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The Journal for Medical and Health Law (JMG) discusses in an article the support services for family caregivers in Austria. Given the demographic changes, support for these caregivers is becoming increasingly important. Legal tools have been created to facilitate care and ensure the safety of those affected. The Care Reform 2022-2024 includes measures such as care leave and care part-time, as well as family hospice leave and family hospice part-time. There is also financial support, insurance coverage, and a family caregiver bonus. Care policy must continue to be critically reviewed and adjusted to meet the needs of family caregivers. [Extracted from the article]

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Nahezu alle Fachleute sind sich darüber einig, dass das deutsche Gesundheitssystem an seine Grenzen gestoßen ist und umfassend überarbeitet werden muss. Zwar geben Versicherte und Steuerzahler sehr viel Geld für Gesundheitsversorgung aus, erhalten dafür aber nicht immer entsprechende Spitzenleistungen. Und das, obwohl im Gesundheitssystem hochkompetente Leistungserbringer tätig sind und in weiten Bereichen leistungsfähige Einrichtungen und Strukturen bereitstehen. Dem stehen Leistungsbremsen gegenüber, die in verschiedenen Bereichen Dysfunktionalitäten mit teilweise gravierenden Folgen erzeugen: unzureichende Kompromissfähigkeit zwischen Bundes- und Landespolitik, dysfunktionale Sektorierung, Diskrepanzen zwischen Angebot und Bedarf, Wettstreit zwischen Qualität und Ökonomie und über allem steht als Gipfel die mangelhafte Beteiligung der Patienten/Versicherten – sie finanzieren schließlich das Gesundheitssystem! Dieser Artikel geht über die Beschreibungen der aktuellen Situation hinaus und versucht zu analysieren, warum es Deutschland nicht gelingt, die sehr guten inhaltlichen und strukturellen Voraussetzungen in ein modernes, leistungs- und lernfähiges Gesundheitssystem zu übersetzen.

Copyright of Die Dermatologie is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Ethik in der Medizin is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Die Urologie is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Die Urologie is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Health care systems and with them the design of primary care differ considerably in the individual European countries. The aim of this article is to provide a comparative description of the framework conditions of primary care in Germany, Great Britain, Italy, the Netherlands, and Norway. Methods: The comparison is primarily based on the Commonwealth Fund's International Health Care System Profiles from 2020, supplemented by published analyses of individual countries, international surveys and comparisons, and published reports from general practitioners (GPs) about working in other countries. Results: Measured in terms of gross national product, Germany has the highest health care expenditure, the number of hospital beds is by far the highest, and at the same time the length of stay is comparatively long. The immediate framework conditions for primary care differ significantly between the individual countries in many respects, e.g., with regard to the gatekeeper function, the remuneration system, the practice size, and the team composition. International surveys show that the average weekly working hours and the number of patient contacts are by far the highest in Germany. Job satisfaction is lower in Germany and currently in the UK than in the other countries. Conclusion: Our comparison illustrates the partly massive differences in the countries considered. Several indicators suggest that the framework conditions of primary care in Germany are not particularly favorable in an international comparison, despite the overall high health care expenditure. [ABSTRACT FROM AUTHOR]

Copyright of Moderne Staat is the property of Verlag Barbara Budrich GmbH and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Die Unfallchirurgie is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

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„Patientensicherheit ist nur bei uns in Deutschland reduziert worden auf einige wenige, wenn auch wichtige Detailthemen.“ Im Titelinterview mit „Monitor Versorgungsforschung“ spricht sich Dr. Ruth Hecker, Vorsitzende des Aktionsbündnisses Patientensicherheit e.V. (APS) dafür aus, den Begriff neu aufzuladen und eher im Sinne des angelsächsischen „Patient Safety“ zu begreifen. Dazu führt sie den WHO-Aktionsplan „Patientensicherheit – 2021 bis 2030“ an, in dem Patientensicherheit als System zur „Entwicklung und Aufrechterhaltung sektorübergreifender und multinationaler Synergien, Partnerschaften und Solidarität zur Verbesserung der Patientensicherheit und der Qualität der Versorgung“ verstanden wird.

