Gesundheitswesen最新文献

Not least since the COVID-19-pandemic, digitalization has become increasingly important for the work of the public health service (PHS) in order to ensure the functionality at all levels of the PHS such as the exchange of information between health authorities themselves and other stakeholders. The digital skills of employees in the local health authority (LHA) are an important factor for the digitalization und functionality of the PHS. This paper uses the example of a health authority to examine the question of what digital competence or digital skills public health service employees have and need. The digital skills were assessed using questionnaires for employees and IT contact persons as well as by analysing employee requests to the IT (IT ticket system). In a participatory approach of the real-world lab, employees of a LHA were involved in defining the basic level of digital skills and developing the survey methods. Almost all of the 37 participating employees rated their general digital skills at the basic level. Depending on the specific skill, between a quarter and all employees stated that they had mastered the specific skills at the basic level. Requests to both the IT contact persons and the IT ticket system were almost exclusively below the basic level. Face-to-face training is preferred for knowledge transfer. Lack of time has an inhibiting effect on the acquisition of digital skills. It turned out that employees overestimated their general digital skills. Digital skills should be assessed using various surveys and methods. A training concept should consider the basic digital skills, the sensitivity of this topic, the time required and personal assistance.

Theda Borde, recipient of the 2025 Salomon Neumann Medal of the German Society for Social Medicine and Prevention (DGSMP), holds a degree in political science and a doctorate in Public Health. She served as Professor and, for a period, as Rector at the Alice Salomon University of Applied Sciences Berlin. Her research and teaching focus on the social determinants of health, gender and health, interprofessional collaboration in healthcare, and migration and health. Four core principles that shaped the work of Salomon Neumann also characterize Theda Borde's scholarly contributions: addressing the needs of socioeconomically disadvantaged populations, generating scientific evidence on their health status, translating research findings into practice, and taking a public stance - particularly in times of populist resistance. Theda Borde's work, however, extends beyond Neumann's historical framework: participation and co-creation are central to her understanding of health equity and the advancement of social justice.

Prevention and health promotion can be a way of helping to improve the autonomy, independence, well-being and quality of life of people who are at risk of, at the beginning of or already in need of care. This study is based on the hypothesis that frailty as a defined care risk can be contained or, if necessary, prevented so that people can live longer and age more healthily in their home environment. There is sufficient evidence that relationship and behavioral factors have a much stronger influence on development opportunities in old age than genetic and biological dispositions. Against this background, social legislation has established preventive measures in Social Code XI in addition to the preventive services offered in Social Code V with the introduction of the Prevention Act (PrävG) in 2015. In order to determine the potential for prevention, the Medical Service was obliged to check in each of its reports on the need for care whether preventive measures should be recommended beyond the current care situation. Based on anonymized routine data from a large long-term care insurance company, the Medical Service reports from 2022 and 2023 were analyzed nationwide to determine the need for long-term care. A mixed-methods approach was used to interpret potential indications between insurance-related aspects and the recommendation practice in the expert reports. Our study revealed a gap between preventive healthcare offered and recommendations for such support in the legislative codes. This gap needs to be closed to improve healthy aging.

The new out-of-hospital intensive care (AKI) law, which is now included in social law, allows critically ill patients, most of whom are tracheostomy patients or require ventilation, to live a participatory life in a home environment as far as possible. As a service provided by statutory health insurance companies, it requires a special prescription from a statutory health insurance provider and, in the case of ventilated or tracheotomized patients, a qualified potential assessment for weaning and/or decannulation (removal of the tracheostomy tube). A mandatory assessment by the Medical Advisory Service (MAS) at the place of care is the basis for the health insurance company's decision for benefit approval. A secondary data analysis was carried out consisting of 1615 initial reports from the Hessian MAS of the first 17 months after the new regulations and requirements for AKI were implemented. Of the high proportion of tracheotomized patients (72.6%) of the total population, 27.7% received continuous or intermittent invasive ventilation. In 46.5% of cases, a potential assessment, which was mandatory at the time, was still pending. From a socio-medical perspective, in around 8.2% of all assessed cases, the AKI requirements were not met. The MAS assessment enables a more individual and differentiated picture of the special constellation according to ICF criteria with a view to the socio-medical necessity of AKI care. Furthermore, it helps to ensure adequate medical and nursing care on site and reviews any weaning potential that may have not been sufficiently exploited to this point.