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Langenberger B, Baier N, Hanke FC, Fahrentholz J, Gorny C, Sehlen S, Reber KC, Liersch S, Radomski R, Haftenberger J, Heppner HJ, Busse R, Vogt V. The detection and prevention of adverse drug events in nursing home and home care patients: Study protocol of a quasi-experimental study. Nurs Open 2021; 9:1477-1485. [PMID: 34859616 PMCID: PMC8859083 DOI: 10.1002/nop2.1146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Revised: 10/21/2021] [Accepted: 11/16/2021] [Indexed: 11/11/2022] Open
Abstract
AIM To estimate the cost-effectiveness of an intervention facilitating the early detection of adverse drug events through the means of health professional training and the application of a digital screening tool. DESIGN Multi-centred non-randomized controlled trial from August 2018 to March 2020 including 65 nursing homes or home care providers. METHODS We aim to estimate the effect of the intervention on the rate of adverse drug events as primary outcome through a quasi-experimental empirical study design. As secondary outcomes, we use hospital admissions and falls. All outcomes will be measured on patient-month level. Once the causal effect of the intervention is estimated, cost-effectiveness will be calculated. For cost-effectiveness, we include all patient costs observed by the German statutory health insurance. RESULTS The results of this study will inform about the cost-effectiveness of the optimized drug supply intervention and provide evidence for potential reimbursement within the German statutory health insurance system.
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Affiliation(s)
- Benedikt Langenberger
- Department of Health Care Management, Technische Universität Berlin, Berlin, Germany
| | - Natalie Baier
- Department of Global Health Economics, Kiel Institute for the World Economy, Kiel, Germany
| | | | - Jacqueline Fahrentholz
- Long-term Care Services Management, AOK Nordost - Die Gesundheitskasse, Potsdam, Germany
| | - Christina Gorny
- Long-term Care Services Management, AOK Nordost - Die Gesundheitskasse, Potsdam, Germany
| | - Stephanie Sehlen
- Health Services Management, AOK Nordost - Die Gesundheitskasse, Potsdam, Germany
| | | | - Sebastian Liersch
- Health Services Management, AOK Nordost - Die Gesundheitskasse, Potsdam, Germany
| | - Ralf Radomski
- Department of Innovative Health Services, VIACTIV Krankenkasse, Bochum, Germany
| | - Jens Haftenberger
- Department of Contract Management, IKK Brandenburg und Berlin, Potsdam, Germany
| | - Hans Jürgen Heppner
- Department of Geriatrics, Universität Witten/Herdecke, Witten, Germany.,Clinic of Geriatrics, Helios Klinikum Schwelm, Schwelm, Germany
| | - Reinhard Busse
- Department of Health Care Management, Technische Universität Berlin, Berlin, Germany
| | - Verena Vogt
- Department of Health Care Management, Technische Universität Berlin, Berlin, Germany
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Roth K, Baier N, Busse R, Henschke C. Arbeitszufriedenheit und Burnout in der präklinischen Notfallversorgung. Notf Rett Med 2021. [DOI: 10.1007/s10049-021-00881-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Zusammenfassung
Hintergrund
Einsätze unter unterschiedlichen und erschwerten Bedingungen können Burnout-Werte für Mitarbeiter im Rettungsdienst erhöhen. Zufriedenheit am Arbeitsplatz wird als Faktor gesehen, der im Zusammenhang mit erhöhten Burnout-Werten steht.
Ziel der Arbeit
Ziele waren die Untersuchung der Arbeitszufriedenheit und des Burnout-Syndroms bei nichtärztlichen Mitarbeitern im Rettungsdienst sowie die Analyse des Zusammenhangs zwischen hohen Burnout-Werten und Faktoren der Zufriedenheit.
Material und Methoden
Mittels eines Onlinefragebogens wurden Mitarbeiter zu Arbeitszufriedenheit und Aspekten, die das Erleben des Burnouts messen, befragt. Einer deskriptiven Auswertung folgte eine Zusammenhangsanalyse zwischen Arbeitszufriedenheit und einzelnen Burnout-Dimensionen (emotionale Erschöpfung [EE] und Depersonalisierung [DP]) mittels binärer logistischer Regressionen.
