Ulrich Lisa-R, Schatz Tanja R, Lappe Veronika, Ihle Peter, Barthen Linda, Gerlach Ferdinand M, Erler Antje
Institut für Allgemeinmedizin, Goethe-Universität Frankfurt, Theodor-Stern-Kai 7, 60590, Frankfurt, Deutschland.
PMV-Forschungsgruppe, Universität zu Köln, Köln, Deutschland.
Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz. 2017 Dec;60(12):1372-1382. doi: 10.1007/s00103-017-2642-6.
Health service planning that takes into account as far as possible the regional needs and regional discrepancies is a controversial health issue in Germany.
In a pilot scheme, we tested a planning process for regional healthcare services, based on the example of dementia care. The aim of this article is to present the strengths and limitations of this planning process.
We developed an indicator set for dementia care based on routine regional data obtained from two German statutory health insurance companies. Additionally, primary data based on a questionnaire sent to all GPs in the area were evaluated. These data were expanded through the addition of official socio-demographic population data. Procedures and evaluation strategies, discussion of the results and the derivation of planning measures followed, in close agreement with a group of local experts.
Few epidemiological data on regional variations in health care planning are publicly available. Secondary data from statutory health insurance companies can be assessed to support the estimation of regional health care needs, but interpretation is difficult. The use of surveys to collect primary data, and the assessment of results by the local health board may facilitate interpretation and may contribute towards more valid statements regarding regional health planning.
Despite the limited availability of data and the considerable efforts involved in data analysis, the project demonstrates how needs-based health service planning can be carried out in a small region, taking into account the increasing demands of the local health care providers and the special local features.
尽可能考虑地区需求和地区差异的卫生服务规划在德国是一个有争议的卫生问题。
在一个试点项目中,我们以痴呆症护理为例,测试了一种地区医疗服务的规划流程。本文旨在介绍该规划流程的优点和局限性。
我们根据从两家德国法定健康保险公司获得的常规地区数据,制定了一套痴呆症护理指标集。此外,还对基于向该地区所有全科医生发放的问卷收集的原始数据进行了评估。这些数据通过添加官方社会人口统计数据得到扩充。随后,与一组当地专家密切合作,遵循相关程序和评估策略,对结果进行讨论并推导规划措施。
关于卫生保健规划地区差异的流行病学数据很少公开。法定健康保险公司的二手数据可用于支持对地区卫生保健需求的估计,但解读起来很困难。通过调查收集原始数据,并由地方卫生委员会对结果进行评估,可能有助于解读,并可能有助于就地区卫生规划做出更有效的陈述。
尽管数据有限且数据分析工作艰巨,但该项目展示了如何在一个小地区开展基于需求的卫生服务规划,同时考虑到当地医疗服务提供者不断增加的需求和当地的特殊情况。