[Social medicine, public health and governance for health]. / Sociální lékarství, verejné zdravotnictví a rízení péce o zdraví.

Social medicine, public health and governance for health have a long tradition in the Czech Republic but some problems persist. Possible solutions are reliable information, research, education and training. Action plans for Health 2020 implementation are appreciated as well as a valuable help of the WHO Country Office, Czech Republic.Key words: social medicine, public health, health, health governance, governance for health, Health 2020, World Health Organization.

[Social Law Entitlements and Compensations for Visually Impaired Patients in Germany, Focussed on Glaucoma]. / Sozialmedizinische und versorgungsrechtliche Aspekte des Glaukoms.

Although prevention of progression is the most important issue in the treatment of glaucoma patients, information on visual aids and social law entitlements is also helpful. In this article, the main aspects of compensation for visual impairment are outlined so that you can competently support your patients, without much effort, with helpful tips and appropriate instructions.

[Socio-medical aspects of mental disorders: mental disorders in the German medical health care system and socio-medical therapeutic interventions]. / Sozialmedizinische Aspekte bei psychischen Erkrankungen : Psychische Erkrankungen im medizinischen Versorgungssystem und therapeutische Maßnahmen.

In the first article social medicine was defined. In this second article the health care system and special socio-medical treatments for the individual are described. The role of social medicine is to describe and optimize the health care system. The legal basis for the structure of the health care system is the Social Law. The individual encounter between therapists and patients is also regulated by law. This includes a contract of personal service. Liability of therapists is therefore restricted to correct treatment, which must be documented, and not depending on outcome. Therapists must cooperate with each other. There are special socio-medical treatments for individuals. This includes sickness certificates, enforced treatment, guardianship, support by counselling services, socio-medical support by physicians and psychotherapists in private practice, care and assessment in rehabilitation centres, and measures for reintegration into working life.

[Social-sanitary situation in Marañón's work in the context of the fight against infectious diseases]. / La cuestión sociosanitaria en la obra de Marañón en el contexto de la lucha contra las enfermedades infecciosas.

Gregorio Marañón y Posadillo (1887-1960), played a leading role in the birth of endocrinology in Spain as is well known. However, his medical work included other important and significant fields. Thus, it was especially in the 1910s and 1920s, when Marañón dealt with the social-sanitary situation in madrid probably due to his professional attachment to the treatment of several infectious diseases and epidemic outbreaks. Actually, since 1911 onwards, he was in charge of the wards of infectious diseases in the Hospital General de Madrid where he had the opportunity of treating an important number of patients suffering from this type of pathology and, as a consequence, in the following years he published several articles in medical journals and presented in the Royal Academy of Medicine in Spain, some reports on infectious diseases and the Spanish health and social conditions at the time. This paper try to analyze this field of Marañón's social and scientific activity.

[Aspects of expertise which are jointly valid for German sociomedicine and statutory health care]. / Trägerübergreifende Aspekte der Begutachtung nach dem SGB IX - Teil II: Fallbeispiel -

A project group of the Medical Advisory Board of the German Federal Rehabilitation Council (BAR) developed fundamental joint principles on experts' opinions according to the social law code no. IX (SGB IX). The principles aim at medical experts working in different social organisations and statutory health care insurance. It was intended to create a "sociomedical language" which should be used as jointly as possible by experts in rehabilitation and social medicine and which is based on the ICF (International Classification of Functioning, Disability and Health, WHO 2001). Its stringent application will increase the utility of medical expertise across different institutions. The authors recommend to evaluate whether this model could provide a tool in the communication and cooperation between different sectors of the health system. Part I describes the theoretical model, Part II its application to a virtual individual case history.

[Aspects of expertising which are jointly valid for German sociomedicine and statutory health care]. / Trägerübergreifende Aspekte der Begutachtung nach dem SGB IX--Teil I: Grundlagen.

