Das Gesundheitswesen
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Advantages and setbacks of the existing Swiss disease notification system are reviewed. The public takes interest in the notification data output. ⋯ It is intended to lower this number to < 30. Other measures to upgrade the system include annual review and publication of an updated list of notifiable diseases, limitation to an essential core of parameters collected from physicians on initial and follow-up questionnaires, and practical advice on diagnostic and control measures provided for in questionnaires for the infectious disease under query.
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Improvement of Children's Immunisation Coverage: Only the branches for infants, children and adolescents in the public health departments carry out regular data collections concerning the protection given by vaccination of children and adolescents. These immunisation records as well as selected studies show a lack of vaccination and immunisation in these age groups. The analysis of these immunisation records by the public health departments shows specific vaccination deficits which are basic for specific strategies that must be taken to improve the immunisation coverage. ⋯ All these persons together have to develop strategies to improve the immunisation coverage in the short as well as in the long run. The public health department coordinate these strategies, validate coverage data and and evaluate them. The central points of such a concept are here presented.
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Das Gesundheitswesen · Apr 1997
[Reliability of expert assessment in disability evaluation within the scope of disability insurance].
With the introduction of the law on the statutory nursing care insurance in Germany ("Pflegeversicherung") in 1995, new benefits are provided for the most severely disabled people. Provision of benefits is contingent on a standardised examination performed by the medical service of the German statutory health insurance system (MDK). Results of the first study on the inter-rater reliability of this standardised examination are presented in this paper. ⋯ Between the 2 rater groups there was no substantial difference in reliability. However, there was a trend for higher agreement within the group of nurses. Although the overall reliability of the assessment of disability is relatively high in comparison to many other diagnostic procedures (such as x-ray readings), efforts should be made towards further improvement of this standardised examination.