Gesundheitswesen最新文献

The shortage of physicians and nurses in the healthcare sector in Germany is often compensated by deployment of health professionals from abroad. However, this is accompanied by various challenges. These include, for example, communication and language difficulties and a lack of understanding of administrative and bureaucratic processes. Using a narrative literature analysis combined with the presentation of our own research results, this article summarizes challenges in this area, based on results from nine years of research and a total of six research projects in this field. Furthermore, it proposes approaches to solutions that have proved to be successful in practice in Germany as well as in international settings.

During the COVID-19 pandemic, residents of care homes for the elderly were at a particularly high risk of contracting the virus and dying from it. Strict protective measures were therefore taken, including bans on visits. However, the negative effects of these contact-restricting measures on the mental and physical health, quality of life, right to self-determination and ultimately the dignity of the residents soon became apparent and the question was raised as to whether isolation (confinement disease) was even more harmful to health than the disease itself. Statements on infection control measures in care facilities, studies with the views of those affected (residents, relatives, employees in care facilities) and interviews with residents of care facilities as well as reviews on adverse effects of the protective measures were researched. The search included both so-called "gray literature" and publications from PubMed. The residents suffered greatly from isolation and from the fact that decisions were made about them without consulting them. They complained about the loss of their autonomy and felt that their dignity was violated. The reviews showed that the residents generally experienced loneliness, anxiety, sadness and depression more frequently, and in some cases also physical deterioration. In future, care must be taken to achieve a good balance from a legal and health perspective between protection against infection and protection of the mental and physical health, well-being and quality of life of residents, respect for autonomy, the right to self-determination and the dignity of residents. This requires a broad social discussion in which not only experts from the fields of infectiology but also from the fields of geriatrics, nursing, public health, ethics and law, but in particular also those affected themselves or their representatives, their relatives, are heard and their arguments taken into account.

Medication safety represents an increasingly pertinent aspect of quality and risk management in hospitals. However, little is known about the relevance of specific methods in controlling medication safety with respect to medical care processes. The aim of this study, therefore, is to assess the implementation of medication safety measures and the significance of specific hospital characteristics.We analyzed data from 2018, comprising structured quality reports of 1987 sites that were the first to contain information on 13 medication safety tools and measures. Relative implementation rates were assessed both in general and for subgroups. The latter were formed based on site size, presence of specialized departments as well as university hospital affiliation. The relevance of corresponding differences between subgroups was examined using threshold analysis.Across all 13 medication safety measures, implementation rates varied highly (gapless medication safety after hospital release: 71.4%; SOP for good prescription practice: 23.5%). Rates also increased in relation to site size from 31.5% (<50 hospital beds) to 61.5% (>500 hospital beds). This pattern was especially prevalent for medication safety measures pertaining to electronics and IT. There were significant differences between eight measures based on the presence of specialized departments as well as university hospital affiliation. Two measures (medication safety training, description of optimal medication processes) did not vary with the hospital characteristics.Our results highlight the importance of standardized assessments of quality assurance data in hospital settings. The present data analysis enables the identification of those measures that have already been implemented. Implementation seems to be associated with hospital characteristics as well as regulatory guidelines. However, it is noteworthy that medication safety measures are not being implemented across the board. This might be explained by economic, social and technological barriers. These hurdles should be dealt with on a long-term basis and via adequate incentives.

Accessing medical services requires resources, which can be particularly scarce for single parents. During times of crisis and the associated daily challenges, the threshold for seeking out medical care increases further. This study is based on data on 6,155 mothers from the Socioeconomic panel (SOEP) survey waves of 2019 and 2021. The COVID-19 pandemic is used here as an example of a crisis. The results suggest that single parents have an overall higher need for medical care, reflected by poorer health and more medical diagnoses. During the COVID-19 pandemic, a decline in the utilization of healthcare services was observed, especially among single mothers. It is important to create support opportunities for (single) mothers to improve and maintain their health during times of crisis.

Due to the nature of demographic developmens, there is an increasing need for prevention measures in healthcare. In Germany, people with statutory health insurance have a legal right to general health check-ups for early detection of diseases that are significant in terms of population medicine. However, the older population has thus far made inadequate use of these services, resulting in significant losses of prevention potential. This paper examines the impact of objective and subjectively perceived access to health services on the use of general health check-up among citizens aged 55 years and older in the state of Saxony-Anhalt, Germany.The study uses data from a written cross-sectional survey of residents from four major and minor cities in Saxony-Anhalt. Bivariate logistic regression models were used for the statistical analysis of data to evaluate the relation between access parameters to health services and utilization.In all, 953 questionnaires were included in the analyses; 59.7% of the respondents used the general health check-up in the recommended time interval. In the multivariate analyses, the study showed that neither subjective satisfaction with access nor self-reported travel times to family doctors were significant factors affecting the utilization. On the other hand, being a member of statutory health insurance funds and the use of a private car increased the likelihood of utilization. Other determinants that had an influence on the use of general health checks were net household income and need for long-term care.The results of this study indicate potential for increasing utilization of general health check-up among older people. However, increased use of free health check-ups by this section of the population cannot be achieved primarily by improving accessibility, but must be addressed by other factors, such as attitudes towards health checks, which requires further analysis.

The aim of this study was to describe and analyse knowledge of women in childbed with and without a migration background about ante- and postnatal support services.Questionnaires were provided in 26 languages. In a cross-sectional survey, 641 women answered questions about their knowledge of 11 different regional support services, and information sources for these and other support service providers. Median split was used to derive mothers with good and poor knowledge.German was not the mother tongue of 30% of the participants (n=194) and were therefore defined as "mothers with migration background". Of these, 83% (n=161) were aware of services offered by midwives and<40% knew of other support services. Women with migration background were significantly less likely to know the support services (OR 0.16, 95% CI 0.11 to 0.23), even after controlling for other sociodemographic variables. Furthermore, they obtained significantly less frequently information about relevant services from gynaecologists, midwives, relatives/acquaintances or by themselves.Especially for mothers with migration background, knowledge about ante- and postnatal support services must be made more accessible. In this, midwives could play a decisive role.

Aim: To date, there are only a few studies analyzing health professionals' health literacy (HL). Mostly, the focus has been on personal rather than professional HL. To bridge this gap, a new concept and an associated survey instrument have been developed in a three-country consortium. The aim of this article was to examine the professional HL of general practitioners (GPs) in Germany.

Method: The survey instrument used consists of 34 items and assesses subjective difficulties in four dimensions to be addressed in promoting patients' HL: "information and knowledge management", "conveying information and knowledge", "patient-centred communication", "professional digital HL". A total of 297 GPs and internists working in general practice were surveyed online over the summer of 2022. The professional HL (score from 0 to 100) was analyzed descriptively and examined in relation to gender, selected job-related, and organizational characteristics, using multiple linear regression.

Results: Depending on the four areas, GPs achieved approximately half to almost three-quarters of the highest possible score. The dimension "patient-centred communication" was perceived as the easiest, followed by "information and knowledge management", and "conveying information and knowledge". The most challenging dimension was "professional digital HL". According to the multivariate analysis, professional HL shows a relation to gender, organizational framework and training conditions, job duration, and coping with the diversity of digital information. The strength of correlation varies by area and is rather weak in some instances.

Conclusions: The results demonstrate the importance of promoting professional HL of GPs and provide numerous indications of where to start. They also indicate that the regression models should be extended by additional determinants, since the included variables can explain only a small amount of variance.