Ergebnisse
In die Analyse wurden 1082 Fragebögen einbezogen. Die Majorität der Studienteilnehmer war männlich, jünger als 40 Jahre und in Vollzeit tätig. In den Dimensionen EE und DP wiesen 26,2 % bzw. 40,0 % der Befragten hohe Burnout-Werte auf. Zwischen 17,7 % und 75,9 % der Befragten waren mit einzelnen Aspekten des Arbeitsplatzes unzufrieden (z. B. Flexibilität des Dienstplans, Fortbildungsurlaub, Gehalt, beruflicher Status). Die Zufriedenheit mit dem beruflichen Status und der Berufswahl ist signifikant mit niedrigeren Burnout-Werten in den Dimensionen EE und DP assoziiert.
Diskussion
Die Ergebnisse zeigen die Notwendigkeit einer Verbesserung der Arbeitsbedingungen. Die negative Assoziation zwischen der Zufriedenheit mit dem beruflichen Status sowie der Berufswahl und Burnout-Werten sollte die Diskussion über Strategien zur Anerkennung der Berufe aus gesellschaftlicher Sicht noch stärker anstoßen.
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Fischer-Rosinský A, Slagman A, King R, Reinhold T, Schenk L, Greiner F, von Stillfried D, Zimmermann G, Lüpkes C, Günster C, Baier N, Henschke C, Roll S, Keil T, Möckel M. INDEED-Utilization and Cross-Sectoral Patterns of Care for Patients Admitted to Emergency Departments in Germany: Rationale and Study Design. Front Public Health 2021; 9:616857. [PMID: 33937166 PMCID: PMC8085405 DOI: 10.3389/fpubh.2021.616857] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Accepted: 03/18/2021] [Indexed: 12/04/2022] Open
Abstract
Introduction: The crowding of emergency departments (ED) has been a growing problem for years, putting the care of critically ill patients increasingly at risk. The INDEED project's overall aim is to get a better understanding of ED utilization and to evaluate corresponding primary health care use patterns before and after an ED visit while driving forward processes and methods of cross-sectoral data merging. We aim to identify adequate utilization of EDs and potentially avoidable patient contacts as well as subgroups and clusters of patients with similar care profiles. Methods: INDEED is a joint endeavor bringing together research institutions and hospitals with EDs in Germany. It is headed by the Charité–Universitätsmedizin Berlin, collaborating with Otto von Guericke University Magdeburg, Technische Universität Berlin, the Central Research Institute of Ambulatory/Outpatient Health Care in Germany (Zi), and the AOK Research Institute as part of the Federal Association of AOK, as well as experts in the technological, legal, and regulatory aspects of medical research (TMF). The Institute for Information Technology (OFFIS) was involved as the trusted third party of the project. INDEED is a retrospective study of approximately 400,000 adult patients with statutory health insurance who visited the ED of one of 16 participating hospitals in 2016. The routine hospital data contain information about treatment in the ED and, if applicable, about the subsequent hospital stay. After merging the patients' hospital data from 2016 with their outpatient billing data from 2 years before to 1 year after the ED visit (years 2014–2017), a harmonized dataset will be generated for data analyses. Due to the complex data protection challenges involved, first results will be available in 2021. Discussion: INDEED will provide knowledge on extracting and harmonizing large scale data from varying routine ED and hospital information systems in Germany. Merging these data with the corresponding outpatient care data of patients offers the opportunity to characterize the patient's treatment in outpatient care before and after ED use. With this knowledge, appropriate interventions may be developed to ensure adequate patient care and to avoid adverse events such as ED crowding.