Im Doppel-Titelinterview zum Jahresstart 2024 mit „Monitor Versorgungsforschung“ diskutieren Prof. Josef Hecken, der unparteiische Vorsitzende des Gemeinsamen Bundesausschusses (G-BA), und Univ.-Prof. Dr. med. Wolfgang Hoffmann, der Vorsitzende des Deutschen Netzwerks Versorgungsforschung (DNVF), über die künftige Rolle, den Stellenwert und auch die Stellung der inzwischen erwachsen gewordenen Versorgungsforschung. Der weht, je häufiger ihre Ergebnisse in weitreichende politische Entscheidungsprozesse – wie derzeit in die Bundeskrankenhausreform – einfließen, mehr und mehr Gegenwind entgegen. Damit muss die Versorgungsforschung umgehen lernen.

Mit Blick auf die bevorstehende Landtagswahl in Brandenburg am 22. September 2024 diskutierten im Alten Rathaus zu Potsdam, in Blickweite zum Brandenburger Landtag, im Rahmen des Talkformats „AOK-Forum live“ Politiker:innen über die Herausforderungen und Chancen für die Gesundheitsversorgung des Flächenlandes. Der Titel der Veranstaltung: „Brandenburg hat die Wahl: Für eine Gesundheitsversorgung mit Zukunft“.

Copyright of Arthroskopie is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Zeitschrift für Herz-, Thorax- und Gefaesschirurgie is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: The functionality and treatment capacity of hospitals are decisive components to safeguard the in-hospital treatment of patients in crises and catastrophes. This is shown by the severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) pandemic and the war in Ukraine. The aim of this study is the elicitation of treatment capacities of hospitals in the trauma network of the German Society for Trauma Surgery (DGU) assuming a damage situation with a multitude of trauma patients needing treatment. Material and method: The 622 hospitals in the trauma network were surveyed to elicit the current treatment capacities depending on the principles and standards of treatment. For this purpose, a questionnaire for voluntary participation in the survey was placed online via the Academy of Trauma Surgery (AUC) of the DGU and an electronic platform (SurveyMonkey). The data presented in this article represent an extract of the total data focussed on the issues involved in the study. Results: A total of 252 of the 622 hospitals certified in December 2022 (40%) participated in the survey and 250 datasets could be utilized. Local, regional and supraregional trauma centers were equally represented. Using a tactical abbreviated surgical control (TASC) focussed on survival, the treatment capacities in the individual triage categories could be increased with respect to the scenarios in question. It was also clear that the availability of teams skilled in the surgical treatment of body cavity injuries still represents a challenge. Conclusion: The results of the survey demonstrate the extent to which treatment capacities for the care of injured and wounded patients are currently available in the hospitals of the DGU trauma network and to what extent they can be increased. In this way, due the dynamics a mass casualty incident can initially lead locally and temporarily to a decompensated crisis management. The aim of all efforts and preparations must therefore be to durably strengthen hospitals so that this can be avoided as reliably as possible and to include these considerations in the hospital structural reform. [ABSTRACT FROM AUTHOR]

Background: The war in Ukraine and the severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) pandemic have moved the resilience of the healthcare system in Germany into the focus of a broad discussion. The preparation for such a damage situation is characterized by the relationship between the available treatment capacity and needs which go far beyond the norm. The aim of a resilient healthcare system must be to adequately react to such exceptional situations. Particularly in acute disaster and mass casualty situations, medical standards and an individualized surgical treatment must be maintained for as long as possible. Material, method and objective: The aim of this article is to elucidate the current terminology on medical treatment of patients in disasters from a surgical perspective, to further develop available concepts and possible concepts of crisis management based on three schematically presented scenarios. Furthermore, the general reaction possibilities for mobilization of treatment capacities are described. Results: In order to uniformly collate the quality of medical treatment in a damage situation, it is meaningful to include the stages of individualized treatment, compensated crisis care and decompensated crisis care. Within the framework of a mass casualty situation or a disaster, traumatological and surgical patients are predominant and the aim must be to maintain or restore the stage of a compensated crisis management. Depending on the extent of the damage situation, this can only be realized in a timely manner independent of state boundaries and by a superordinate central management structure. For a comprehensive provision of surgical treatment capacities, the depiction of a continuous overview of the situation with current resources and structural data of the hospitals in the affected region is necessary. Conclusion: The aim of all efforts and preparations must therefore be to durably strengthen hospitals and to train and develop this with respect to coping with a damage situation in disaster medicine. In this respect it is important to establish a consensus on terminology, the type of treatment and the tactical strategic principles of surgical treatment to cope with a disaster or damage situation. [ABSTRACT FROM AUTHOR]

