Richter S, Raspe H
Institut für Sozialmedizin, Universität zu Lübeck.
Dtsch Med Wochenschr. 2012 Jun;137(24):1291-6.
German statutory health insurance-registered physicians increasingly offer individual health services (IHS). Within a mixed methods study, focus groups were conducted to describe deficits and recommendations from patients' point of view about how physicians should handle IHS.
Seven semi-structured focus groups (alltogether 50 participants) were conducted, stratified for region, gender and school education and homogenised for age and health status. The discussions were recorded, transcribed and content-analysed (thematic coding).
Across all focus groups patients wished in-depth advise, neutral information, transparent dissociation of IHS from services of statutory health insurances (SHI), appropriate time for consideration and information, consultations for a second opinion and transparent billing of all medical services. There was no consensus about who should initiate IHS and who should develop and disseminate information on IHS. Members of SHI wish for information on SHI services and transparent information developed by neutral parties.
The handling of IHS needs to be regulated urgently. Based on the integration of quantitative and qualitative data we infer patient-centred conclusions and recommendations for SHI-accredited physicians.
在德国法定医疗保险机构注册的医生越来越多地提供个性化健康服务(IHS)。在一项混合方法研究中,开展了焦点小组讨论,以从患者角度描述医生在处理IHS方面存在的不足及建议。
开展了7个半结构化焦点小组讨论(共50名参与者),按地区、性别和学校教育程度进行分层,并按年龄和健康状况进行同质化处理。讨论内容进行了录音、转录和内容分析(主题编码)。
在所有焦点小组中,患者希望获得深入建议、中立信息、IHS与法定医疗保险(SHI)服务的透明区分、考虑和提供信息的适当时间、寻求第二种意见的咨询以及所有医疗服务的透明计费。对于谁应发起IHS以及谁应制定和传播IHS信息,没有达成共识。SHI成员希望获得有关SHI服务的信息以及由中立方提供的透明信息。
IHS的处理急需规范。基于定量和定性数据的整合,我们为SHI认可的医生得出了以患者为中心的结论和建议。