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Affiliation(s)
- Antje Fischer-Rosinský
- Emergency and Acute Medicine (Charité Virchow Klinikum-CVK, Charite Campus Mitte-CCM), Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Anna Slagman
- Emergency and Acute Medicine (Charité Virchow Klinikum-CVK, Charite Campus Mitte-CCM), Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Ryan King
- Institute of Social Medicine, Epidemiology and Health Economics, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Thomas Reinhold
- Institute of Social Medicine, Epidemiology and Health Economics, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Liane Schenk
- Institute of Medical Sociology and Rehabilitation Science, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Felix Greiner
- Department of Trauma Surgery, Otto von Guericke University Magdeburg, Magdeburg, Germany
| | | | - Grit Zimmermann
- TMF-Technology, Methods, and Infrastructure for Networked Medical Research, Berlin, Germany
| | | | - Christian Günster
- Allgemeine Ortskrankenkasse (AOK) Research Institute-Wissenschaftliches Institut der AOK (WIdO), Berlin, Germany
| | - Natalie Baier
- Kiel Institute for World Economy, Kiel, Germany.,Department of Health Care Management, Berlin University of Technology, Berlin, Germany
| | - Cornelia Henschke
- Department of Health Care Management, Berlin University of Technology, Berlin, Germany.,Faculty of Health Sciences Brandenburg, Brandenburg University of Technology Cottbus-Senftenberg, Cottbus, Germany
| | - Stephanie Roll
- Institute of Social Medicine, Epidemiology and Health Economics, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Thomas Keil
- Institute of Social Medicine, Epidemiology and Health Economics, Charité-Universitätsmedizin Berlin, Berlin, Germany.,Institute for Clinical Epidemiology and Biometry, University of Würzburg, Würzburg, Germany.,State Institute of Health, Bavarian Health and Food Safety Authority, Bad Kissingen, Germany
| | - Martin Möckel
- Emergency and Acute Medicine (Charité Virchow Klinikum-CVK, Charite Campus Mitte-CCM), Charité-Universitätsmedizin Berlin, Berlin, Germany
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Roth K, Baier N, Felgner S, Busse R, Henschke C. [Association between Safety Culture and Risk of Burnout: A Survey of Non-Medical Rescue Workers]. Gesundheitswesen 2020; 84:199-207. [PMID: 33302321 DOI: 10.1055/a-1276-0817] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
BACKGROUND Stressors such as safety culture in organizations that increase the risk of burnout have been studied in nursing and inpatient care settings. However, investigations in the setting of preclinical emergency medical services (EMS) are still limited. The study aims at (1) investigating burnout in health care workers in preclinical EMS and their perceived safety culture, and (2) analyzing the association between the two. METHODS Using the Maslach Burnout Inventory (MBI) and the Emergency Medical Services - Safety Attitudes Questionnaire (EMS-SAQ), an online survey was conducted with non-medical health care workers in preclinical EMS. Descriptive analyses were performed using frequencies, mean values, percentages and the Pearson correlation coefficient. A logistic regression model was used to determine the relationship between safety culture and the risk of burnout. RESULTS A total of 1,101 questionnaires was considered for analysis. Most of the participants were male (86.2%) and younger than 40 years (73.2%). A high risk of burnout for participants was found for the dimensions of emotional exhaustion and depersonalization (EE 26.3% and DP 40.2%). In the context of measuring safety culture, especially management, working conditions, and safety climate were negatively perceived by the participants. Furthermore, high stress recognition (EE: OR=3.317, p<0.01; DP: OR=1.910, p<0.01), negative job satisfaction (EE: OR=0.297, p<0.01; DP: OR=0.576, p<0.01) and negatively perceived working conditions (EE: OR 0.598, p<0.05; DP: 0.937, p<0.05) were significantly associated with a high risk of burnout. CONCLUSION This is the first large scale study investigating burnout among non-medical health care workers in preclinical EMS and their perceived safety culture in Germany as well as the association between the two. The results show the necessity to focus on perceived dimensions of safety culture in organizations, to develop measures reducing stress and improve job satisfaction and working conditions. In the context of increasing skills shortage, this is especially relevant with regard to the challenges of patient safety and quality of outcomes in care.
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Affiliation(s)
- Karsten Roth
- Fachgebiet Management im Gesundheitswesen, Technische Universität Berlin, Berlin.,Projektmanagement, Hans Peter Esser GmbH, Kürten
| | - Natalie Baier
- Fachgebiet Management im Gesundheitswesen, Technische Universität Berlin, Berlin.,Kiel Institut für Weltwirtschaft, Kiel
| | - Susanne Felgner
- Fachgebiet Management im Gesundheitswesen, Technische Universität Berlin, Berlin
| | - Reinhard Busse
- Fachgebiet Management im Gesundheitswesen, Technische Universität Berlin, Berlin
| | - Cornelia Henschke
- Fachgebiet Management im Gesundheitswesen, Technische Universität Berlin, Berlin.,Fakultät für Gesundheitswissenschaften Brandenburg, Brandenburgische Technische Universität Cottbus - Senftenberg
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Baier N, Pieper J, Schweikart J, Busse R, Vogt V. Capturing modelled and perceived spatial access to ambulatory health care services in rural and urban areas in Germany. Soc Sci Med 2020; 265:113328. [PMID: 32916432 DOI: 10.1016/j.socscimed.2020.113328] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 07/22/2020] [Accepted: 08/20/2020] [Indexed: 11/29/2022]
Abstract
Studies on social and regional inequalities in access to health care often use spatial indicators such as physician density to measure access to health care. However, the concept of access is more complex, comprising, among others, patient perceptions. In this study, we evaluate the association between different spatial measures of access (i.e. physician density, distance to the nearest provider, and measures based on floating catchment area methods) and measures of perceived spatial access to ambulatory health care in rural and urban areas in Germany. Using correlation and regression analysis, we found that the significance and strength of the relation between perceived and modelled spatial access depends on the type of area and the physician group. The distance to the nearest physician is associated with perceived spatial access to GPs only in rural areas but not in urban areas. More sophisticated measures of spatial access seem not to explain perceived access better than the simpler indicators.
