Evaluation der Psychotherapie-Richtlinie“ [从初级保健提供者的角度与心理治疗师的沟通、合作和交流-作为“心理治疗- richlinie评估”项目一部分的调查结果]。
IF 1.4 Q4 HEALTH POLICY & SERVICES Pub Date : 2025-07-01 Epub Date: 2025-05-20 DOI: 10.1016/j.zefq.2025.04.005
Pauline Birte Schlesiger , Jürgen Wasem , Luisa Friedrich , Sandra Werner , Sarah Schlierenkamp , Gerald Lux , Anke Walendzik , Carina Abels , Klemens Höfer , Kathrin Klipker , Ursula Marschall , Dieter Best , Christa Schaff , Helene Timmermann , Silke Neusser

Background

General practitioners (GPs) and psychotherapists fulfill a variety of functions in the care for individuals with mental illness. However, little is currently known about the exchange and communication between these two groups. To address this gap, an exploratory study has been conducted from the perspective of primary care providers to analyze the nature of exchange and communication with psychotherapists.

Methodology

A standardized cross-sectional survey was conducted among primary care providers for adults (PEW) and children/adolescents (PKJ) as part of the ’Evaluation of the Psychotherapy Guideline’ project. In July 2021, a random sample from the pool of a target group of specialists with N = 1,700 people from each group were contacted by mail. Another random sample of N = 1,700 from each group was contacted in November 2021. The survey questionnaire included, among other things, questions about the exchange with psychotherapists. The exploratory analysis was descriptive.

Results

A total of N = 255 and N = 444 valid survey questionnaires from PEW and PKJ was analyzed. The majority of primary care providers are over 50 years old (PEW 72.8%; PKJ 62.0%), and more than half are female (PEW 53.8%; PKJ 53.7%). As reported by PEW, the primary modes of communication and exchange with psychotherapists are via written correspondence (20.4%) and telephone (18.0%). For PKJ, the predominant mode of communication is by phone (22.6%). The majority of primary care providers expressed their dissatisfaction with the exchange with psychotherapists, with the highest rates being observed during (PEW 60.8%; PKJ 47.4%) and after referral (PEW 57.4%; PKJ 49.2%). Satisfaction is influenced by a number of factors, including integration into networks, which has been shown to have a positive effect.

Conclusion

The cross-sectional survey provides insight into the communication and collaboration between primary care providers and psychotherapists. To facilitate improvements, further research is needed on the barriers to interdisciplinary cooperation and communication.
背景:全科医生(gp)和心理治疗师在照顾精神疾病患者方面发挥着多种作用。然而,目前对这两个群体之间的交流和沟通知之甚少。为了解决这一差距,从初级保健提供者的角度进行了一项探索性研究,分析了与心理治疗师交流和沟通的性质。方法:作为“心理治疗指南评估”项目的一部分,在成人(PEW)和儿童/青少年(PKJ)的初级保健提供者中进行了标准化的横断面调查。2021年7月,从目标专家群体N = 中随机抽取样本,每组1700人通过邮件联系。2021年11月,从每组中随机抽取N = 1,700人进行联系。调查问卷包括与心理治疗师交流的问题。探索性分析是描述性的。结果:共分析PEW和PKJ有效问卷N = 255份和N = 444份。大多数初级保健提供者年龄在50岁以上(皮尤研究中心72.8%;PKJ 62.0%),超过一半是女性(皮尤53.8%;PKJ 53.7%)。根据PEW的报告,与心理治疗师沟通和交流的主要方式是通过书面通信(20.4%)和电话(18.0%)。对于PKJ,主要的沟通方式是电话(22.6%)。大多数初级保健提供者表达了他们对与心理治疗师交流的不满,在皮尤研究中心观察到的比率最高(60.8%;PKJ 47.4%)和转诊后(PEW 57.4%;PKJ 49.2%)。满意度受到许多因素的影响,包括融入网络,这已被证明具有积极影响。结论:横断面调查提供了深入了解初级保健提供者和心理治疗师之间的沟通和合作。为了促进改进,需要进一步研究跨学科合作与交流的障碍。
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引用次数: 0
Sicherheitsbedenken und Speak-up in der Patientenversorgung aus Sicht der Auszubildenden der Pflegeassistenzberufe in Tirol – eine multizentrische, explorativ-quantitative Querschnittstudie [从蒂罗尔护理助理实习生的角度看病人护理中的安全问题和畅所欲言——一项多中心探索性定量横断面研究]。
IF 1.4 Q4 HEALTH POLICY & SERVICES Pub Date : 2025-07-01 Epub Date: 2025-06-11 DOI: 10.1016/j.zefq.2025.05.002
Stephanie Siebenförcher , Marten Schmied , Magdalena Hoffmann , Christine Schwarz , David Schwappach , Gerald Sendlhofer , Margret Jäger , Gerhard Müller

