Leitlinien und Evidenz-basierte Medizin in Deutschland

Ollenschläger, Günter; Thomeczek, Christian; Kirchner, H.; Oesingmann, U.; Kolkmann, F. W.

doi:10.1007/s003910050161

Cited by 7 publications

(7 citation statements)

References 5 publications

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“…Weniger bekannt ist, dass die Entwicklung von Leitlinien die Voraussetzung ist, eine qualitativ hochwertige Versorgung auch unter dem Gesichtspunkt ihrer ökonomischen Vertret-und Finanzierbarkeit sicherzustellen. Sie gelten als Hoffnungsträger, die Versorgung auf einem hohen Qualitätsniveau zu stabilisieren und Einsparpotenziale zu realisieren [16]. Im Zusammenhang mit der Problematik der Über-, Unter-und Fehlversorgung sind zwei Anwendungsbereiche von Leitlinien denkbar: (1) Leitlinien als Instrumente zur Identifizierung bzw.…”

Section: Was Sind Leitlinien?unclassified

Leitlinien in der Allergologie

Köberlein¹

2008

Dtsch med Wochenschr

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Section: Was Sind Leitlinien?unclassified

Leitlinien in der Allergologie

Köberlein¹

2008

Dtsch med Wochenschr

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“…Sofern der Tab. 1 Therapieoptionen des postoperativen Ileus der Evidenzgrade I±III der Agency for Health Care Policy and Research (AHCPR) [89] …”

Section: Enterale Ernährungunclassified

Postoperativer Ileus: Teil II (Klinische Therapie)

Kreis

Kasparek²,

Becker³

et al. 2003

Zentralbl Chir

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To avoid or reduce postoperative ileus, the operative trauma should be minimized and epidural anesthesia for spinal inhibition of the sympathetic nervous system or i. v. lidocaine should be used, all of which probably act by reducing visceral afferent nerve fiber activity. Recent data suggest that perioperative fluid restriction might reduce postoperative ileus. Epidural anesthesia with local anesthetics and replacing opioids by non-steroidal anti-inflammatory drugs (NSAIDs) for postoperative pain treatment improve the recovery of gastrointestinal motility disturbances. Prior to the operation, the patient should be informed regarding postoperative motility disorders, its length and the presumed resumption of oral food intake, which has been shown to shorten hospital stay. Early postoperative food intake stimulates small and large bowel motility via interenteric reflex arches, avoids i. v. lines and renders discharge acceptable for the patient. Treatment of postoperative ileus includes osmotic laxatives and prokinetic drugs like erythromycine and acetylcholinesterase inhibitors. By combining epidural anesthesia and the sparse use of i. v. opioids with early food intake and, if necessary, laxatives or prokinetics, postoperative ileus should be coped adequately. Nevertheless, the development of new specific prokinetic drugs with minimal or no side effects should remain a target for drug companies to further improve treatment of postoperative ileus.

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“…Indeed, the history of Western health systems is rich in examples of "inspired" that some of the approaches were already known and applied in Germany, although not on a wide scale, before the introduction of the DMPs. This was the case for self-management support via patient education (Petermann 1995) and the use of evidence-based guidelines (Ollenschläger et al 2000). Hence, there was no clear-cut and tangible model in the form of a single program.…”

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confidence: 99%

Born in the USA? A Comparison of “Inspired” Health Care Reforms in Germany and France

Brunn

2021

Journal of Health Politics, Policy and Law

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Context: Despite numerous examples of health policy transfer in Western health systems, the nature of such “inspired” reforms has received little detailed attention. The aim of this article is to apply and refine a specific theoretical angle for the analysis of these reforms, using the theoretical frameworks of transfer and translation. Methods: The design is based on a comparative case study: the introduction of disease management programs (DMPs) for diabetes in Germany in 2002 and in France in 2008, drawing on a literature review and semi-structured interviews. Findings: In introducing its DMP, Germany chose and combined several components in a process of selective borrowing, while France opted for copying a specific foreign program and adapting it. Such differences in process are linked to distinct system structures, in particular the setup of health insurance and the representation of physicians. Further, the displayed versus actual degree of inspiration varied significantly, with a branding strategy in Germany (high display of foreign influence) and the inverse picture in France (high degree of actual inspiration). Conclusions: This analysis has applied the dual perspective of transfer and translation. Both proved complementary and necessary, and translation appeared as a main determinant of implementation success.

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Leitlinien und Evidenz-basierte Medizin in Deutschland

Cited by 7 publications

References 5 publications

Leitlinien in der Allergologie

Leitlinien in der Allergologie

Postoperativer Ileus: Teil II (Klinische Therapie)

Born in the USA? A Comparison of “Inspired” Health Care Reforms in Germany and France

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