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Affiliation(s)
- Natalie Baier
- Department of Health Care Management, Technische Universität Berlin, Straße des 17. Juni 135, 10623, Berlin, Germany; Berlin Centre of Health Economics Research (BerlinHECOR), Straße des 17. Juni 135, 10623, Berlin, Germany; Kiel Institute for the World Economy, Kiellinie 66, 24105, Kiel, Germany.
| | - Jonas Pieper
- Berlin Centre of Health Economics Research (BerlinHECOR), Straße des 17. Juni 135, 10623, Berlin, Germany; Department III, Civil Engineering and Geoinformatics, Beuth University of Applied Sciences, Luxemburg Straße 9, 13353, Berlin, Germany
| | - Jürgen Schweikart
- Berlin Centre of Health Economics Research (BerlinHECOR), Straße des 17. Juni 135, 10623, Berlin, Germany; Department III, Civil Engineering and Geoinformatics, Beuth University of Applied Sciences, Luxemburg Straße 9, 13353, Berlin, Germany
| | - Reinhard Busse
- Department of Health Care Management, Technische Universität Berlin, Straße des 17. Juni 135, 10623, Berlin, Germany; Berlin Centre of Health Economics Research (BerlinHECOR), Straße des 17. Juni 135, 10623, Berlin, Germany
| | - Verena Vogt
- Department of Health Care Management, Technische Universität Berlin, Straße des 17. Juni 135, 10623, Berlin, Germany; Berlin Centre of Health Economics Research (BerlinHECOR), Straße des 17. Juni 135, 10623, Berlin, Germany
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Baier N, Sax LM, Sundmacher L. Reply to the comment on "Trends in rates of orthopedic surgery in Germany: the good, the bad, the ugly.". Eur J Health Econ 2020; 21:813-814. [PMID: 31960182 PMCID: PMC7366601 DOI: 10.1007/s10198-019-01154-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Affiliation(s)
- Natalie Baier
- Department of Health Care Management, Berlin Centre for Health Economics Research (BerlinHECOR), Technische Universität Berlin, Str. des 17. Juni 135, 10623, Berlin, Germany.
| | - Lisa-Marie Sax
- City University London, Northampton Square, Clerkenwell, London, EC1V 0HB, UK
| | - Leonie Sundmacher
- Department of Health Services Management, Ludwig-Maximilians-Universität München, Schackstraße 4, 80539, Munich, Germany
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Berger E, Fuchs S, Baier N, Peters H, Busse R. Benefits of non-drug interventions for people with suicidal crises in unipolar depression. Eur J Public Health 2019. [DOI: 10.1093/eurpub/ckz186.591] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Depression is one of the most common and serious diseases worldwide: According to WHO, more than 300 million people worldwide were affected by depression in 2015. In this group, the suicide rate is about 20 times higher than the population average. In Germany, around 10,000 people take their lives each year, many of them suffering from depression. The Institute for Quality and Efficiency in Health Care commissioned the Department of Health Care Management at the Berlin University of Technology to conduct a Health Technology Assessment on whether non-drug interventions influence coping with suicidal crises in unipolar depression.
Methods
A systematic search of primary studies and systematic reviews (e.g., in MEDLINE, PSYCINFO) was performed to assess the benefit of ambulatory crisis intervention programmes or psychosocial interventions compared to another non-drug treatment, drug treatment, inpatient treatment or no treatment/waiting list in adult suicidal patients with unipolar depression regarding patient-relevant outcomes (e.g., suicide attempts, suicidal ideation, depression).
