Personalabbau, Arbeitsplatzunsicherheit und Gesundheit — Ergebnisse einer repräsentativen Umfrage

Zok, Klaus

doi:10.1007/3-540-27971-7_7

Cited by 3 publications

(3 citation statements)

References 2 publications

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“…The proportion of patients who changed their health insurance company was about twice as high in the ankle arthrodesis group (21.2%) as in the total ankle replacement group (10.2%), which is probably due to the lower average age of the arthrodesis collective, as younger patients generally change health insurance more frequently [50]. The inclusion of non-completers in the analysis resulted in an approximation of the unplanned reoperation rates between total ankle replacement and ankle arthrodesis groups which suggests a bias in the complete case analysis due to right censored data [51].…”

Section: Unplanned Reoperation Rates and Revision Rates After Total A...mentioning

confidence: 95%

Outcome after total ankle replacement or ankle arthrodesis in end-stage ankle osteoarthritis on the basis of german-wide data: a retrospective comparative study over 10 years

Kostuj,

Hönning,

Mittelmeier

et al. 2024

BMC Musculoskelet Disord

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Background In symptomatic end-stage osteoarthritis of the ankle joint, total ankle replacement and ankle arthrodesis are the two primary surgical options for patients for whom conservative treatment fails. Published revision rates are often biased and difficult to compare. In this study, unplanned reoperation rates and revision rates were determined for both surgical interventions based on a large dataset, and risk factors for unplanned reoperations were identified. Methods German-wide health data of the largest German health-care insurance carrier between 2001 and 2012 were retrospectively analyzed, and unplanned reoperation rates within 10 years were determined for index surgeries conducted in 2001 and 2002. Unplanned reoperation rates within 5 years for index surgeries conducted in 2001/2002 were compared to index surgeries conducted in 2006/2007. Multivariate logistic regression was used to identify risk factors for unplanned reoperations. Results After ankle arthrodesis, 19% (95% confidence interval [CI], 16–22%) of 741 patients needed to undergo an unplanned reoperation within ten years. After total ankle replacement, the unplanned reoperation rate was 38% [95% CI, 29–48%] among 172 patients. For initial surgeries conducted at a later date, unplanned reoperation rates within five years were 21% [95% CI, 19–24%] for 1,168 ankle arthrodesis patients and 23% [95% CI, 19–28%] for 561 total ankle replacement patients. Significant risk factors for unplanned reoperations after ankle arthrodesis in the initial cohort were age < 50 years (odds ratio [OR] = 4.65 [95% CI 1.10;19.56]) and osteoporosis (OR = 3.72 [95% CI, 1.06;13.11]); after total ankle replacement, they were osteoporosis (OR = 2.96 [95% CI, 1.65;5.31]), Patient Clinical Complexity Level (PCCL) grade 3 (OR = 2.19 [95% CI, 1.19;4.03]), PCCL grade 4 (OR = 2.51 [95% CI, 1.22;5.17]) and diabetes mellitus (OR = 2.48 [95% CI, 1.33;4.66]). Kaplan-Meier analyses including 1,525 ankle arthrodesis patients and 644 total ankle replacement patients revealed an average unplanned reoperation-free time of approximately 17 years for both procedures. Conclusions Similar revision rates and unplanned reoperation rates for both procedures in the later-date cohort can likely be attributed to a learning curve for surgeons as well as advances in implant design. This analysis of billing health insurance data supports an increase in total ankle replacement surgeries.

