Klinger Isabell, Heckel Maria, Shahda Sophie, Krisen Ursula, Stellmacher Silke, Kurkowski Sandra, Junghanß Christian, Ostgathe Christoph
Palliativmedizinische Abteilung, Friedrich-Alexander-Universität Erlangen-Nürnberg, Krankenhausstr. 12, 91054, Erlangen, Deutschland.
Zentrum für Innere Medizin, Medizinische Klinik III - Hämatologie, Onkologie, Palliativmedizin, Universitätsmedizin Rostock, Rostock, Deutschland.
Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz. 2022 Jun;65(6):650-657. doi: 10.1007/s00103-022-03542-x. Epub 2022 May 3.
Germany has a federal state system. Pandemic response teams are key instruments of pandemic management. The aim of this article is to describe the structures and powers of pandemic response teams that were explored during a study on the care of the critically ill and dying in times of a pandemic (PallPan). The focus is on health-related pandemic response teams on the national state level (macrolevel) and federal and community level (mesolevel) as well as pandemic response teams in healthcare facilities (microlevel).
Members of pandemic response teams took part in qualitative semi-structured interviews (October 2020-February 2021). The evaluation was carried out by means of qualitative structuring content analysis.
Forty-two persons reported on 43 crisis teams from 14 federal states. Response teams in healthcare facilities and public administration differ primarily with regard to their competencies. Officially predetermined regulations regarding the initiation, personal composition, tasks, responsibilities, and competencies of pandemic response teams are not predefined in Germany. The macrolevel defined the legal and financial conditions for pandemic management. Meso- and microlevel pandemic response teams bear responsibility for maintaining the provision of healthcare. The defaults of local public health authorities are decisive for the pandemic response team's work. Main tasks and measures were the provision of information and the procurement and distribution of resources.
In terms of preparing for future pandemic situations, the knowledge gained will help to address concerns about maintaining healthcare for specific population groups, such as seriously ill and dying people, to the locally differing responsible bodies, even under pandemic conditions.
德国实行联邦制。大流行应对团队是大流行管理的关键工具。本文旨在描述在一项关于大流行期间危重症和临终患者护理的研究（PallPan）中所探讨的大流行应对团队的结构与权力。重点关注国家层面（宏观层面）、联邦和社区层面（中观层面）与健康相关的大流行应对团队以及医疗机构中的大流行应对团队（微观层面）。
大流行应对团队成员参与了定性半结构化访谈（2020年10月至2021年2月）。通过定性结构化内容分析进行评估。
来自14个联邦州的42人汇报了43个危机应对团队的情况。医疗机构和公共行政部门的应对团队在能力方面存在主要差异。在德国，关于大流行应对团队的启动、人员构成、任务、职责和能力的官方预先规定并未明确。宏观层面界定了大流行管理的法律和财政条件。中观和微观层面的大流行应对团队负责维持医疗服务的提供。当地公共卫生当局的缺失对大流行应对团队的工作起决定性作用。主要任务和措施包括提供信息以及资源的采购与分配。
就为未来大流行情况做准备而言，所获得的知识将有助于向当地不同的责任机构说明在大流行情况下为特定人群（如重症和临终患者）维持医疗服务的相关问题。
