Das Gesundheitswesen
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Das Gesundheitswesen · Oct 2016
Review[The Common Risk Factor Approach - An Integrated Population- and Evidence-Based Approach for Reducing Social Inequalities in Oral Health].
Worldwide, non-communicable diseases including dental caries and periodontal diseases, remain a major public health problem. Moreover, there is a social gradient in health across society that runs from the top to the bottom in a linear, stepwise fashion. Health promoting behaviours become more difficult to sustain further down the social ladder. ⋯ The main implication of the CRFA for oral health policies is to work in partnership with a range of other sectors and disciplines. Oral health issues need to be integrated with recommendations to promote general health. Improvements in oral health and a reduction in oral health inequalities are more likely by working in partnership across sectors and disciplines using strategies that focus upstream on the underlying determinants of oral diseases.
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Das Gesundheitswesen · Feb 2016
Review[Bavarian Centre for Health: Health-related Prevention - Pragmatic and Need-oriented].
The idea of improving population health by means of collective action and prevention of diseases in 1973 resulted in the decision of the Bavarian Parliament to establish a "Bavarian Centre for Health Education". According to its statutes, the aim was to promote the cooperation between institutions and organizations working in the field of public health and health education in Bavaria and to make their efforts effective by information, organization and coordination. ⋯ The renaming of "Bavarian Centre for Health Education" to "Bavarian Centre for Health" represents the change in the underlying concept of health. This paper traces the development until today.
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Das Gesundheitswesen · Jan 2014
Review[Medical tourism and travel - an interdisciplinary approach].
Medical tourism (or medical travel, international patient service, cross-border or global health care) is a new current phenomenon with increasing relevance for the two disciplines of medicine and tourism. Both sides hope to improve their reputation and image, as well as to increase their revenues and rate of employment; furthermore, they want to provide better care and service for patients and tourists: Medical tourism can close the gap of the health care system at home, providing better quality, quicker access and cheaper procedures abroad, also with treatments, not - legally - available in the sending country. For the tourism sector it broadens the variety of tourism products and supply of the host country and combines medical treatments and recovery with an attractive stay in a tourism destination for patients and their companions. But in spite of all popularity of this new type of tourism and treatment, there is quite a lack of theory and academic analysis. ⋯ There is a great need for more scientific research in the field of medical tourism, based on the common knowledge of both disciplines tourism and medicine. First there is neither an internationally agreed definition nor a common methodology for data collection. So the real impact of touristic and medical services both for the source and for the receiving countries is un-known and imprecise. Second the internal processes of the health system have to be adapted to the needs of international patients, e. g., medical fee schedule, billing, language, inter-cultural qualifications of the staff. Moreover the whole service chain has to be taken into account, especially the pre- and post-processes, which mostly start or end abroad. Here quality standards as well as accreditations are current issues. Furthermore, several sociocultural impacts need to be analysed, such as making health care less affordable for local patients and/or moral and ethical concerns about certain treatment methods. Another area concerns the legal questions of risk, liability and malpractice.
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Das Gesundheitswesen · Feb 2012
Review Comparative Study[Variations in the epidemiolgy of adverse events: methodology of the Harvard Medical Practice Design].
The Harvard Medical Practice (HMP) Design is based on a multi-staged retrospective review of inpatient records and is used to assess the frequency of (preventable) adverse events ([P]AE) in large study populations. Up to now HMP studies have been conducted in 9 countries. Results differ largely from 2.9% to 3.7% of patients with AE in the USA up to 16.6% in Australia. ⋯ Further conclusions are hindered by divergences in defining periods of observation, by presenting frequencies as cumulative prevalences, and differences in the reporting of study results. As a consequence future HMP studies should go for complete, consistent and transparent coverage. Further research should concentrate on advancing methods for collecting data on (P)AE.
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Das Gesundheitswesen · Aug 2011
Review Comparative Study[Authorization and reimbursement of orphan drugs in an international comparison].
This paper analyses schemes to promote the authorisation of and reimbursement for orphan drugs. ⋯ On the one hand, the use of special criteria for drug admission, HTA, and reimbursement promotes R&D for orphan drugs. On the other hand, high opportunity costs arise, because huge efforts are made for a minority of patients. A solution for this moral dilemma may be the application of "rule of rescue" or of "no cure, no pay" programmes.