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Section: Unplanned Reoperation Rates and Revision Rates After Total A...mentioning

confidence: 95%

Outcome after total ankle replacement or ankle arthrodesis in end-stage ankle osteoarthritis on the basis of german-wide data: a retrospective comparative study over 10 years

Kostuj,

Hönning,

Mittelmeier

et al. 2024

BMC Musculoskelet Disord

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“…Verschiedene Studien deuten auf Zugangs- und Schnittstellenprobleme hin 6 . In diesem Zusammenhang wurde auch die Zeit bis zum Beginn einer psychotherapeutischen Behandlung und das damit zusammenhängende Problem des Zugangs der Versicherten zur Psychotherapie diskutiert 7 8 9 .…”

Section: Hintergrundunclassified

Mixed-Methods-Ansatz zur Evaluation der Reform der Psychotherapie-Richtlinie: ein Studienprotokoll

Diekmann¹,

Schlierenkamp²,

Walendzik

et al. 2023

Gesundheitswesen

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Zusammenfassung Hintergrund Die Psychotherapie-Richtlinie (PT-RL) gestaltet die Rahmenbedingungen der Psychotherapie in der vertragsärztlichen Versorgung in Deutschland. Aufgrund der Diskussion um Wartezeiten und inadäquate Versorgung von Betroffenen trat 2017 eine Reform in Kraft, um den Zugang zur Psychotherapie sowie den gesamten Versorgungs- und Behandlungsverlauf zu verbessern. Ziel des Projektes ist die Evaluation der neu eingeführten Versorgungselemente in der PT-RL sowie die Identifikation möglicher Implementierungsschwierigkeiten. Methoden Zur Evaluation der Reform der PT-RL finden sowohl quantitative als auch qualitative Methoden Anwendung. Um einen Vergleich der Versorgungssituation vor und nach der Reform durchzuführen, wird eine vergleichende retrospektive, kohortenbasierte Analyse auf Basis anonymisierter Routinedaten der BARMER und der AOK durchgeführt. Zusätzlich wird mit Hilfe einer Querschnittsanalyse erfasst, wie die neuen Versorgungselemente in der Praxis umgesetzt werden. Dazu erfolgt eine Befragung von Psychotherapeut*innen, Hausärzt*innen und Patient*innen. Fokusgruppen mit relevanten Interessensgruppen stellen zusammen mit einer Literaturrecherche die Basis für die Befragung dar. Zusammen mit den Routinedaten zur Versorgungssituation nach Reform der PT-RL und aggregierten, anonymisierten Daten der KBV zur vertragsärztlichen Versorgung sowie zur Inanspruchnahme der Terminservicestellen ergeben die Befragungsergebnisse die Datenbasis für die Querschnittsanalyse. Schlussfolgerung Durch die Verbindung von quantitativen und qualitativen Daten können die Auswirkungen der Strukturreform der PT-RL von 2016 auf individueller und struktureller Ebene sowie in Bezug auf den gesamten Versorgungs- und Behandlungsprozess analysiert werden. Darauf aufbauend werden Vorschläge für eine bedarfsgerechte Weiterentwicklung der PT-RL unter Berücksichtigung der Perspektiven verschiedener Interessensgruppen ausgearbeitet.

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“…These tendencies are also relevant for health research, since not only unemployment itself, but also the subjective threat of job insecurity can cause psychosocial stress (Dragano, Siegrist 2006, Ferrie 2006, Zok 2006). The results of longitudinal studies indicate that job insecurity has a negative effect on mental health, but also that the latter improves significantly once people return to secure employment (Ferrie 2006).…”

mentioning

confidence: 99%

Unemployment, Precarious Work and Health

Kieselbach¹,

Mannila²

2012

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Personalabbau, Arbeitsplatzunsicherheit und Gesundheit — Ergebnisse einer repräsentativen Umfrage

Cited by 3 publications

References 2 publications

Outcome after total ankle replacement or ankle arthrodesis in end-stage ankle osteoarthritis on the basis of german-wide data: a retrospective comparative study over 10 years

Outcome after total ankle replacement or ankle arthrodesis in end-stage ankle osteoarthritis on the basis of german-wide data: a retrospective comparative study over 10 years

Mixed-Methods-Ansatz zur Evaluation der Reform der Psychotherapie-Richtlinie: ein Studienprotokoll

Unemployment, Precarious Work and Health

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