Patients’ understanding of health information in Germany

Background: Patient–physician communication and textual health information are central to health care. Yet, how well patients understand their physicians and written materials is under-studied. Objectives: Focusing on outpatient health care in Germany, the aim of this research was to assess patients’ levels of understanding oral and written health information and to identify associations with socioeconomic variables. Methods: This analysis drew on a 2017 health survey (n=6,105 adults 18 years of age and above). Measures for the quality of patient–physician communication were derived from the Ask Me 3 program questions for consultations with general practitioners (GPs) and specialists (SPs), and for textual health information via a question on the comprehensibility of written materials. Correlations with socioeconomic variables were explored using bivariate and multivariable logistic regression analyses. Results: Over 90% of all respondents reported that they had understood the GP’s and SP’s explanations. A lack of understanding was most notably correlated with patients’ selfreported very poor health (odds ratio [OR]: 5.19; 95% confidence interval [CI]: 2.23–12.10), current health problem (OR: 6.54, CI: 1.70–25.12) and older age (65 years and above, OR: 2.97, CI: 1.10–8.00). Fewer patients reported that they understood written materials well (86.7% for last visit at GP, 89.7% for last visit at SP). Difficulties in understanding written materials were strongly correlated with basic education (OR: 4.20, CI: 2.76–6.39) and older age (65 years and above, OR: 2.66, CI: 1.43–4.96). Conclusions: In order to increase patients’ understanding of health information and reduce inequalities among patient subgroups, meeting the communication needs of patients of older age, low educational status and with poor health is essential

Challenges and opportunities for general practice specific CME in Europe - a narrative review of seven countries

Background: Several changes have led to general practitioners (GPs) working in a more differentiated setting today and being supported by other health professions. As practice changes, primary care specific continuing medical education (CME) may also need to adapt. By comparing different primary care specific CME approaches for GPs across Europe, we aim at identifying challenges and opportunities for future development. Methods: Narrative review assessing, analysing and comparing CME programs for general practitioners across different north-western European countries (UK, Norway, the Netherlands, Belgium (Flanders), Germany, Switzerland, and France). Templates containing detailed items across seven dimensions of country-specific CME were developed and used. These dimensions are role of primary care within the health system, legal regulations regarding CME, published aims of CME, actual content of CME, operationalisation, funding and sponsorship, and evaluation. Results: General practice specific CME in the countries under consideration are presented and comparatively analysed based on the dimensions defined in advance. This shows that each of the countries examined has different strengths and weaknesses. A clear pioneer cannot be identified. Nevertheless, numerous impulses for optimising future GP training systems can be derived from the examples presented. Conclusions: Independent of country specific CME programs several fields of potential action were identified: the development of curriculum objectives for GPs, the promotion of innovative teaching and learning formats, the use of synergies in specialist GP training and CME, the creation of accessible yet comprehensive learning platforms, the establishment of clear rules for sponsorship, the development of new financing models, the promotion of fair competition between CME providers, and scientifically based evaluation. Keywords: Continuing medical education; Curriculum; General practice; Narrative review; Program evaluation

Challenges and opportunities for general practice specific CME in Europe: a narrative review of seven countries

Background: Several changes have led to general practitioners (GPs) working in a more differentiated setting today and being supported by other health professions. As practice changes, primary care specific continuing medical education (CME) may also need to adapt. By comparing different primary care specific CME approaches for GPs across Europe, we aim at identifying challenges and opportunities for future development. Methods: Narrative review assessing, analysing and comparing CME programs for general practitioners across different north-western European countries (UK, Norway, the Netherlands, Belgium (Flanders), Germany, Switzerland, and France). Templates containing detailed items across seven dimensions of country-specific CME were developed and used. These dimensions are role of primary care within the health system, legal regulations regarding CME, published aims of CME, actual content of CME, operationalisation, funding and sponsorship, and evaluation. Results: General practice specific CME in the countries under consideration are presented and comparatively analysed based on the dimensions defined in advance. This shows that each of the countries examined has different strengths and weaknesses. A clear pioneer cannot be identified. Nevertheless, numerous impulses for optimising future GP training systems can be derived from the examples presented. Conclusions: Independent of country specific CME programs several fields of potential action were identified: the development of curriculum objectives for GPs, the promotion of innovative teaching and learning formats, the use of synergies in specialist GP training and CME, the creation of accessible yet comprehensive learning platforms, the establishment of clear rules for sponsorship, the development of new financing models, the promotion of fair competition between CME providers, and scientifically based evaluation

