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Background: Although there is sufficient evidence that sex-/gender-based differences can influence treatment decisions and healthcare for adults with congenital heart disease (ACHD), there are major research shortfalls in this regard. The aim of this study was to assess these in a large ACHD cohort. Methods: In this cross-sectional study, patient-reported outcome measures from a questionnaire completed by 3880 ACHD (53.6% female; 41.9 ​± ​17.1 years) were used to assess gender-related differences concerning underlying CHD condition, comorbidities, health care details, individual counselling needs, and quality of life (QoL). Results: Significant differences observed included a female predominance in tetralogy of Fallot, atrial septal defects, and persistent ductus arteriosus, and a male predominance in aortic valve stenosis/insufficiency and transposition of the great arteries. The prevalence of coronary artery disease was significantly higher in men, while women reported a higher prevalence of pulmonary hypertension, arrhythmias, neurologic restrictions, and overall comorbidities. Men consulted their primary care physician more often if a CHD-related medical problem was suspected. A total of 2194 patients (54.4% female) stated that they had never been referred to an institution specialized in CHD. Both sexes had a high counselling demand, but there were significant differences between male and female participants. In terms of QoL, female participants reported greater impairments, especially in everyday activities, more pain/physical complaints, and more anxiety/depression. Conclusion: Both specialists and primary care physicians (PCPs) require an understanding of the importance of gender-based differences in ACHD, since, for the majority of ACHD, PCPs are the first contact persons for medical issues.

Background: Although 17.5% of German travelers were business travelers in the years 2011–2013, little is known about their pathologies. Recent publications indicate that infections are the primary health issue in general travelers. Our aim was to investigate whether business travelers from Germany to China also primarily suffer from infections. Methods: From 2011 to 2013, 587 calls for service of German business travelers to China were collected by a medical assistance provider. 482 of these calls were evaluated regarding demographics, reported diseases and conditions and the type of service provided by the medical assistance company. Results: The most common reasons for calls for service were “factors influencing health status and contact with health service” (18.8%), “injury and poisoning” (16.0%) as well as “symptoms, signs, and ill-defined conditions” (13.7%). Most patients asked for “medical advice” (37.8%), referral to “outpatient care” (25.1%) or “inpatient care” (16.6%). “Evacuation and/or repatriation” was required mainly due to “injury and poisoning” (n = 12), “diseases of the circulatory system” (n = 5) or “mental disorders” (n = 3). Conclusion: German business travelers to China are seeking primarily administrative support from a medical assistance provider and are mostly affected by non-infectious diseases. Pre-travel preparation of such travelers need to place more emphasis on non-communicable health risks and prevention.

Una atención primaria eficaz es el pilar básico de cualquier sistema sanitario. A la hora de ofrecer una atención primaria costo-efectiva y eficiente para la población, existen muchas diferencias entre distintos países. En este artículo revisamos la literatura científica y socio-política actual de forma estructurada. Los resultados se complementan con la experiencia de una médico residente española en su último año de formación en medicina familiar y comunitaria, que completó cuatro meses de rotación en el sistema de salud alemán. De esta forma, destacamos algunas de las características de ambos sistemas sanitarios incluyendo los gastos, la relación entre atención primaria y secundaria, la organización en el ámbito académico y la formación de los futuros médicos de atención primaria. Tanto en España como en Alemania la atención primaria desempeña un papel central, ha de superar carencias, y en algunos puntos ambos países pueden aprender el uno del otro.