Results
The search yielded a total of 4,159 hits. After two rounds of screening for relevance and removing duplicates, 4 studies remained for inclusion in the qualitative and quantitative analysis. The studies present RCTs assessing the effects of cognitive behavioural therapy (CBT) of the 2. and 3. wave - all short-term programmes focussing on suicidality. Results indicate a benefit of CBT compared to standard treatment, depending on the outcome, on the “wave” and on the time of follow up assessment.
Conclusions
There is some evidence on benefits of CBT for adult patients with suicidal crises in unipolar depression. However, the quality of the included RCTs is weak and evidence on benefits of other non-drug interventions in outpatient care is missing. Further research is needed to identify effective interventions, especially for the vulnerable weeks immediately after suicide attempt.
Key messages
Short term cognitive behavioural therapy with suicidal prevention elements may influence coping with suicidal crises in unipolar depression positively. Further research is needed to identify effective interventions for the vulnerable weeks immediately after suicide attempt.
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Affiliation(s)
- E Berger
- Department of Health Care Management (MiG), Berlin University of Technology, Berlin, Germany
| | - S Fuchs
- Department of Health Care Management (MiG), Berlin University of Technology, Berlin, Germany
| | - N Baier
- Department of Health Care Management (MiG), Berlin University of Technology, Berlin, Germany
| | - H Peters
- Psychotherapeutic group practice Friedenau, Berlin, Germany
| | - R Busse
- Department of Health Care Management (MiG), Berlin University of Technology, Berlin, Germany
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Baier N, Sax LM, Sundmacher L. Trends and regional variation in rates of orthopaedic surgery in Germany: the impact of competition. Eur J Health Econ 2019; 20:163-174. [PMID: 29968053 DOI: 10.1007/s10198-018-0990-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/06/2017] [Accepted: 06/22/2018] [Indexed: 06/08/2023]
Abstract
Competition in hospital services has been fostered in an increasing number of OECD countries with the goal that hospitals improve quality and/or efficiency. With the same intention competition has been promoted in Germany when introducing a system of prospective payments based on diagnosis-related groups (DRGs) in 2003. Beyond its intended effects, however, the reform led to a substantial increase in hospital activity, particularly for orthopaedic surgery. To shed more light on these developments, this paper analyses the relationship between the rates of certain orthopaedic surgical procedures and hospital competition across and within each of Germany's 402 districts. We measured competition with the Herfindahl-Hirschman Index (HHI) based on market shares for hip replacements, knee replacements and spine surgeries. Using spatial panel regression, which allows for spatial dependency and unobserved individual heterogeneity, we found that the rate of hip and knee replacements rose as market concentration increased. A potential explanation might be that hospitals specialize in these particular procedures.
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Affiliation(s)
- Natalie Baier
- Department of Health Care Management, Berlin Centre for Health Economics Research (BerlinHECOR), Technische Universität Berlin, Str. des 17. Juni 135, 10623, Berlin, Germany.
| | - Lisa-Marie Sax
- City University London, Northampton Square, Clerkenwell, London, EC1V 0HB, UK
| | - Leonie Sundmacher
- Department of Health Services Management, Ludwig-Maximilians-Universität München, Schackstraße 4, 80539, Munich, Germany
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Baier N, Geissler A, Bech M, Bernstein D, Cowling TE, Jackson T, van Manen J, Rudkjøbing A, Quentin W. Emergency and urgent care systems in Australia, Denmark, England, France, Germany and the Netherlands - Analyzing organization, payment and reforms. Health Policy 2018; 123:1-10. [PMID: 30503764 DOI: 10.1016/j.healthpol.2018.11.001] [Citation(s) in RCA: 49] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2017] [Revised: 09/11/2018] [Accepted: 11/01/2018] [Indexed: 10/27/2022]
Abstract
INTRODUCTION Increasing numbers of hospital emergency department (ED) visits pose a challenge to health systems in many countries. This paper aims to examine emergency and urgent care systems, in six countries and to identify reform trends in response to current challenges. METHODS Based on a literature review, six countries - Australia, Denmark, England, France, Germany and the Netherlands - were selected for analysis. Information was collected using a standardized questionnaire that was completed by national experts. These experts reviewed relevant policy documents and provided information on (1) the organization and planning of emergency and urgent care, (2) payment systems for EDs and urgent primary care providers, and (3) reform initiatives. RESULTS In the six countries four main reform approaches could be identified: (a) extending the availability of urgent primary care, (b) concentrating and centralizing the provision of urgent primary care, (c) improving coordination between urgent primary care and emergency care, and (d) concentrating emergency care provision at fewer institutions. The design of payment systems for urgent primary care and for emergency care is often aligned to support these reforms. CONCLUSION Better guidance of patients and a reconfiguration of emergency and urgent care are the most important measures taken to address the current challenges. Nationwide planning of all emergency care providers, closely coordinated reforms and informing patients can support future reforms.
