[Differences in Billing Patterns Between GPs and Pediatricians Using Early Diagnostics in Children and Adolescents as an Example: Analysis of Nationwide Data from Statutory Health Insurance Physicians]. / Kompensation von Leistungen zwischen Hausärzten und Kinder- und Jugendmedizinern am Beispiel der Früherkennungsuntersuchungen bei Kindern und Jugendlichen ­ Analyse von bundesweiten KBV-Daten.

BACKGROUND: Despite a 13.1% increase in the number of pediatricians between 2011 - 2020, the capacity of pediatric care has largely stagnated. This is due to increasing flexibility in working hours and a declining willingness of doctors to establish practices. In addition, there is an imbalance in the distribution of pediatric medical care capacities. While metropolitan areas are often characterized by oversupply, there is an increasing shortage of pediatricians, especially in rural areas. As a result, general practitioners in rural areas are increasingly taking over part of pediatric care. We quantify this compensation effect using the example of examinations of general health and normal child development (U1-U9). METHODS: Basis of the analysis was the Doctors' Fee Scale within the Statutory Health Insurance Scheme (Einheitlicher Bewertungsmaßstab, EBM) from 2015 (4th quarter). Nationwide data from the National Association of Statutory Health Insurance Physicians (KBV) for general practitioners and pediatricians from 2015 was evaluated. In the first step, the EBM was used to determine the potential overlap of services between the two groups of doctors. The actual compensation between the groups was quantified using general health and normal child development as an example. RESULTS: In section 1.7.1 (early detection of diseases in children) of the EBM, there is a list of 16 options for services that can be billed (fee schedule positions, GOP) by general practitioners and pediatricians. This particularly includes child examinations U1 to U9. The analysis of the national data of the KBV for the early detection of diseases in children showed significant differences between rural and urban regions in the billing procedure. Nationwide, general practitioners billed 6.6% of the services in the area of early detection of diseases in children in 2015. In rural regions this share was 23% compared to 3.6% in urban regions. The analysis of the nationwide data showed that the proportion of services billed by general practitioners was higher in rural regions than in urban regions. CONCLUSION: The EBM allows billing of services by both general practitioners and pediatricians, especially in the area of general GOP across all medical groups. The national billing data of the KBV shows that general practitioners in rural regions bill more services from the corresponding sections than in urban regions.

[Utilization of Gynaecological Cancer Screening by Women 20 to 35 Years of Age Receiving Unemployment Benefits Under Social Security Code II]. / Die Inanspruchnahme gynäkologischer Krebsfrüherkennungsuntersuchungen bei 20- bis 35-jährigen Frauen mit Bezug sozialer Transferleistungen nach Sozialgesetzbuch II.

The aim of the study was to analyze associations between utilization of gynaecological cancer screening (GCS) and the number of months during which state unemployment benefits (Social Security Code II) were drawn by women aged 20 to 35 years. The sample included 223 women with complete interview data (participation rate: 69%). The findings show that more women drawing unemployment benefits for a short-term (<12 months) utilized GCS compared to those receiving long-term benefits (>36 months).

Methods for determining pesticides and polychlorinated biphenyls in food samples--problems and challenges.

Determination of residual amounts of pesticides and polychlorinated biphenyls (PCBs) in food samples requires the use of specific techniques regarding sample preparation as well as instrumental analysis which should be characterized by a very low detection limit. A problem associated with the use of pesticides and PCBs is the need for controlling their residues in the environment, particularly in food, as these chemicals show a propensity to accumulate. The analysis of food samples for the presence of pesticides and PCBs brings on many difficulties because of the specificity of sample preparation consisting of multistep purification procedures of samples that contain trace amounts of an analyte. Concentration determinations of pollutants that easily dissolve in complex matrices, particularly in the presence of a large apportionment of interfering substances, pose a big challenge. Therefore, the basic step in food analysis for the presence of pesticides and PCBs is sample preparation which mainly consists of analyte enrichment and the removal of interfering substances. But all steps of the analytical procedure that include sample collection and preparation, extraction of analytes from matrix, extract purification, and final determination, are very significant; their precision and correct application have a decisive effect on the final result.

Applications of sample preparation techniques in the analysis of pesticides and PCBs in food.

Pesticides and polychlorinated biphenyls (PCBs) are found in various parts of the environment in quite small concentrations, but they accumulate and thus become a threat to human health and life. A review is focused on the application of some popular techniques for sample preparation in analysis of these compounds in food. Even with the emergence of advanced techniques of final analysis, complex matrices, such as food, require extensive sample extraction and purification. Traditional sample preparation techniques are time consuming and require large amount of solvents, which are expensive, generate considerable waste, contaminate the sample and can enrich it for analytes. There have been many sample preparation techniques proposed to meet the requirements connected with the multiplicity of food. Optimal sample preparation can reduce analysis time, sources of error, enhance sensitivity and enable unequivocal identification and quantification. Sample extraction and purification techniques are discussed and their most recent applications in food analysis are provided. This review pointed out that sample preparation is the critical step.