Abgewickelte Gesundheitsinstitutionen als (Quasi-)Innovationen

2020 ◽  
Vol 69 (6-7) ◽  
pp. 467-487
Author(s):  
Marlene Haupt ◽  
Christian Römhild ◽  
Charlotte Fechter
Keyword(s):  
Health Care ◽  
Disease Management ◽  
Health Care System ◽  
Profit Maximization ◽  
Well Being ◽  
Consumer Sovereignty ◽  
Prävention Und Gesundheitsförderung ◽  
German Healthcare System ◽  
Prevention And Health Promotion ◽  
Care System

Zusammenfassung Zum Abbau von Ineffizienzen im deutschen Gesundheitssystem wurden Institutionen wieder eingeführt, welche in ähnlicher Form bereits im Gesundheitssystem der DDR existiert haben. Drei Beispiele wurden ausgewählt: Die heutigen Medizinischen Versorgungszentren ähneln den Polikliniken der DDR, die Disease-Management-Programme sind mit der Dispensaire-Versorgung der DDR vergleichbar und die Bereiche Prävention und Gesundheitsförderung gab es in der DDR in Form der Gesundheitserziehung. Diese heutigen Institutionen werden dahingehend untersucht, inwiefern sie dazu beitragen, Ineffizienzen abzubauen und vor dem Hintergrund der Ökonomisierung im deutschen Gesundheitswesen zur Steigerung des Patientenwohls beitragen. Dabei wird betrachtet, wie sie hinsichtlich der Dimensionen Gewinnmaximierung, Wettbewerb, Preisbildung und Kundensouveränität wirken. Abstract: Liquidated Healthcare Institutions as (Quasi-)innovations To reduce inefficiencies in the German health care system, institutions have been reintroduced that have already existed in a similar form in the health care system of the GDR. Three examples have been selected: Today’s medical care centers (MVZ) are similar to the GDR’s so called „Polikliniken“, the disease management programs are comparable to the GDR’s dispensaire care, and the prevention and health promotion today were called health education („Gesundheitserziehung“) in the GDR. These institutions are being examined to what extent they serve to reduce inefficiencies and, regarding the economization in the German healthcare system, contribute to increasing patient well-being. In detail, this analysis uses the dimensions of profit maximization, competition, pricing and consumer sovereignty.

scholarly journals Potential Benefits and Risks Resulting From the Introduction of Health Apps and Wearables Into the German Statutory Health Care System: Scoping Review (Preprint)

2019 ◽  
Author(s):  
Alexandra Heidel ◽  
Christian Hagist
Keyword(s):  
Health Care ◽  
Disease Management ◽  
Health Care System ◽  
Data Privacy ◽  
Digital Health ◽  
Treatment Quality ◽  
Exclusion Criterion ◽  
Health Apps ◽  
Risks And Benefits ◽  
Care System

BACKGROUND Germany is the first country worldwide that has introduced a digital care act as an incentive system to enhance the use of digital health devices, namely health apps and wearables, among its population. The act allows physicians to prescribe statutory financed and previously certified health apps and wearables to patients. This initiative has the potential to improve treatment quality through better disease management and monitoring. OBJECTIVE The aim of this paper was to outline the key concepts related to the potential risks and benefits discussed in the current literature about health apps and wearables. Furthermore, this study aimed to answer the research question: Which risks and benefits may result from the implementation of the digital care act in Germany? METHODS We conducted the scoping study by searching the databases PubMed, Google Scholar, and JMIR using the keywords health apps and wearables. We discussed 55 of 136 identified articles published in the English language from 2015 to March 2019 in this paper using a qualitative thematic analysis approach. RESULTS We identified four key themes within the articles: Effectivity of health apps and wearables to improve health; users of health apps and wearables; the potential of bring-your-own, self-tracked data; and concerns and data privacy risks. Within these themes, we identified three main stages of benefits for the German health care system: Usage of health apps and wearables; continuing to use health apps and wearables; and sharing bring-your-own; self-tracked data with different agents in the health care sector. CONCLUSIONS The digital care act could lead to an improvement in treatment quality through better patient monitoring, disease management, personalized therapy, and better health education. However, physicians should play an active role in recommending and supervising health app use to reach digital-illiterate or health-illiterate people. Age must not be an exclusion criterion. Yet, concerns about data privacy and security are very strong in Germany. Transparency about data processing should be provided at all times for continuing success of the digital care act in Germany.

scholarly journals Rural Michigan Farmers’ Health Concerns and Experiences: A Focus Group Study