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Affiliation(s)
- Natalie Baier
- Department of Health Care Management, Berlin Centre for Health Economics Research (BerlinHECOR), Technische Universität Berlin, Straße des 17.Juni 135, 10623, Berlin, Germany.
| | - Alexander Geissler
- Department of Health Care Management, Berlin Centre for Health Economics Research (BerlinHECOR), Technische Universität Berlin, Straße des 17.Juni 135, 10623, Berlin, Germany
| | - Mickael Bech
- University of Southern Denmark, Campusvej 55, 5230, Odense M, Denmark; Department of Political Science, Aarhus University, Bartholins Allé 7, 8000, Aarhus, Denmark
| | | | - Thomas E Cowling
- Department of Primary Care and Public Health, Imperial College London, Kensington, London, SW72AZ, UK; Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, Keppel St, Bloomsbury, London, WC1E 7HT, UK
| | - Terri Jackson
- Melbourne Institute of Applied Economic and Social Research, University of Melbourne, Parkville, 3010, Melbourne, Victoria, Australia
| | - Johan van Manen
- Dutch Health Authority, Postbus 3017, 3502 GA, Utrecht, Netherlands
| | - Andreas Rudkjøbing
- Department of Public Health, University of Copenhagen, Nørregade 10, 1165 Copenhagen, Denmark
| | - Wilm Quentin
- Department of Health Care Management, Berlin Centre for Health Economics Research (BerlinHECOR), Technische Universität Berlin, Straße des 17.Juni 135, 10623, Berlin, Germany
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Baier N, Roth K, Felgner S, Henschke C. Burnout and safety outcomes - a cross-sectional nationwide survey of EMS-workers in Germany. BMC Emerg Med 2018; 18:24. [PMID: 30126358 PMCID: PMC6102842 DOI: 10.1186/s12873-018-0177-2] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2017] [Accepted: 08/10/2018] [Indexed: 12/21/2022] Open
Abstract
Background The association between burnout and patient safety has been analyzed in many studies for nurses, physicians, and residents. However, studies concerning prehospital emergency medical services (EMS) workers are limited, although they are particularly under risk for emotional stress. This study aims to descriptively analyze the overall degree of burnout among EMS-workers, and potential adverse events that might harm patients as well as the relationship between burnout and perceived safety outcomes for EMS-workers in Germany. Methods EMS-workers were recruited via German EMS-journals, social media and a professional association to participate in an online survey. The questionnaire includes the ´Maslach Burnout Inventory´ (MBI), the ‘Emergency Medical Services Safety Inventory’ (EMS-SI), and items about job satisfaction and the individual person. Data was descriptively analyzed by calculating frequencies, means, percentages and Pearson correlation coefficients. The association between burnout and patient safety was analyzed using linear and logistic regression models. Results A total of n = 1101 questionnaires were considered for data analysis. The vast majority of participants were male, younger than 40 years old, and full-time employees with an EMS-experience of 12 years on average. Between 19.9 and 40% of the participants showed a high degree of burnout in one of the burnout dimensions. Safety compromising behavior was the outcome measure with the highest percentage of participants reporting a negative outcome measure. The dimensions emotional exhaustion and depersonalization were positively associated with the safety outcomes injury and safety compromising behavior. Additionally, experiences, job satisfaction and the intention to leave the current job were significantly associated with the outcome measures. Conclusion This is the first study that examines the association between the degree of burnout and patient safety for EMS-workers. The results suggest that an expansion of psychological support for EMS-workers should be considered. Further research should concentrate on the complex relations between working conditions, burnout and patient safety. Electronic supplementary material The online version of this article (10.1186/s12873-018-0177-2) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Natalie Baier
- Institute of Health Care Management, Berlin Centre of Health Economics Research (BerlinHECOR), Technische Universität Berlin, Straße des 17. Juni 135 (H80), 10623, Berlin, Germany.