The article examines the efficiency of the Austrian healthcare system in international comparison. There are issues such as shortages of beds and personnel during the pandemic. The Austrian healthcare system is compared to other EU member states. The system falls within the average range but has potential for a more efficient use of resources. Factors such as alcohol consumption, fruit and vegetable consumption, and nicotine consumption influence efficiency. The authors recommend identifying structural inefficiencies and adopting concepts from more efficient countries to improve the Austrian healthcare system. [Extracted from the article]

Background: According to the legal definition healthcare systems and their components (e.g., hospitals) are part of the critical infrastructure of modern industrial nations. During the last few years hospitals increasingly became targets of cyber attacks causing severe impairment of their operability for weeks or even months. According to the German federal strategy for protection of critical infrastructures (KRITIS strategy), hospitals are obligated to take precautions against potential cyber attacks or other IT incidents. Objective: This article describes the process of planning, execution and results of an advanced table-top exercise which took place in a university hospital in Germany and simulated the first 3 days after a cyber attack causing a total failure of highly critical IT systems. Material and methods: During a first stage lasting about 8 months IT-dependent processes within the clinical routine were identified and analyzed. Then paper-based and off-line back-up processes and workarounds were developed and department-specific emergency plans were defined. Finally, selected central facilities such as pharmacy, laboratory, radiology, IT and the hospitals crisis management team took part in the actual disaster exercise. Afterwards the participants were asked to evaluate the exercise and the hospitals cyber security using a questionnaire. On this basis the authors visualized the hospitalʼs resilience against cyber incidents and defined short-term, medium-term and long-term needs for action. Results: Of the participants 85% assessed the exercise as beneficial, 97% indicated that they received adequate support during the preparations and 75% had received sufficient information; however, only 34% had the opinion that the hospitalʼs and their own preparedness against critical IT failures were sufficient. Before the exercise took place, IT-specific emergency plans were present only in 1.7% of the hospital facilities but after the exercise in 86.7% of the clinical and technical departments. The highest resilience against cyber attacks was not surprisingly reported by facilities that still work routinely with paper-based or off-line processes, the IT department showed the lowest resilience as it would come to a complete shutdown in cases of a total IT failure. Conclusion: The authors concluded that the planning phase is the most important stage of developing the whole exercise, giving the best opportunity for working out fallback levels and workarounds and through this strengthen the hospitals resilience against cyber attacks and comparable incidents. A meticulous preparedness can minimize the severe effects a total IT failure can cause on patient care, staff and the hospital as a whole. [ABSTRACT FROM AUTHOR]

Refugees with mental disorders are confronted with access barriers to the psychiatric and psychotherapeutic care system. In order to counter these barriers, a model project to support the health care and integration of mentally distressed refugees was established in the district of Konstanz (coordinated psychotherapeutic treatment involving trained peer support; KOBEG) and evaluated in an initial 3‑year model phase. A coordination center refers the patients to local certified psychotherapists. Language and culturally sensitive trained mentors (peers) support and accompany the refugees during the therapy. The utilization of the refered therapy and the experiences of the participating therapists serve as indicators for the effectiveness of the peer-supported therapy referral. The effectiveness of therapeutic measures and support by trained peers was evaluated on the basis of the psychological symptom burden (symptom checklist 27) and functional impairment (work and social adjustment scale) before and after an average of 10 months of project participation. The study focuses on the refugees (use of services and mental distress) and the psychotherapists (reported experiences). Initial results showed an above-average stress level among the refugees at the time of the initial interview, a high participation rate and a low drop-out rate. The follow-up survey showed significant improvements in terms of psychological symptom burden as well as functional impairments. The (qualitative) survey among psychotherapists underlines the effectiveness of KOBEG, 93% of the therapists intend to continue working with refugees within the framework of the project. [ABSTRACT FROM AUTHOR]