A project group of the Medical Advisory Board of the German Federal Rehabilitation Council (BAR) developed fundamental joint principles on experts' opinions according to the social law code no. IX (SGB IX). The principles aim at medical experts working in different social organisations and statutory health care insurances. It was intended to create a "sociomedical language" which should be used as jointly as possible by experts in rehabilitation and social medicine and which is based on the ICF (International Classification of Functioning, Disability and Health, WHO 2001). Its stringent application will increase the utility of medical expertise across different institutions. The authors recommend to evaluate whether this model could provide a tool in the communication and cooperation between different sectors of the health system. Part I describes the theoretical model, Part II its application to a virtual individual case history.

[Comparison of expertises between long-term care insurance (SGB XI) and the law on ambulatory care for disabled individuals in Berlin (HPG)]. / Ein Vergleich der sozialmedizinischen Begutachtungen zur Pflegeversicherung (SGB XI) und nach dem Berliner Landespflegegesetz (HPG).

A long-term care insurance (SGB XI) was established in Germany in 1995. Previously, care for predominantly disabled and disabled elderly people in Berlin was regulated by a law enforced by the Berlin government (HPG). The objective of this study was to investigate the differences in age, sex, diagnosis and care of the disabled individuals at home. In a cross-sectional study, the social medicine certificates of 3.916 disabled individuals were evaluated. The certificate assesses the grade of disability and the care needed for a person entitled to benefit from either the HPG or later from SGB XI. Disabled females benefiting from the HPG and SGB XI regulations are in the majority. The male: female ratio for HPG was 1:2.215 and for SGB XI 1:2.759. The differences between male and female as well as between HPG and SGB XI are statistically significant. The even higher proportion of females for those benefiting from SGB XI is due to the demographic change over time. The results of the study also show that the certificates differ in diagnosis, in the care needed at home, and in the grades of disability. By logistic regression analysis, the univariate method shows the amount of care needed at home to be greater for the HPG than for the long-term care insurance. The collective of disabled persons benefiting from HPG were derived from the ambulatory and the stationary sector. In this study, those individuals who were investigated and supported by SGB XI originated from the ambulatory sector, although the law also supports those under hospital care. By calculating analysis of multivariate logistic regression with grades of disability taken as dependent and disability of a given person as independent variables related to the grades of disability when applying SGB XI were compared to HPG. The independent variables have different hierarchies for both laws and need to be divided into more specific subgroups. Interestingly, age and sex did not influence the grading of disability. Diseases leading to disability differ between male and females. Males suffer mostly from neurologic and psychiatric and females from orthopaedic diseases. The criteria for the particular grades are too broad and a better specification is suggested, in that the grades should be increased from three to five. For exceptional cases, a more flexible procedure should be allowed, which is possible under the present SGB XI regulations.

[Classification of social medical products provided by the German Medical Services of the Statutory Health Insurance in Hessen]. / Zur Klassifikation sozialmedizinischer Leistungen des Medizinischen Dienstes der Krankenversicherung in Hessen nach Produktgruppen1.

Based on agreements presented by a task force the German Medical Services of the Statutory Health Insurance in Hessen developed its own classification of social medical assignments. According to economic systematics they were arranged in groups of external and internal products reflecting providing services in form of medical expertises and fulfilment of legal obligations. Further typologisation of the products can be achieved by relational marks. Documentation based on this classification as a part of social medical controlling supports modern planning and management concepts. This way practical sociomedicine as an applied health science makes its contribution to economic efficiency of the statutory health care system.

[Challenges in social medicine counseling and expert assessment]. / Herausforderungen der sozialmedizinischen Beratung und Begutachtung.

The services of expert testimony and professional consultation in sociomedicine are considerably challenged. It is not so much the question of maintaining their traditional functions but of developing them in order to maintain at least the status quo. These challenges consist for example of the lack of a scientific basis for the complex function of allocation, piloting and control of medical resources. Some new approaches are offered by the ICIDH, by new instruments of medical assessment and by quality management including "evidence-based medicine". Furthermore the services of expert testimony must bridge the gap between patients and social services in a way which is satisfactory for the population. Nevertheless, these services must maintain strict independence.