| | - Karsten Roth
- Institute of Health Care Management, Berlin Centre of Health Economics Research (BerlinHECOR), Technische Universität Berlin, Straße des 17. Juni 135 (H80), 10623, Berlin, Germany.,ASB Köln e.V, Sülzburgstraße 146, 050937, Köln, Germany
| | - Susanne Felgner
- Institute of Health Care Management, Berlin Centre of Health Economics Research (BerlinHECOR), Technische Universität Berlin, Straße des 17. Juni 135 (H80), 10623, Berlin, Germany
| | - Cornelia Henschke
- Institute of Health Care Management, Berlin Centre of Health Economics Research (BerlinHECOR), Technische Universität Berlin, Straße des 17. Juni 135 (H80), 10623, Berlin, Germany
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Vogt V, Sundmacher L, Witzheller KB, Baier N, Creutz T, Henschke C. [Mortality Related to Alcohol and Tobacco Consumption - A Benchmarking of Regional Trends and Levels]. Gesundheitswesen 2015; 78:378-86. [PMID: 26110246 DOI: 10.1055/s-0035-1548777] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
STUDY AIM Regional characteristics are being increasingly taken into account in studies on the determinants of health and health-care. A systematic observation and inclusion of regional particularities has, however, been absent from strategic planning and financing decisions to date. Furthermore, regional-level changes over time have, for the most part, not been considered in the existing studies. Accordingly, this article seeks to depict both the levels and trends in potentially avoidable mortality on the district level and to establish a benchmark that shows the theoretical goals for the reduction in avoidable deaths in each district. METHOD Gender-specific and age-standardised potentially avoidable deaths were determined for each of the 413 German districts in the period from 2000 to 2008 on the basis of cause of death statistics provided by statistical agencies of the German federal states. Deaths due to lung cancer and alcohol-related diseases were taken into account as these are considered to be avoidable through primary prevention. The district-specific benchmark values were ascertained using 2 linear hierarchic nested models and tested for significance using an F-test. RESULTS Overall, the lung cancer mortality was found to have declined amongst men and gradually increased amongst women during the time period under consideration. The benchmark for deaths from lung cancer in women shows that the increase in mortality is principally observed in West German and urban districts. In relation to the alcohol-related deaths we also see an east-west divide, with higher rates in eastern Germany. Shrinking districts in eastern Germany were able, however, to record a big reduction in rates in recent years. An unfortunate development in the trend of alcohol-related mortality in women was notably observed in regional areas of Bavaria. CONCLUSION The analysis offers decision makers the possibility of pinpointing regions with high intervention need. Increasing lung cancer mortality rates in women living in cities points to, for example, a heightened need for anti-smoking campaigns in urban areas. In relation to alcohol-related diseases, a heightened need for target group-specific prevention was identified in East German districts as well as some districts in Bavaria.
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Affiliation(s)
- V Vogt
- Fachbereich Health Services Management, Ludwig-Maximilians-Universität München, München
| | - L Sundmacher
- Fachbereich Health Services Management, Ludwig-Maximilians-Universität München, München
| | - K B Witzheller
- Fachgebiet Management im Gesundheitswesen, Gesundheitsökonomisches Zentrum Berlin, Technische Universität Berlin, Berlin
| | - N Baier
- Fachgebiet Management im Gesundheitswesen, Gesundheitsökonomisches Zentrum Berlin, Technische Universität Berlin, Berlin
| | - T Creutz
- Fachgebiet Management im Gesundheitswesen, Gesundheitsökonomisches Zentrum Berlin, Technische Universität Berlin, Berlin
| | - C Henschke
- Fachgebiet Management im Gesundheitswesen, Gesundheitsökonomisches Zentrum Berlin, Technische Universität Berlin, Berlin
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Vuillermet M, Billon-Lanfrey D, Reibel Y, Manissadjian A, Mollard L, Baier N, Gravrand O, Destéfanis G. Status of MCT focal plane arrays in France. ACTA ACUST UNITED AC 2012. [DOI: 10.1117/12.921868] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
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15
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Voss AC, Baier N. [Radiation therapy of lymphogranulomatosis: Results under special consideration of recurrences in the early stages (author's transl)]. Strahlentherapie 1980; 156:105-10. [PMID: 7355409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
Absolute 5-year survival rates from 105 primarily irradiated patients with Hodgkin's disease amount to 79% for Stage I and to 88% for Stage II cases. Out of this collective, the patients free from recurrences during 5 years come to a rate of 75% in Stage I and 41% in Stage II. In 37 patients, recurrences were observed, the causes of which are being examined. From the site of the recurrences conclusions may be drawn in view of an improved treatment.
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