The SARS-CoV-2 pandemic led to high demands on the educational sector. For tertiary education, investigations mostly focused on the effects of digital teaching. However, little is known regarding ...health effects. Moreover, the emphasis was mainly on students, not university staff members. An international online questionnaire consisting of quantitative and qualitative items (from the LockedDown project) was translated into German and used in Austria from June to November 2020. This study reports on social and psychological health plus the perceived benefits of the pandemic. A total of 1175 students and 716 staff members participated. While staff members reported higher stress levels at the beginning of the pandemic, they were more pronounced for students from Week 5 onwards (Chi2 < 0.001). Quality of Life (QoL) decreased more in the student population, and depression/anxiety was higher and rose compared to staff. Moreover, students reported fewer benefits of the pandemic. Students perceived the burden of the pandemic later than staff members who needed to adapt their work processes immediately. Mental health interventions in a pandemic seem to be needed at different points in time depending on the target group.
Background
Performance-oriented financing of healthcare aims at demand-based and efficient resource allocation. Often, clinical pathways (CPs) are introduced in this context.
Purpose
For CP success ...(a) the degree of utilization of and divergence, (b) cost effects and (c) health professionals’ acceptance rate of and satisfaction are relevant. There are gaps in research regarding these issues in general, and more specifically in the German speaking part of Europe.
Methodology/Approach
Employing a two-stage mixed-methods pilot study, we studied (a) and (b) quantitatively in Germany, Austria, and Switzerland, and (c) qualitatively in Germany and Austria.
Results
Many hospitals already implemented CPs, but the utilization varies. They are expected to yield middle-range savings, but intangible benefits are more important. In general, employees are in favor of CPs, but several conditions need to be met, e.g. adaptability to local requirements.
Conclusion
Linking the results to the Consolidated Framework for Implementation Research showed many criteria are covered, which might lead to the positive evaluations, but also highlights the complexity of the intervention.
Practice Implication
As enhanced acceptance rates are expected to lead to higher benefits and vice versa, management team should safeguard employee participation and perceived benefits in all phases of the CP cycle.
The study investigates the effects of multidisciplinary treatment for rheumatic treatment regarding (a) financial feasibility based on costs/remuneration in comparison to conventional treatment and ...(b) Patient reported outcome measures (Proms) to check for effectiveness. For (a), cost data and remuneration with and without multimodal rheumatologic complex treatment (MRCT) is analysed, including cost types. The database encompasses 18,794 treatment cases. For (b), a case study with retrospective patient data analysis (N = 375, all treated in a specialized German hospital) regarding self-reported quality of life and physical functions is carried out for subjects receiving MRCT. While conventional treatment is fully covered, MRCT is only incentivized for cases with long in-patient treatment, so financial feasibility for hospitals is limited. Patients with MRCT reported significant improvements in quality of life (p < .001; Nottingham Health Profile) as well as in physical functions (Functional Questionnaire Hannover FFbH, p < .001) at discharge compared to admission. As short-term MRCT is not fully remunerated, less severe cases may not receive adequate care. Financial incentives should at least cover the costs incentivize the offer and thus ensure patient access to MRCT. Measuring the outcomes of the treatment process by means of Proms can contribute to the internal quality management. It also offers an inter-institutional benchmark to service providers, which can be used as a basis for performing comparative quality measurements and researching effectiveness.
Pay for Quality (P4Q) concepts are discussed as solution for ensuring quality in health care in the context of budgetary concerns. However, little is known regarding the application to and ...effectiveness for complex chronic treatments. This article describes the incentivization approach taken in Germany, where complex codes requiring specific quality criteria were implemented into the Diagnosis Related Groups (DRGs) system. Using two examples (early complex geriatric rehabilitation, multimodal rheumatological complex treatment), we analyze the quality indicators according to the Donabedian Model and contrast the effects regarding compensation to traditional treatments. In total, the approach allows taking into account treatment and financial requirements.
Aim
We examined the status and necessity of a cultural change regarding the internal health promotion perspective in the Austrian hospital sector to check how the implementation of workplace health ...promotion proceeded compared to the last survey.
Subject and methods
This was done by analyzing the current situation of working conditions, replicating a quantitative study by Schaffenrath-Resi et al. (Schaffenrath-Resi et al. Pflege Gesellschaft 15:145–162,
2010
). A link to an online survey was sent to all hospitals in Austria. The topics covered were the internal evaluation and current status, reasons and pitfalls of workplace health promotion.
Results
While approximately 40% of the respondents state using health circles, only 18.5% report a holistic workplace health promotion (WHP) approach, though certain elements are offered by the majority (+70%). Program failure beliefs are rather focused on the employees.
