[The contribution of health conferences and health regions to regional planning and management in health care: an overview at the federal states level]. / Der Beitrag von Gesundheitskonferenzen und Gesundheitsregionen zu regionaler Planung und Steuerung im Gesundheitswesen ­ ein Überblick auf Ebene der Bundesländer.

Demands for increased health care coordination and cooperation have been raised for a long time in Germany. Over the past years, the public health services in the federal states have initiated networks at the regional level dealing with health-related topics, namely health conferences and health regions. In the areas of health promotion and prevention, health care services and nursing care sector, these networks make an important contribution to regional planning and management by setting up networks among relevant municipal players and developing a more comprehensive approach. This narrative review, worked out in collaboration with experts from the German federal states, aims to present an overview of the characteristics, key topics and results of health conferences and health regions. Furthermore, we describe differences and similarities between the approaches in the federal states as well as the respective supporting measures in the context of funding programmes and the legal basis. The results show that health conferences and health regions are established in a great number of administrative districts in the federal states. There have been many health conferences and health regions since years and, according to the evaluations, show positive impacts on regional cooperation across departmental, sectoral and professional boundaries. They deal with a wide range of topics related to local needs and problems aiming to use synergies and meet challenges in the regional provision of healthcare and prevention measures. Besides building network capacities, the assessment of local needs and the development of strategies, health conferences and health regions also initiate numerous local cooperation projects to improve the health of the population. Against the background of expected future challenges that will have to be faced by the public health services, we finally discuss the significance of regional planning and management functions of the public health services. We also we provide some recommendations related to the conditions for setting up health conferences and health regions and discuss their future development.

[Optimization of Community Health Care: First Experiences of the Office for Medical Care in Districts and Municipalities of Bavaria]. / Optimierung der kommunalen Gesundheitsversorgung: Erste Erfahrungen des Kommunalbüros für ärztliche Versorgung des Landes Bayern.

Background: Demographic changes pose serious challenges for the healthcare system. One important goal is to sustain the local healthcare provision in the future - especially in rural areas. In this context, more attention must be given to the statutory health service by communal as well as state authorities. Most of the municipalities have to tackle this problem for the first time and, due to lack of support, are faced with serious impediments. The aim of this paper is to describe the sphere of action of the Office for Medical Care in Districts and Municipalities (OMCDM) as well as its core outcome. Methods: The Bavarian Ministry of Health and Care (StMGP) established the OMCDM at the Bavarian Health and Food Safety Authority to support communal authorities. On behalf of the StMGP, this office analyses the existing set-ups of local health services and advises local authorities on improvement. For 2012-2015, the OMCDM database was analyzed for frequency and main reasons of contact with health services. Results: The action of the OMCDM is driven by a comprehensive assessment, specialist counseling, and networking to develop action potential for the individual local health authorities. Over the past four years, there has been an increasing demand for support. Until 2015-11-30, 233 cases of counseling and 155 intensive counseling cases were recorded. The topics most frequently mentioned in these consultations were primary care by General Practitioners (68%) and specialist care (29%). Other important issues were the search for successors (33%), the establishment of new practices (23%) and opening of branch practices (18%). Conclusion: On behalf of Bavarian government, the OMCDM offers easy access to objective and neutral counseling about statutory health services for Bavarian municipalities. This offer has been used frequently by districts and municipalities. Primary care by general practitioners on the local level was the most common reason to contact the OMCDM. The establishment of the Office for Medical Care in Districts and Municipality is a comprehensive support for local authorities and can be regarded as a pattern for other states in Germany.