Berufserwartungen von Medizinstudierenden: Ergebnisse einer bundesweiten Befragung

Background: Demographic change, technical progress, and changing patterns of service use influence the future demand for physicians in the German health care system. The attitudes of medical students towards their later work in the health system is important for current health care planning. For that reason a nationwide survey aimed to identify major trends in preferred specialty, workplace characteristics (regional location, hospital) and perceived hindrances for clinical work. Methods: A questionnaire consisting of 34 closed questions was developed at the University of Mainz in 2009 and administered over the Internet in June and July 2010 to all medical students in Germany. The questions addressed the students’ intentions regarding specialty training, location of practice, workload, and regional preference, as well as potential reasons why they might choose not to practice clinical medicine in the future. Results: 12 518 web-based questionnaires were filled in (approx. 15.7% of all medical students in Germany in 2010). The mean age was 24.9 years, with 64% female and 36% male. Favored specialties were internal medicine (42.6%), family medicine (29.6%), pediatrics (27.0%) and surgery (26.8%). Nearly all respondents (96%) stated that they attached importance to compatibility of work and family life. Working in a salaried position (92.2%) was preferred to working in private practice (77.7%). General practice, in particular in rural locations, was significantly less favored than work as a specialist in cities. Conclusion: Although the coming generation of physicians anticipate working in clincial settings in the future, shortfalls in the areas of primary care and in rural locations are likely if medical students adhere to their preferences stated in the questionnaire

Health Technology Assessment. Konzepte, Methoden, Praxis für Wissenschaft und Entscheidungsfindung.

Perleth M, Busse R, Gerhardus A, Gibis B, Lühmann D, eds. Health Technology Assessment. Konzepte, Methoden, Praxis für Wissenschaft und Entscheidungsfindung. Berliner Schriftenreihe Gesundheitswissenschaften. Berlin: Medizinisch Wissenschaftlicher Verlag; 2008

4. MVZ-Survey der KBV

Seit Einführung der Medizinischen Versorgungszentren (MVZ) im Jahr 2004 führt die Kassenärztliche Bundesvereinigung regelmäßig Umfragen zu deren Entwicklung durch. Neben den jährlich veröffentlichten Grunddaten zu MVZ, die auf der Grundlage einer Befragung der 17 Kassenärztlichen Vereinigungen erstellt werden, ist dies der MVZ-Survey. Zum vierten Mal wurde der MVZ-Survey im Jahr 2014 als Befragung aller ärztlichen Leiter bzw. Geschäftsführer von MVZ (Vollerhebung) seit 2005 durchgeführt. Von 2.006 (Stand 31.12.2013) angeschriebenen MVZ haben 339 den Online-Fragebogen bis zum Ende beantwortet, was einer Teilnahmequote von 17% entspricht. Der vierte MVZ-Survey dient der Bestandsaufnahme der Versorgungsform MVZ. Mittels Online-Befragung wurden insbesondere folgende Schwerpunkte betrachtet: Gründungsmotivation, wirtschaftliche Situation, Kooperation und Vernetzung sowie differenzierte Betrachtung der MVZ in ländlichen und städtischen Regionen. Ausgewählte Befragungsergebnisse werden im Folgenden beschrieben und ausgewertet, sowie Entwicklungstendenzen und Trends aufgezeigt