Conclusions
Evaluations of the current programs are required to clarify not only how WHP was designed but also reasons for WHP failure. In addition, future research would profit from a broader database.
The virus that causes COVID-19 is rapidly spreading across the globe. Elderly patients with multiple pre-existing conditions are at a higher risk. This case study describes acute inpatient treatment ...of a COVID-19 patient with uncontrolled diabetes mellitus, kidney complications, heart failure, chronic pain, depression, and other comorbidities in an isolation ward without mechanical ventilation.
This article describes outcomes of the complex therapy of Parkinson’s disease according to Operation and Procedure Code 8-97d, an interdisciplinary approach to the treatment of Morbus Parkinson ...established in Germany. The code defines mandatory minimum requirements for the organizational structures and processes of hospital treatment. The aim of the study was to analyze profession-related treatment costs, accompanying diseases and hospitalization times for inpatient Parkinson therapy and to compare these for interdisciplinary versus conventional approaches. A structured procedure analysis was carried out. Indication-based cost calculations and an analysis of secondary diagnoses were performed. In addition to the primary diagnosis of Parkinson’s disease, all patients surveyed are suffering from further diseases in Major Diagnostic Category (MDC) 1, 5, 6, 10, 11, and 23. Among the patients surveyed who were receiving complex therapy, secondary diagnoses falling into MDC 8 dominated. The average hospitalization time for those patients receiving interdisciplinary treatment for Parkinson’s disease was 18.16 days, significantly longer than the 12.01 days for the comparison group. Analysis of the costs revealed significant differences in the total costs of medical service and in the personnel and operating costs of nonmedical infrastructure. The high standards demanded of the hospital structure for the provision of interdisciplinary services, together with a prescribed therapy density including quality assurance assessments, result in patients being hospitalized for longer; this is reflected in higher costs. Treatment of Parkinson’s patients should not only include the primary disease but also any accompanying diseases. For this, appropriate reimbursement higher than for the conventional Parkinson’s diagnosis-related group (DRG) is needed.
Patients with fibromyalgia (FM) have often tried many outpatient treatments, and breakthrough pain frequently stops them from performing everyday tasks and participating in society. FM-pain that has ...become chronic, therefore, affects quality of life. This case study describes the administration of interdisciplinary inpatient pain therapy due to a primary diagnosis of fibromyalgia with integrated complementary medicine. The female patient, who had several concomitant disorders and had been suffering from pain for many years, benefited from the holistic treatment approach in terms of a reduction in pain and an improvement in physical functions and mental health. The ability to have a positive effect on pain symptoms in the longer term is essential. Compliance with the treatments used should also be improved, so that a healthier lifestyle and better pain management can continue after discharge from hospital. These results are supported by other study results and should provide the impetus for major studies to evaluate holistic pain therapies in FM.
Lay Summary
Workplace health promotion (WHP) is often faced with low-participation rates despite high relevance. This limits the potential for creating positive effects for the organization and its ...staff. Therefore, we investigated the barriers perceived by employees themselves using a representative sample (regarding age, gender and education) in Germany. Data were collected using a quantitative online questionnaire and then analyzed regarding underlying patterns. We found that there are different barrier types, and their importance differs depending on demographic criteria of the participants and the organizations they work for. These results can help organizations to reduce participation barriers to WHP for their staff.
PurposePreventing diseases and promoting health is most effective in large settings like the workplace. Digital workplace health promotion (DWHP) became more popular during the SARS-CoV-2 pandemic. ...While e-health appliances have received research interest, little is known regarding the target populations' perspective on and potentials of the DWPH.Design/methodology/approachAn online pilot study was done in Germany in June 2021. The study is representative regarding age, gender and education. The user perspective on DWHP was investigated using 12 quantitative and 2 qualitative items.FindingsThe majority of the 690 participants perceives DWHP as valid long-term addition to regular workplace health promotion. Nearly 55.7% use DWHP when available, but most (65.4%) do not use these offers more than regular ones. Spontaneous participation is relevant for about 55%. Problems occur due to technical equipment (29.4%) and premises (36.3%). Open remarks highlight specifics to be observed in offer design, for example, data security issues.Research limitations/implicationsTo conclude, DWHP has a high potential to improve health at the workplace initiatives regarding participation rates, outcomes and costs. Challenges can be overcome by ensuring data protection and skills, which can be transferred to other life domains, improving population health. The potentials of DWHP for population health via spillover effects, employee well-being and employer branding have not yet been reached.Originality/valueThe aim of this study is giving a first overview of employee views on and use of DWHP.
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