2021 ◽  
Vol 12 ◽  
pp. 215013272110535
Author(s):  
Nathan Wright ◽  
Marylee Scherdt ◽  
Michelle L. Aebersold ◽  
Marjorie C. McCullagh ◽  
Barbara R. Medvec ◽  
...  
Keyword(s):  
Health Care ◽  
Focus Groups ◽  
Health Care System ◽  
Health Care Services ◽  
Well Being ◽  
The United States ◽  
Full Time ◽  
Rural Residents ◽  
Care Services ◽  
Care System

Objectives: Rural residents comprise approximately 15% of the United States population. They face challenges in accessing and using a health care system that is not structured to meet their unique needs. It is important to understand rural residents’ perceptions of health and experiences interacting with the health care system to identify gaps in care. Methods: Our team conducted focus groups with members of the Michigan Farm Bureau during their 2019 Annual Meeting. Topics explored included resources to manage health, barriers to virtual health care services, and desired changes to localized healthcare delivery. Surveys were used to capture demographic and internet access information. Conclusion: Analysis included data from 2 focus groups (n = 14). Participants represented a wide age range and a variety of Michigan counties. The majority were full-time farm owners with most—93% (n = 13)—reporting they had access to the internet in their homes and 86% (n = 12) reporting that their cellphones had internet capabilities. Participants identified challenges and opportunities in 4 categories: formal health care; health and well-being supports; health insurance experiences; and virtual health care. Conclusion: The findings from this study provide a useful framework for developing interventions to address the specific needs of rural farming residents. Despite the expressed challenges in access and use of health care services and resources, participants remained hopeful that innovative approaches, such as virtual health platforms, can address existing gaps in care. The study findings should inform the design and evaluation of interventions to address rural health disparities.

scholarly journals Towards Excellence in Asthma Management: Final Report of an Eight-Year Program Aimed at Reducing Care Gaps in Asthma Management in Quebec

2008 ◽  
Vol 15 (6) ◽  
pp. 302-310 ◽  
Author(s):  
Louis-Philippe Boulet ◽  
Eileen Dorval ◽  
Manon Labrecque ◽  
Michel Turgeon ◽  
Terrence Montague ◽  
...  
Keyword(s):  
Health Care ◽  
Disease Management ◽  
Health Care System ◽  
Inhaled Corticosteroids ◽  
Asthma Management ◽  
Final Report ◽  
Asthma Care ◽  
Treatment Needs ◽  
Care Gaps ◽  
Care System

BACKGROUND AND OBJECTIVES: Asthma care in Canada and around the world persistently falls short of optimal treatment. To optimize care, a systematic approach to identifying such shortfalls or ‘care gaps’, in which all stakeholders of the health care system (including patients) are involved, was proposed.METHODS: Several projects of a multipartner, multidisciplinary disease management program, developed to optimize asthma care in Quebec, was conducted in a period of eight years. First, two population maps were produced to identify regional variations in asthma-related morbidity and to prioritize interventions for improving treatment. Second, current care was evaluated in a physician-patient cohort, confirming the many care gaps in asthma management. Third, two series of peer-reviewed outcome studies, targeting high-risk populations and specific asthma care gaps, were conducted. Finally, a process to integrate the best interventions into the health care system and an agenda for further research on optimal asthma management were proposed.RESULTS: Key observations from these studies included the identification of specific patterns of noncompliance in using inhaled corticosteroids, the failure of increased access to spirometry in asthma education centres to increase the number of education referrals, the transient improvement in educational abilities of nurses involved with an asthma hotline telephone service, and the beneficial effects of practice tools aimed at facilitating the assessment of asthma control and treatment needs by general practitioners.CONCLUSIONS: Disease management programs such as Towards Excellence in Asthma Management can provide valuable information on optimal strategies for improving treatment of asthma and other chronic diseases by identifying care gaps, improving guidelines implementation and optimizing care.

scholarly journals Integrating staff well-being into the Primary Health Care system: a case study in post-conflict Kosovo

2015 ◽  
Vol 9 (1) ◽  
Author(s):  
Albertien van der Veen ◽  
Tineke van Pietersom ◽  
Barbara Lopes Cardozo ◽  
Feride Rushiti ◽  
Genc Ymerhalili ◽  
...  
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Health Care System ◽  
Well Being ◽  
Primary Health Care System ◽  
System A ◽  
Post Conflict ◽  
Primary Health ◽  
Care System

scholarly journals Governance of health care systems in an ageing world – the case of Australia

