Sterben und Tod im gesellschaftlichen Wandel

Bundesgesundheitsblatt - Gesundheitsforschung - Gesundheitsschutz - Sterben, Tod und Trauer in den modernen Gesellschaften unterliegen einem tiefgreifenden sozialen, professionellen und...     

Demografischer Wandel und Notwendigkeit der Priorisierung im Gesundheitswesen

The German health care system will face major challenges in the near future. Progress in medicine as well as demographic change will combine to drastically exacerbate the scarcity of resources in the health care system. The word scarcity in this case not only refers to the availability of funds. Other resources, e.g., staff, attention, time, and organs for transplantation, are also becoming scarce. It is conceivable that, in the future, it will no longer be possible to provide medical services for all patients to the same extent as in the past. If the necessary resources are not available in the health care system, if the potential for saving resources has been more or less exhausted, and if rationing shall not be an option, the only option to resort to will be prioritization. Prioritization in the health care sector denotes a supply of services according to specific, predetermined criteria. A broad and open public debate, which would have to be accompanied as well as moderated by the Health Council (“Gesundheitsrat”), is essential for determining such criteria.     

Demografischer Wandel

The growing absolute number of the elderly causes an increase in the number of patients suffering from not only chronic diseases and multimorbidity, but also higher usage of the health care system. In the German Federal State of Mecklenburg–Western Pomerania (MW), the effects of demographic change will be more pronounced than in other regions. The objective of this article is to show the consequences of the changing population structure for the health care system. Using examples from MW, innovative models to secure high quality health care at the population level are presented. Examples include the establishment of subsidiary practices, multidisciplinary ambulatory health care centers, delegation models, ambulatory health care managers, telemedicine, and intensified and improved interdisciplinary networking. In the context of the demographic change, assisted care, adequate symptom control, maintaining personnel competence, preservation of an independent lifestyle with a high quality of life, and stimulation of social participation become priority objectives of medical care. Besides the effectiveness and the quality of results with regard to these objectives, innovative health care models should be economically evaluated at the population level under real life practice conditions.     

Hochschulmedizin im Wandel

Editorial

Hochschulmedizin im Wandel     

Arbeitswelt im Wandel

Background

Demographic change and thus the ageing of workforces poses enormous challenges for German companies as well as the entire economy.

Objectives

How exactly will this ageing process evolve and what does it mean for times absent from work? And how can companies react in terms of better health promotion?

Methods

This article is based on analyses of official statistics and relevant literature on health promotion, as well as a case study.

Results

Overall, the observed absence from work is very likely to increase in the future. Professional health promotion programs, i.?e. diversity in the age composition of work teams, can contribute to maintaining and improving the performance of ageing workforces.

Discussion

In practice, the question of how the necessary cultural changes inside a company can best be achieved within the framework of company health promotion programs is highly relevant.

     

Sexuelle Gesundheit im Wandel

Bundesgesundheitsblatt - Gesundheitsforschung - Gesundheitsschutz -     

Ethik in der Medizin: Balance zwischen medizinischem Fortschritt, kulturellem Wandel und ethischen Normen

Ohne Zusammenfassung     

Demographischer Wandel und Anforderungen an das Gesundheitswesen Stellungnahme anlässlich der Anhörung durch die Enquete-Kommission “Demographischer Wandel” des Deutschen Bundestages zum Thema “Reformbedarf des Gesundheitswesens” am 22. Januar 2001 in Berlin

The Federal Statistical Office is forecasting an increase of individual life expectancy for Germans, paralleled by a decrease of the proportion of young people in the population. The question arises, whether this development will increase the strain on the German Health system in a way that cannot be financed in the future. This memorandum tries to answer this question solely on the basis of existing health data. It is stated that an extended life span is not necessarily associated with a longer time period of illness and disability. There are indications that the increasing ageing of the population does not lead to a proportional rise in expenditure in health care for the elderly. The increase of the proportion of elderly people does not only reflect improved life expectancy as a consequence of cultural, medical and social developments. Instead, reduction of birth rates will significantly impose constraints of the Health System, the extend of which cannot at present be estimated due to the scarcity of evidence based knowledge.     

Patientenrechte und BürgerbeteiligungBestand und Perspektiven

Citizen participation and patient rights are the collective and individual expression of an active partnership between those involved in the medical and health care system. Citizen participation is the complement and continuation of existing individual patient rights through collective rights of citizens, the insured and patients to take part in communication and decision-making processes concerning information, quality, effectiveness and efficiency. In Germany and Europe individual patient participation is accepted as an objective and guaranteed by law (“Charter of Patient Rights”). The participation of citizens as a collective involvement in decision-making processes going beyond the individual case is neither as an objective nor in practice generally established. The article presents the situation of individual and collective rights in Germany and Europe, legitimates collective citizens' rights to participate in decision-making processes at the levels of the medical and the health care system and discusses different forms and examples of participation in national, regional and local institutions. Citizen participation is a “discovery procedure” and, from a legal point of view, not an outcome-determined but a procedure-oriented concept of organisation of the medical and health care system.