[Backache in insurance companies : Occupational health management]. / Rückenschmerz in Versicherungsunternehmen : Betriebliches Gesundheitsmanagement.

AIM OF THE STUDY: The article examines how big German insurance companies handle back pain in terms of occupational health management (OHM). METHODOLOGY: Narrative interviews with experts from 8 out of the 20 biggest enterprises were conducted. RESULTS: Musculoskeletal diseases are the number one or number two reason for sick leave. All enterprises offer OHM; there is a variety of measures, e. g., sport, massage, advice, ergonomics, healthy food and leadership training. The measures are hardly ever evaluated. DISCUSSION: The literature is controversial whether or which OHM measures are effective. In our sample few measures were evaluated; for more evidence based treatment this should be changed.

[Development of the Physician-patient Relationship in Germany during the Last Years from the Perspective of the Heads of Chambers and KVs]. / Die Entwicklung der Arzt-Patienten-Beziehung in Deutschland in den letzten Jahren aus Sicht von Vertretern der Ärztekammern und der Kassenärztlichen Vereinigungen.

INTRODUCTION: In some media the opinion is expressed that the physician-patient relationship has deteriorated in the past few years. In the present study we have analysed the validity of this statement, if it can be differentiated, what the reasons for it may be and in what ways the physician-patient relationship can be improved. METHODS: 8 chairmen or presidents of chambers of medicine or associations of statutory health insurance physicians were comprehensively interviewed; another 3 gave written replies to a questionnaire. All statements were subjected to an analysis of content. RESULTS: It is not the physician-patient relationship that has changed but rather a whole series of thematic fields, e. g., the image of the medical profession, the role of the physician, the behaviour of the patients, and the general circumstances, etc. The belief in the individual physician-patient -relationship has not changed. For those topics in which changes have occurred, a series of reasons has been mentioned, and numerous -proposals for improvements have been made. CONCLUSION: An analysis of "the" physician-patient relationship is not enough, instead a differentiation along the interfaces of the above-mentioned topics should be undertaken. It is recommended that these qualitative results should, as far as possible, be examined quantitatively. In some areas the chambers and the statutory health insurance physician associations could themselves positively influence the physician-patient relationship directly, in other aspects also indirectly.

[Use of hospital data for ophthalmological research : A feasibility study]. / Nutzung von Krankenhausdaten zur ophthalmologischen Forschung : Eine Machbarkeitsstudie.

AIMS: This study was carried out to investigate whether ophthalmology hospitals can exchange patient data for research purposes, i.e. whether this is technically and legally feasible and whether it is worthwhile, i.e. whether the data are useful for answering important medical questions. METHODS: In-depth interviews were conducted with experts and a literature search was carried out. RESULTS: Patient data were found to be fundamentally well-suited for research purposes and there is a corresponding need for research. There are also specific scientific question which need to be answered, e.g. development of visual acuity after various surgical procedures for glaucoma. There are also legal and technical difficulties but it is possible to solve these problems. Potential solutions are described. DISCUSSION: The results of this study show that it is basically feasible for hospitals and hospital personnel to exchange patient data and to combine them. As opposed to earlier attempts which tried to collect as much data as possible and then analyzed what to do with the data afterwards, it is recommended that a medical question should first be defined followed by a search for data afterwards. Furthermore, researching would be facilitated by an improved exchange of data by information systems.

Prevalence of female subfertility in German gynecological practices.

INTRODUCTION: The aim of this study was to calculate the number of women with a subfertility diagnosis in gynecological practices in Germany between 2006 and 2010 based on the data from a large epidemiological database. METHODS: All calculations are based on a representative, epidemiological database called "disease analyzer". Women with a confirmed diagnosis of female infertility (ICD 10: N97) or/and with documentation of procreative management (ICD 10: Z31) were identified. They were summarized under the term "subfertility". RESULTS: In total, data on 1,975,253 female patients with between 2006 and 2010 were included. Estimates for patients with "subfertility" compared to number of women lived in Germany (aged 18-45) was 2.44% (CI: 2.43-2.45) in 2006, 2.52% (CI: 2.51-2.53) in 2007, 2.56% (CI: 2.55-2.57) in 2008, 2.68% (CI: 2.67-2.69) in 2009 and 2.69% (CI: 2.68-2.70) in 2010. The difference was significant (p < 0.01). In total, between 2006 and 2010 an estimated 8.91% of all German women had been diagnosed "subfertile". CONCLUSION: When calculated for 5 years almost 1 out of 10 women aged 18 to 45 was counseled, investigated or treated by her gynecologist for "subfertility". This study provides reliable, representative data on a major healthcare issue in Germany.

The risk of developing depression when suffering from neurological diseases.

AIM OF THE STUDY: To investigate the comorbidity of Alzheimer's/dementia, epilepsy, multiple sclerosis and Parkinson's with depression. METHODS: 42,914 patients who were newly diagnosed with the four comorbid diseases were included in the study. We analyzed how many of these patients developed depression within five years. RESULTS: Between 21% (males with epilepsy) and 39% (women with Parkinson's)/44% (Alzheimer's patients under 60 years) developed depression within five years. CONCLUSION: We recommend routine checks for depression in patients diagnosed with one of these diseases, especially in the most comorbid ones.

[Pareto optimal communication of the medical qualities of practicing ophthalmologists: a new option for patient information?]. / Paretooptimale Kommunikation der medizinischen Stärken niedergelassener Augenärzte: Eine neue Möglichkeit der Patienteninformation?

BACKGROUND: This investigation analyzed the possibility to provide information about the medical qualities of ophthalmologists to make it easier for patients to find the right physician in a Pareto optimal way, i.e. to supply information so that nobody is harmed and at least one derives benefits. METHODS: Extensive interviews with key deciders in the system for ophthalmological care were carried out and analyzed. RESULTS: Pareto optimization is possible. However, implementation is not yet feasible mainly because of legal and economic restrictions and because of difficulties of the measuring system. In order to come to a result, a major medical, economic and legal effort would be required which is unlikely to come into place in the short-term. CONCLUSION: At least in the near future there will be no new Pareto optimal information systems available for patients in order to find the appropriate ophthalmologist. In the mid-term the situation could change if the open questions can be resolved.