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Diseases that impair breathing through the mouth and nose often necessitate the creation of a tracheostoma. This procedure is linked to complex care requirements. The present study investigates deficits in care as perceived subjectively by patients with a tracheostoma.A qualitative study design was employed, utilizing semi-structured interviews. Participants were recruited from a single center using theoretical and maximum variation sampling. For speech-limited and pediatric patients, their relatives were also interviewed. The interviews took place in the second quarter of 2024 and were recorded. The transcripts were then coded using thematic analysis, and the results were summarized into main themes.A total of 33 individuals participated in the study (24 patients, including 2 pediatric patients, and 9 relatives). The subjective care deficits identified can be categorized into several themes: impairments related to the tracheostoma, lack of information about the tracheostoma, the desire for autonomy in self-care, social participation, provision of medical supplies, and navigation within the healthcare system.The identified care deficits mainly pertained to the need for information, the challenge of finding tracheostoma-competent physicians and nurses, and issues related to social participation. In contrast, medical aspects of tracheostoma care were discussed less in the interviews compared to organizational and psychosocial challenges.

Endometriosis is a chronic gynaecological disease with an estimated prevalence of 10-15%. The German guideline provides evidence-based recommendations for diagnosis and treatment, but care provided is inadequate care due to long diagnostic pathways. Recent German research focused on regional variations in outpatient care, however research on inpatient endometriosis care is still lacking.The aim of the study was to examine inpatient endometriosis care - hospital locations and their caseloads. Spatial coverage, caseload distribution patterns and possible clusters, including certified endometriosis centres (CEC) and non-certified hospitals nationwide were analysed.German hospital quality report data from 2021 was used as data source. The location, certification status and caseload, meaning coded ICD-10 N80 Endometriosis cases, were collected for all hospitals. Then, 20-, 40- and 60-minutes' drive radius of CEC and non-certified hospitals were determined. Global and Local Moran's I was calculated to assess spatial clusters in caseload.A CEC 60-minutes' drive radius covers 78.15% of the area in Germany. Including all hospital locations that coded endometriosis, a maximum driving time of 40-minutes provides almost nationwide coverage. High caseload clusters appeared in urban areas and low caseload clusters especially in eastern Germany.The results indicate spatial clusters in providers caseload and difficulties in access to CEC for patients depending on location. Further research with patient-level data is needed to investigate the spatial distribution of patients and precise travel time for inpatient care.

Initial studies showed that healthcare professionals are confronted with patients with extremist attitudes and do not feel safe when dealing with these patients. With this in mind, an e-learning training programme on extremism was designed for healthcare professionals. The paper deals with the results of the accompanying research on this training programme.The data comes from a pre- and post-survey to evaluate the e-learning training course entitled 'Extremist attitudes in medical and psychotherapeutic treatment', which was designed for physicians and psychological psychotherapists. The data analyses include questions on knowledge and skills.A total of 2,971 professionals took part in the pre- and post-survey. The findings showed a significant increase in learning among participants in the training programme in all eight areas of competence (confidentiality, areas of phenomena, legal principles, etc.). In addition, concerns and worries about dealing with potential threats were reduced and the participants felt more confident in dealing with potential patients from the extremist milieu after the training programme. However, there were still uncertainties, especially in dealing with dangerous situations.Training on the topic of extremism is effective in ensuring greater safety for medical professionals in dealing with these issues. Networking with experts in the field is recommended for certain issues.

Achieving a work-life balance is a central issue for many physicians when choosing a specialty. Women in particular often feel compelled to choose between career and family, which frequently leads to setbacks in their professional advancement. In pediatrics, the proportion of women is especially high; however, there is little data on the compatibility of parenthood and professional life in this field.An anonymous web-based survey was conducted using a questionnaire adapted from other postgraduate medical training surveys. The survey ran from March 15 to May 1, 2023, and was aimed at physicians in pediatric postgraduate training. The results were analyzed statistically using GraphPad Prism and through qualitative content analysis.A total of 652 out of 4,160 invited individuals participated in the survey (16%). The results showed that women with children were less likely to pursue senior positions or self-employment compared to childless women or men. Instead, they more often preferred employed positions in outpatient practices. Part-time work, for both women and men, was perceived to be a disadvantage in career development, due to a lack of continuity, supervision, and acceptance from superiors.The survey highlights the urgent need for more flexible working hours, predictable schedules, and fewer overtime demands in order to better balance work and family life. The results emphasize the importance of making pediatrics a more family-friendly specialty. Key measures include flexible work models, on-site childcare, and proper recognition of actual hours worked during training, also for those on part-time contracts. Mentoring and support programs could further encourage women to pursue careers as senior physicians or in private practice, despite family obligations.

This study examined the extent to which generative artificial intelligence can be used for analyzing reports from the statutory accident insurance system. To this end, medical documents were evaluated using targeted prompts with both ChatGPT and a specially customized CustomGPT model. The results showed that simple tasks, such as extracting basic personal data or identifying missing causal links, were performed with high accuracy and a low error rate. However, when it came to more complex legal issues or the interpretation of contextual information, the models demonstrated limited reliability. The use of a tailored CustomGPT model did not yield a significant improvement in response quality compared to the standard version. In its current stage of development, the technology is not suitable for practical use in evaluating reports from the statutory accident insurance system. Future research should investigate newer versions of ChatGPT as well as alternative AI systems. It is expected that generative AI will soon be reliably applicable to the use cases explored in this study.

