[Practical Year in Public Health: 10 Years of Experience at the Public Health Department in Frankfurt]. / Das Praktische Jahr im Fach Öffentliches Gesundheitswesen: Ergebnisse aus 10 Jahre Erfahrung am Gesundheitsamt Frankfurt am Main.

BACKGROUND: Since the winter semester 2013/14, the Public Health Department in Frankfurt has been the first to offer an internship in public health to medical students in their practical year in Germany. In this study, we analyzed how students evaluated their practical experience and the logbook within clinical training at the Public Health Department. METHODS: A rotation procedure was set up and a logbook with subject-specific learning objectives was developed. After the internship, students participated in an evaluation using a standardized questionnaire. The results of the last 10 years were evaluated quantitatively. RESULTS: The evaluation results of 15 medical students of the last 10 years showed a very high level of internship satisfaction. There was a high acceptance of the logbook regarding structure, learning objectives and skills. CONCLUSION: The internship at the Frankfurt Public Health Department provides the opportunity to be involved in daily activities of public health practice, gives an overview of learning objectives, and underlines good public health training.

Differences in opioid prescription rates between patients with musculoskeletal disorders enrolled in coordinated ambulatory healthcare and patients receiving usual care: a retrospective observational cohort study.

OBJECTIVES: To compare opioid prescription rates between patients enrolled in coordinated ambulatory care and patients receiving usual care. DESIGN: In this retrospective cohort study, we analysed claims data for insured patients with non-specific/specific back pain or osteoarthritis of hip or knee from 2014 to 2017. SETTING: The study was based on administrative data provided by the statutory health insurance fund 'Allgemeine Ortskrankenkasse', in the state of Baden-Wurttemberg, Germany. PARTICIPANTS: The intervention group consisted of patients enrolled in a coordinated ambulatory healthcare model; the control group included patients receiving usual care. Outcomes were overall strong and weak opioid prescriptions. Generalised linear regression models were used to analyse the effect of the intervention. RESULTS: Overall, 46 001 (non-specific 18 787/specific 27 214) patients with back pain and 19 366 patients with osteoarthritis belonged to the intervention group, and 7038 (2803/4235) and 963 patients to the control group, respectively. No significant difference in opioid prescriptions existed between the groups. However, the chance of being prescribed strong opioids was significantly lower in the intervention group (non-specific back pain: Odds Ratio (OR) 0.735, 95% Confidential Interval (CI) 0.563 to 0.960; specific back pain: OR 0.702, 95% CI 0.577 to 0.852; osteoarthritis: OR 0.644, 95% CI 0.464 to 0.892). The chance of being prescribed weak opioids was significantly higher in patients with specific back pain (OR 1.243, 95% CI 1.032 to 1.497) and osteoarthritis (OR 1.493, 95% CI 1.037 to 2.149) in the intervention group. CONCLUSION: Coordinated ambulatory healthcare appears to be associated with a lower prescription rate for strong opioids in patients with chronic musculoskeletal disorders. TRIAL REGISTRATION NUMBER: German Clinical Trials Register (DRKS00017548).