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Our-of-hours care is part of the statutory mandate of the Associations of Statutory Health Insurance Physicians (KVs) and guarantees outpatient care outside of regular consultation hours. Despite coordinated availability via the 116117 telephone number, there are structural and qualitative differences in the implementation of the out-of-hour care, particularly with regard to equipment and human resources. Against the background of increasing expectations of cross-sectoral care and the existing shortage of specialists, the question arises as to which lack of resources in the out-of-hours care leads to avoidable emergency admissions and to what extent telemedical options can help to relieve the burden from a medical perspective.A survey was conducted among physicians on out-of-hours care between June 1st, and August 31st 2023 using an anonymized online questionnaire. Participants were recruited by the Regional Statutory Health Insurance Physician Associations which organize out-of-hours care regionally. The questionnaire included demographic and professional items, questions about resource requirements and potential of telemedical services in the out-of-hours care. Data were subjected to descriptive analysis.A total of 4,052 physicians participated in the survey. Resource limitations most frequently associated with potentially avoidable hospital admissions were laboratory diagnostics, sonography and specialist expertise. The greatest perceived potential for telemedicine services lay in specialist consultation for diagnostic and therapeutic, as well as for radiological assessment. Approximately 67% of respondents indicated that home visits by healthcare assistants could be supported with telemedical support.Targeted use of telemedicine and improved access to diagnostic resources can, in the view of the surveyed physicians, strengthen the out-of-hours care and help avoid unnecessary hospital admissions. There is particular potential in specialist consultations, diagnostics, and the support of non-physician home visits-also as a response to the growing shortage of healthcare professionals. However, this requires careful implementation that takes legal, technical, personnel, and financial factors into account.

In Germany, a wide range of health apps is now available, supported by the Digital Healthcare Act (DVG), which has been in effect since 2020. These digital applications raise hopes for more equitable access to healthcare, particularly for people in rural areas. While previous studies have primarily focused on users and healthcare professionals, there is little empirical research on the perspectives of stakeholders involved in app development. This paper is based on a qualitative interview study with 16 actors from the field of health app and DiGA development. The data were analysed using reflexive thematic analysis. Three main, partially overlapping motivations for engaging in this field were identified: personal experiences as a patient, a professional background in healthcare, or economic interest. Regardless of their motivation, the interviewees agreed that health is a special good that carries certain moral obligations. At the same time, they cited legal ambiguity and bureaucratic obstacles as main challenges. The findings show that digital health innovations operate within a tension between economic growth and the social mandate of healthcare. We argue that understanding the motivations, challenges experienced, and values guiding stakeholders in health app development is particularly relevant, as their actions and values shape the technologies that are increasingly becoming part of the healthcare system.

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.

Social medicine, as practiced in the Federal Republic of Germany, is based on an interdisciplinary foundation. Within the multifaceted range of tasks assigned to it by the social insurance system, it implements both participatory and transformative processes through multiprofessional cooperation and co-creation. A symposium organized by the DGSMP's "Practical Social Medicine and Rehabilitation" department with significant participation of its Working Group on Nursing at the 60th annual conference of the German Society for Social Medicine and Rehabilitation (DGSMP) on September 19, 2025, at the Charité hospital, was dedicated to the theoretical and practical complexity of social medicine. It was conceived as a catalyst for defining a contemporary profile for social medicine and for fostering constructive discourse in the future. Six individual presentations addressed key concepts constituting social medicine and social legislation for categorizing social medicine's multiprofessional practice. The interdisciplinary agenda included selected topics from epistemological, historical, legal, health science, nursing science, and medical perspectives.

Patients, relatives and staff ('second victims') often experience stressful events in the clinical setting, such as deaths, serious diagnoses or acts of violence, which can lead to stress and crises. The aim of the scoping review was to identify the existing literature on psychosocial support services in somatic clinics and associated differences, e. g. in the target group(s).Comprehensive database searches and hand searches were conducted (including CINAHL, BASE, MEDLINE via PubMed, Springer Medizin). Only English- and German-language articles dealing with psychosocial support services in somatic medicine were included.A total of 68 publications were included. The results showed a heterogeneity and complexity of psychosocial support services as well as an increased discussion of psychosocial stress in everyday clinical practice. Psychosocial support services were reported to contribute to psychological and emotional relief, improve mental health and increase patient safety. Furthermore, the implementation of comprehensive peer support programmes was demonstrated to engender annual savings in excess of €1.5 billion within the healthcare system.

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.

Regional hospice and palliative care networks (RHPCN) can help improve collaboration between health care providers in order to provide comprehensive care for seriously ill patients and their families in the last stages of life. In Germany, RHPCNs are eligible for funding by statutory health insurers from 2022 under Section 39 d SGB V. What are the challenges RHCPNs face and what good practices have emerged in their work?As part of the project HOPAN (German Innovation Fund of the Federal Joint Committee [G-BA], grant N° 01VSF22042), an online survey was conducted among RHPCNs in Germany between December 2023 and February 2024. The survey explored challenges and good practices in six areas of network work. Quantitative data was analysed using a frequency analysis with the statistical software SPSS (closed questions). Free text answers were openly coded using MAXQDA 2022.A total response rate of n=408 data sets was achieved, of which n=64 data sets were included in the analysis after plausibility checks and data cleaning. The most significant challenges facing RHPCNs were the lack of awareness of the network among the general public (n=39; 60.9%) and care providers (n=27; 42.2%), varying qualifications and quality standards of network partners (n=31; 48.2%), and acquisition of new network partners (n=27; 42.2%). The most frequently mentioned good practices were appreciative, transparent, and regular communication (n=41; 50.6%), a personal approach to new network partners (n=38; 28.3%), and attractive network activities (n=33; 25.2%).Many RHPCNs are currently encountering challenges in establishing and expanding their network infrastructure. The implementation of effective network moderation and delivery of high-quality network activities can enhance the reach of RHPCNs. Joint training and further education, in addition to the development of regional care practices and standards, require a high level of commitment from the network partners, which is not yet the case in many instances.