Copyright of Bundesgesundheitsblatt - Gesundheitsforschung - Gesundheitsschutz is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Bundesgesundheitsblatt - Gesundheitsforschung - Gesundheitsschutz is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: A simulation game is a valuable method for conveying teaching content in a practical way. The aim was to design a teaching module for medical sociology on the subject of "The German health care system" which would convey the contents and connections to the students in a practical way using a simulation game. Project description: In addition to the development of scenarios for the simulation game, role cards for various institutions of the health care system were also produced as a result. The students were given the opportunity beforehand to work on theoretical content regarding the German health care system online (the "flipped classroom method"). In the 90-minute face-to-face event the simulation game was played, followed by a feedback session. The initial impressions of the students were collected. Results: In the 2022 summer semester, a total of 185 students from the 4th pre-clinical semester took part in the seminar. The students were divided into twelve seminars. One scenario was worked on per seminar. The simulation game contributed to a better understanding of the health care system. The students were generally very satisfied with this type of knowledge transfer and thought that this method might well be integrated into teaching in the future. Conclusion: Communicating the health care system through a simulation game is evidently suitable for explaining clearly complex issues and presenting the various interests of the individual institutions. In addition, a simulation game stimulates critical debate and can contribute to imparting theoretical content in teaching medical sociology in a practical way. [ABSTRACT FROM AUTHOR]

Mit Reizworten für die Versorgungsforschung wie „Klein-Klein“ oder „keine großen Würfe“ untermauerte Professor Josef Hecken, der unparteiische Vorsitzende des Gemeinsamen Bundesausschusses und Vorsitzender des Innovationsausschusses, seine Anregungen zur Weiterentwicklung des Innovationsfonds, die er im Titelinterview der MVF-Ausgabe (06/22) und in seinem Vortrag im ersten Teil des MVF-Fachkongresses „Priorisierungskatalog Versorgungsforschung“ kundtat. Der neue Vorstandsvorsitzende des DNVF, Prof. Dr. Wolfgang Hoffmann, und Prof. Dr. Bertram Häussler, der Vorsitzende der Geschäftsführung des Berliner IGES Instituts, taten sich als intellektuelle Sparringspartner zusammen, um im gemeinsamen Titelinterview mit „Monitor Versorgungsforschung“ Heckens Forderungen auf Herz und Nieren zu prüfen.

Copyright of Moderne Staat is the property of Verlag Barbara Budrich GmbH and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Die Unfallchirurgie is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Bundesgesundheitsblatt - Gesundheitsforschung - Gesundheitsschutz is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Gefaesschirurgie is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Beim Hybrid-Kongress mit dem Titel „Das Ergebnis zählt! Impulse für mehr Outcome-Orientierung und Patientennutzen im Gesundheitssystem“ im Langenbeck-Virchow-Haus in Berlin, gab nach der Begrüßung durch die beiden Veranstalter – Prof. Dr. Alexander Schachtrupp, Geschäftsführer der B. Braun-Stiftung, und Dr. h.c. Helmut Hildebrandt, Vorstandsvorsitzender der OptiMedis AG, – Prof. Dr. Reinhold Busse (TU Berlin), den wichtigsten Impuls. Sein Vortrag mit dem Titel „Von einem ,volume’- hin zu einem ,value’-basierten Gesundheitssystem“ machte den Beginn eines vierteiligen parallelen Workshop-Erlebnisses, das in der Podiumsdiskussion „Von volume zu value“ gipfelte, aber dann doch noch vom Finale einer gemeinsamen Erarbeitung der vorbereiteten Diskussionsgrundlage eines „Berliner Aufrufs“ für „mehr Outcome-Orientierung und Patientennutzen im Gesundheitssystem“ übertrumpft wurde.

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In einem Panel der diesjährigen Handelsblatt-Tagung „Pharma“ diskutierten Dr. Dorothee Brakmann, Leiterin Marketing- und Sales-Strategie im Bereich Onkologie/Hämatologie sowie Mitglied der deutschen Geschäftsleitung bei Janssen, und Dr. Stefan Knupfer, Stellvertretender Vorsitzender des Vorstandes und Bevollmächtigter des Vorstandes der AOK PLUS, Aspekte der „Value Based Healthcare“ – aus Sicht der Pharmaindustrie und aus Sicht einer großen Krankenkasse. Die inhaltlichen Übereinstimmungen vieler Aussagen waren derart frappant, dass „Monitor Versorgungsforschung“ die beiden bat, das Thema mit Dr. Dr. Klaus Piwernetz, einem der Autoren des Fachbuchs „Strategiewechsel jetzt!“, in einem gemeinsamen Interview nicht nur zu vertiefen, sondern auch mögliche Ansätze zu erarbeiten.

Kommentar von Dr. Dr. Klaus Piwernetz (medimaxx health management GmbH, München ) und Univ.-Prof. Dr. Dr. h.c. Edmund A. M. Neugebauer (Präsident der Medizinischen Hochschule Brandenburg).

Copyright of Ethik in der Medizin is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)