[Memorandum 'Development of health services research in Bavaria from the perspective of the Bavarian State Working Group 'Health Services Research (LAGeV)': status quo - potential - strategies']. / Memorandum "Weiterentwicklung der Gesundheitsversorgungsforschung in Bayern aus Sicht der Landesarbeitsgemeinschaft Gesundheitsversorgungsforschung: Status quo - Entwicklungspotenziale - Strategien".

The aim of the memorandum on the development of health services research (HSR) in Bavaria is to operationalise the global objectives of the State Working Group "Health Services Research" (LAGeV) and to collectively define future topics, specific implementation steps, methods as well as ways of working for the future course of the LAGeV. The LAGeV is an expert committee that integrates and links the competencies of different actors from science, politics and health care regarding HSR and facilitates their cooperation. The memorandum is based on an explorative survey among the LAGeV members, which identified the status quo of health services research in Bavaria, potential for development, important constraints, promoting factors, specific recommendations as well as future topics for the further development of HSR in Bavaria. From the perspective of the LAGeV members, the 12 most important future topics are: 1) Interface and networking research, 2) Innovative health care concepts, 3) Health care for multimorbid patients, 4)Health care for chronically ill patients, 5) Evaluation of innovations, processes and technologies, 6) Patient orientation and user focus, 7) Social and regional inequalities in health care, 8) Health care for mentally ill patients, 9) Indicators of health care quality, 10) Regional needs planning, 11) Practical effectiveness of HSR and 12) Scientific use of routine data. Potential for development of HSR in Bavaria lies a) in the promotion of networking and sustainable structures, b) the establishment of an HSR information platform that bundles information and results in regard to current topics and aims to facilitate cooperation as well as c) in the initiation of measures and projects. The latter ought to pinpoint health care challenges and make recommendations regarding the improvement of health care and its quality. The cooperation and networking structures that were established with the LAGeV should be continuously expanded and be used to work on priority topics in order to achieve the global objectives of the LAGeV.

[Self-help groups conflicts of interest through sponsoring by the pharmaceutical industry]. / Interessenkonflikte der Selbsthilfe durch Pharma-Sponsoring.

Some patient and self-help groups accept financial support from the pharmaceutical industry and medical device manufacturers. For the industry, this constitutes an increasingly important product marketing component. The acceptance of material or other support triggers psychological mechanisms which endanger objective judgement without the persons involved realizing it. Thus, patient groups may evaluate drugs or devices in a positively distorted way.

[The Canadian experience with methods of systematic assessment of performance and revalidation in medicine. Chances for Germany]. / Erfahrungen mit Methoden der systematischen Kompetenzdarlegung und Rezertifizierung in der Medizin in Kanada. Chancen für Deutschland.

Recertification and systematic assessment of performance are components of well-developed medical quality culture. Canada has accumulated a wealth of experience in the development and application of methods of assessment. Germany can learn from the Canadian experience. In this article the Canadian three-step approach to assessment is introduced as well as the experience of its implementation in the provinces of Ontario and Alberta.

[Bremen-north working team on pain--an intervention to improve the quality of medical care in a city district as exemplified by pain therapy]. / Schmerzarbeitsgemeinschaft Bremen-Nord - eine Intervention zur Verbesserung der medizinischen Versorgungsqualität in einem Stadtteil am Beispiel der Schmerztherapie.

The purpose of an intervention in a city district of Bremen was to reduce the discrepancy between the possibilities and realities of pain therapy. All the important participants were included in measures and actions on several levels and for several target groups for a period of two years. An inquiry revealed a high degree of consent among the medical practitioners. The effect of the intervention was an improvement in the prescription of opioids by those physicians who had already been prescribing them, whereas there was no noticeable change in the behaviour of physicians who had not been prescribing opioids to date. In a second step the intervention was examined for reasons and limitations of its efficacy. In conclusion, this is brought in line with the present state of knowledge on the ways and mechanisms by which new medical advances come to the attention of medical practice. The elements of promising strategies to effect positive changes in health services are pinpointed.