With the Network of University Medicine (NUM) and the Medical Informatics Initiative (MII), the BMBF is funding two pioneering, structure-building research measures that are now being merged. The data integration centers (DIZ) of the MII are to be consolidated in the NUM. The aim is to establish a standardized research infrastructure within which the existing data from the clinical routine care of the 36 German university hospitals, from clinical cohorts and clinical-epidemiological studies can be used for various research questions upon request and via coordinated processes. The legal basis for this was the MII's "Informed Broad Consent", which had been agreed upon with ethics committees and data protection authorities and implemented in all NUM locations, with a so-called "health insurance module" that allows the collection and linking of routine medical data from statutory health insurance funds (GKV) and private health insurers (PKV) as a category of care-related data (VeDa). Linking this routine data with data from hospital information systems offers particularly high potential, as no single data source provides a complete picture of medical care and the two data sources complement each other optimally. The aim now is to integrate this routine data into the NUM's secure, transparent and participatory research infrastructure in a strategic partnership with statutory health insurance funds and private health insurance companies. This promotes Germany in its role as a research location and makes a decisive contribution to improving the quality and safety of healthcare in Germany in an evidence-based manner.

Due to effective prevention strategies with regard to oral health in Germany, a huge reduction in the prevalence of dental caries in children and adolescents has been registered in children and adolescents. However, this improvement is considerably lower in deciduous teeth compared to permanent teeth. This shows that there is still a need for action. A study organized by the DAJ (Deutsche Arbeitsgemeinschaft für Jugendzahnpflege) for the school year 2015/2016 came to the conclusion that almost 14% of the 3-year-old children in kindergartens were already affected by tooth decay. Therefore, an earlier start with prophylactic prevention measures is the order of the day. Accordingly, the DAJ extended in 2016 its original recommendations of 2012 and included group prophylaxis measures for children under the age of 3 years. Also in 2019, early oral examinations in dental offices and oral health education for parents were included in the list of services of the German social health insurance. The legislator also justified these extras with the fact that in this age group, a relevant number of children do not receive any group prophylaxis measures. The prophylactic prevention program "Mice Teeth Campaign" helps to close this gap. The program not only promotes group prophylaxis for children under 3 years of age but also effectively supports the group prophylaxis programs for children over the age of 3 that are already being carried out in kindergartens, like the "Kita mit Biss" program. Similar to an open-source software, the prevention program represents a basis that can be individually adapted, changed, and/or expanded accordingly to local conditions. The structure of the basic and elective modules promotes acceptance by kindergartens, allowing for an easier access to a faster consent for the prevention program. Although the primary goal of the prevention program was to contribute in the reduction of early childhood caries, it was important for the project team to develop a program that could be easily transferred to other oral health working groups in Germany. It would be ideal if the participating working groups shared their additionally developed materials, ideas, experiences, and suggestions in a common pool so that all this information would be available to all participants. Technically, this is already possible thanks to the project's website.

The aim of the research project ENQuIRE was to investigate the relationship between quality indicators of emergency departments (ED) and their relevance for patient outcomes. To this end, a data base with 12,067 electronic health records (MDAT) of treatment cases in 15 German ED from 2019 was established. For these MDAT, health claims data of Techniker Krankenkasse (TK) from various service sectors were also requested. In this paper, information from MDAT on the individual patient's admission to the hospital or visit to the ED as an outpatient is compared to health claims data. Based on this, the extent to which the health claims data can be used to replace non-usable information in MDAT is estimated.A selection was made of MDAT from the study population that allowed linkage with health claims data. Based on this, "Abgleich" (comparison) included MDAT for which reliable information on the patient's outpatient discharge, inpatient admission or other was available. By contrast, MDAT for which the information could not be used were included in "Ableitung" (derivation). Both in "Abgleich" as well as "Ableitung", health claims data of inpatient hospital treatments (Social act V § 301) and outpatient treatments accredited by statutory health insurance (Social act V § 295) were linked to MDAT.For 9,113 MDAT from the ENQuIRE study population, information on patient's whereabouts was available without linking health claims data. As part of "Abgleich", inpatient or outpatient billing cases could be identified for 5,450 MDAT. In direct comparison of both linked data sources, information on outpatient discharges and inpatient admissions aligned in more than 90 % of cases. As part of "Ableitung", information for 3,749 MDAT could be derived from health claims data. In combination of "Abgleich" and "Ableitung", the potential of health claims data comprised up to 9,199 outpatient treatments or inpatient admissions.Inpatient admissions following ED visits and outpatient treatments in ED can be meaningfully mapped in health claims data. Despite certain inconsistencies, health claims data matches the respective information in MDAT to a high degree. The potential with regard to the total number of cases is in ENQuIRE roughly similar when comparing both data sources. Which source of information is used for analyses therefore depends primarily on theoretical or methodological considerations.

The VersKiK-study is based on a record-linkage between the German Childhood Cancer Registry (GCCR) and claims data from statutory health insurances (SHI) in order to investigate the frequency of late effects and long-term medical care among pediatric cancer survivors.GCCR defined a basic population of approximately 50,000 former patients with cancer in childhood or adolescence (years of diagnosis 1991-2021) who survived until 1.1.2017. Encrypted GCCR identity data were stochastically linked with encrypted identity data from 13 SHI. For those cancer patients who could be identified in SHI records (study population), claims data covering 2017-2021 were added and combined with basic GCCR information on cancer diagnosis. A comparison between identified cancer patients and those who were not identified in SHI records was made to evaluate the representativeness of the study population for quantitative analyses.A total of 26,127 former childhood cancer patients were identified in SHI data. Since the participating SHI represent approximately two-thirds of the German population, the record linkage could be judged as satisfactory (84% matching rate). We found no significant differences between the study population and the non-matched group regarding age, sex, primary cancer diagnosis, and year of diagnosis.The identified study population is considered representative for survivors of childhood cancer in Germany.