2015 ◽  
Vol 13 (1) ◽  
pp. 729-735 ◽  
Author(s):  
Ewa Banasik
Keyword(s):  
Health Care ◽  
Health Care System ◽  
Health Care Systems ◽  
Well Being ◽  
World Health ◽  
The Political ◽  
Central Component ◽  
Australian Health ◽  
Care Systems ◽  
Care System

The main argument of this paper is that because the burden of diseases increases with age, a greater numbers of older individuals will increase the demand for health care, and whether this demand will be met very much depends on how health care systems are governed. This task is particularly complex in jurisdictions with multi-layer governing systems such as the Australian health care system. Governance, described in terms of stewardship of the well-being of the population and as a central component for building effective health care systems, is increasingly considered to be very important for a well performing health care system (World Health Organization, 2000, 2007). Governance is, however, the least studied function in a health care system (Alliance 2009). Furthermore, the limited governance frameworks and assessments that have been developed thus far fail to include the political context in which health care systems operate (Baez-Camargo and Jacobs, 2011). This paper intends to fill this knowledge gap by exploring the political dynamics of the Australian health care system’s governance and its accountability. Furthering the discourse on governance is especially important in times when health care systems are confronted with the challenges of ageing populations

scholarly journals Whither economic evaluation in the case of COVID-19: What can the field of mental health economics contribute within the Australian context?

2020 ◽  
Vol 54 (12) ◽  
pp. 1157-1161
Author(s):  
Cathrine Mihalopoulos ◽  
Mary Lou Chatterton ◽  
Lidia Engel ◽  
Long Khanh-Dao Le ◽  
Yong Yi Lee
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Decision Making ◽  
Health Care System ◽  
Disease Outbreaks ◽  
Well Being ◽  
Australian Health ◽  
Life Years ◽  
Mental Health Economics ◽  
Care System

COVID-19 has resulted in broad impacts on the economy and aspects of daily life including our collective mental health and well-being. The Australian health care system already faces limitations in its ability to treat people with mental health diagnoses. Australia has responded to the COVID-19 outbreak by, among other initiatives, providing reimbursement for telehealth services. However, it is unclear if these measures will be enough to manage the psychological distress, depression, anxiety and post-traumatic distress shown to accompany infectious disease outbreaks and economic shocks. Decision making has focused on the physical health ramifications of COVID-19, the avoidance of over-burdening the health care system and saving lives. We propose an alternative framework for decision making that combines life years saved with impacts on quality of life. A framework that simultaneously includes mental health and broader economic impacts into a single decision-making process would facilitate transparent and accountable decision making that can improve the overall welfare of Australian society as we continue to address the considerable challenges that the COVID-19 pandemic is creating.

scholarly journals The “little big things”: A qualitative study of ovarian cancer survivors and their experiences with the health care system.

2016 ◽  
Vol 34 (3_suppl) ◽  
pp. 252-252
Author(s):  
Ana Isabel Tergas ◽  
Ana Angarita ◽  
Angelica Cristello ◽  
Melissa Lippitt ◽  
Amanda Nickles Fader ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Health Care ◽  
Cancer Survivors ◽  
Health Care System ◽  
Well Being ◽  
Care Team ◽  
Cancer Center ◽  
Team Approach ◽  
Efficient Delivery ◽  
Care System

252 Background: Navigating a complex and ever-changing health care system can be stressful and detrimental to psychosocial well-being for patients with serious illness. This study explored women’s experiences navigating the health care system during treatment of ovarian cancer. Methods: Focus groups moderated by trained investigators were conducted with ovarian cancer survivors at an academic cancer center. Personal experiences with cancer treatment, provider relationships, barriers to care, and the health care system were explored. Sessions were audiotaped, transcribed, and coded using grounded theory. Subsequent one-on-one interviews were conducted to further evaluate common themes. Results: Sixteen ovarian cancer survivors with a median age of 59 years participated in the focus group study.Provider consistency, personal touch, and patient advocacy positively impacted care experience.Treatment with a known provider, who was well acquainted with the individual’s medical history, was deemed an invaluable aspect of care. Negative experiences that burdened patients, referred to as the “Little Big Things”, included systems-based challenges: scheduling, wait times, pharmacy, transportation, parking, financial, insurance and discharge. Consistency, a “care-team” approach, effective communication, and efficient connection to resources were suggested as ways to improve patients’ experiences. Conclusions: Systems-based challenges were perceived as burdens to ovarian cancer survivors. The role of a consistent, accessible care team and efficient delivery of resources in the care of women with ovarian cancer should be explored further.

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