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1.
Methods Inf Med ; 51(2): 112-20, 2012.
Article in English | MEDLINE | ID: mdl-22101427

ABSTRACT

BACKGROUND: Physician rating websites (PRWs) are gaining in popularity among patients seeking quality information about physicians. However, little knowledge is available about the quantity and type of information provided on the websites. OBJECTIVE: To determine and structure the quantity and type of information about physicians in the outpatient sector provided on German-language physician rating websites. METHODS: In a first step, we identified PRWs through a systematic internet search using German keywords from a patient´s perspective in the two search engines Google and Yahoo. Afterwards, information about physicians available on the websites was collected and categorised according to Donabedian´s structure/process/outcome model. Furthermore, we investigated whether the information was related to the physician himself/ herself or to the practice as a whole. RESULTS: In total, eight PRWs were detected. Our analysis turned up 139 different information items on eight websites; 67 are related to the structural quality, 4 to process quality, 5 to outcomes, and 63 to patient satisfaction/experience. In total, 37% of all items focus specifically on the physician and 63% on the physician's practice. In terms of the total amount of information provided on the PRWs, results range from 61 down to 13.5 items. CONCLUSIONS: A broad range of information is available on German PRWs. While structural information can give a detailed overview of the financial, technical and human resources of a practice, other outcome measures have to be interpreted with caution. Specifically, patient satisfaction results are not risk-adjusted, and thus, are not appropriate to represent a provider's quality of care. Consequently, neither patients nor physicians should yet use the information provided to make their final decision for or against an individual physician.


Subject(s)
Information Dissemination/methods , Internet/statistics & numerical data , Patient Safety/statistics & numerical data , Physician-Patient Relations , Quality of Health Care/statistics & numerical data , Data Collection , Germany , Humans , Outpatients
2.
Gerontology ; 56(4): 385-9, 2010.
Article in English | MEDLINE | ID: mdl-19940454

ABSTRACT

Community-acquired pneumonia is a common disease of the elderly and involves a high mortality risk. Demographic developments are creating new challenges for acute medical treatment strategies in geriatric patients with their underlying multimorbidity. In addition to the diagnostic parameters recorded on hospital admission, such as white cell count and C-reactive protein, procalcitonin, more than the risk scores CRB- and CURB-65 evaluated to date, appears to be a promising parameter for assessing the severity of pneumonia in elderly patients to allow early detection of severe courses and initiation of suitable treatment. The decisive factor is the dynamic course of the procalcitonin values over 3 consecutive days, as demonstrated in this case series.


Subject(s)
Calcitonin/blood , Pneumonia/blood , Protein Precursors/blood , Aged , Aged, 80 and over , Biomarkers/blood , C-Reactive Protein/metabolism , Calcitonin Gene-Related Peptide , Community-Acquired Infections/blood , Community-Acquired Infections/diagnosis , Community-Acquired Infections/mortality , Female , Humans , Inflammation Mediators/blood , Leukocyte Count , Male , Pneumonia/diagnosis , Pneumonia/mortality , Pneumonia, Bacterial/blood , Pneumonia, Bacterial/diagnosis , Pneumonia, Bacterial/mortality , Risk Factors , Severity of Illness Index
3.
Gesundheitswesen ; 69(1): 11-7, 2007 Jan.
Article in German | MEDLINE | ID: mdl-17347927

ABSTRACT

Expenditure on health care has been rising for years. Also, the ageing population is a matter of fact. Generally, ageing goes along with higher expenditure for health care. Debates about the financial situation and solution for this situation are common. This article examines the impact of all aspects of ageism with regard to the expenditure in health care. Besides, for the practical effects of rationing, a multidimensional approach is illustrated. The article discusses the concept of age-dependent prioritisation of health-care spending.


Subject(s)
Delivery of Health Care/economics , Financing, Government/economics , Health Expenditures , Health Policy/economics , Health Priorities/economics , National Health Programs/economics , Resource Allocation/economics , Age Factors , Germany
4.
Ther Umsch ; 63(6): 419-22, 2006 Jun.
Article in German | MEDLINE | ID: mdl-16841579

ABSTRACT

The demographic shift demands more and more customized medical supplies and management structures for geriatric patients. The elderly patient with age-related functional restrictions and multi-morbidity is at special risk for an ill-adapted pharmacotherapy. In addition the frail elderly person is dependent on general-practitioner assistance. The prescription of a suitable drug and a safe and workable (galenic) application form is key to therapeutic success. Age-based intake regulations, repeated education, and intake training are crucial tasks for the general-practitioner when caring for a fast growing elderly patient population.


Subject(s)
Dosage Forms , Drug Administration Routes , Drug Administration Schedule , Drug Delivery Systems/instrumentation , Drug Delivery Systems/methods , Geriatrics/instrumentation , Geriatrics/methods , Aged , Aged, 80 and over , Female , Germany , Humans , Male , Patient Compliance , Patient Education as Topic/methods , Practice Guidelines as Topic , Practice Patterns, Physicians'
5.
MMW Fortschr Med ; 148(4): 39-42, 2006 Jan 26.
Article in German | MEDLINE | ID: mdl-16502799

ABSTRACT

The multimorbid geriatric patient with age-related functional deficits is at particular risk from fever. Although the underlying cause is usually an infection, collagenosis, malignomas or drug-associated side effects all play an increasingly important role in patients of advanced age. In this segment of the population, the question of the reasonableness of a diagnostic work-up weighed against the expected improvement in quality of life is of particular relevance. The most common complication is dehydration, which may be followed by marked confusion. Account being taken of the requirements and the social situation of the individual concerned, any critical development should prompt early hospitalization, ideally in a geriatric hospital.


Subject(s)
Bacterial Infections/diagnosis , Dehydration/prevention & control , Fever of Unknown Origin/etiology , Aged , Aged, 80 and over , Analgesics, Non-Narcotic/therapeutic use , Anti-Bacterial Agents/therapeutic use , Bacterial Infections/drug therapy , Dehydration/etiology , Female , Fever of Unknown Origin/drug therapy , Humans , Male , Risk Factors
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