Background

‘Speak up’ refers to the act of raising safety concerns, which can greatly influence patient safety outcomes. In healthcare, hierarchical structures may inhibit nursing assistant trainees from voicing their concerns effectively. This study explored the speak-up behavior and perceptions of safety culture among nursing assistant trainees in Tyrol (Austria). It also investigated the reasons and barriers for speaking up, as well as potential differences in speak-up behavior based on macro-social characteristics.

Methods

Between May and July 2023, a multicentric, exploratory quantitative cross-sectional study was conducted involving 508 trainees in nursing assistance and advanced nursing assistance across seven training institutions in Tyrol. Data were collected using the “Speaking Up about Patient Safety Questionnaire” (SUPS-Q). Descriptive statistics along with the Mann-Whitney U test were employed for data analysis.

Results

A total of 358 nursing assistant trainee participated in the study. Most trainees reported perceiving safety concerns, actively speaking up about them, and experiencing a generally positive safety culture during their internships. However, common barriers to speaking up included fear of negative repercussions for their training (45.6%) and uncertainty about how to articulate their concerns (31.8%). The primary motivations for addressing safety concerns were the desire to prevent harm (71.3%) and a strong sense of duty (62.5%).

Discussion

Compared to existing studies with nursing students, trainees in the nursing assistant professions seem to express their safety concerns more often. The reasons for this could be primarily intradisciplinary communication and a higher average age.

Conclusion

Trainees in nursing assistance professions tend to be more willing to voice their safety concerns than nursing students. Further multicenter studies should be undertaken to improve the transferability of results.
背景:“Speak up”是指提出安全问题的行为,这可以极大地影响患者的安全结果。在医疗保健中,等级结构可能会抑制护理助理实习生有效地表达他们的担忧。本研究探讨奥地利蒂罗尔市护理助理实习生的畅所欲言行为及安全文化认知。本文还研究了基于宏观社会特征的直言不讳的原因和障碍,以及直言不讳行为的潜在差异。方法:在2023年5月至7月期间,对蒂罗尔7家培训机构的508名护理辅助和高级护理辅助学员进行了一项多中心、探索性定量横断面研究。使用“畅所欲言患者安全问卷”(SUPS-Q)收集数据。采用描述性统计和Mann-Whitney U检验进行数据分析。结果:共有358名实习护理员参与研究。大多数受训者报告说,他们在实习期间感受到安全问题,积极地谈论这些问题,并体验到一种普遍积极的安全文化。然而,说出来的常见障碍包括害怕对培训的负面影响(45.6%)和不确定如何表达他们的担忧(31.8%)。解决安全问题的主要动机是希望防止伤害(71.3%)和强烈的责任感(62.5%)。讨论:与现有的护理学生研究相比,护理助理专业的学员似乎更经常表达他们的安全担忧。造成这种情况的主要原因可能是跨学科的交流和较高的平均年龄。结论:护理辅助专业的实习生比护生更愿意表达他们对安全的担忧。应开展进一步的多中心研究,以提高结果的可转移性。
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引用次数: 0
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Zeitschrift fur Evidenz Fortbildung und Qualitaet im Gesundheitswesen
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