[Do gatekeeping programs increase equality of health care in Germany? A comparison of the health care situation of participants and nonparticipants]. / Führt das Hausarztmodell zu mehr Gleichheit im Gesundheitssystem? Ein Vergleich der Versorgungssituation von Hausarztmodellteilnehmern und Nichtteilnehmern.

This article compares the health care situation of participants in programs of general practitioner-centered health care (gatekeeping) in Germany (participants) with that of statutory health insurance holders who are not participating in such programs (nonparticipants). Because a key objective of the general practitioner model is to reduce the number of visits to specialists, the article also examines factors influencing frequent utilization of specialists in both groups. The analysis draws on a survey conducted by the National Association of Statutory Health Insurance Physicians (Kassenärztliche Bundesvereinigung, 2010) based on a sample representative of the German population. In this context, 5,232 holders of statutory health insurance aged between 18 and 79 years were interviewed on health care policy issues. The results show that regulating the utilization of specialists through the gatekeeping function of general practitioners succeeds in facilitating similar utilization rates across educational levels, between cities and towns, and between men and women. Thus, gatekeeping programs contribute to the reduction of health care inequalities.

[Knowledge and evaluation of health-system reforms as reflected in social determinants]. / Kenntnisstand und Bewertung gesundheitspolitischer Reformen im Spiegel sozialer Determinanten.

Significant reforms have been instituted in Germany's health system in recent years. Although a number of studies have examined the population's knowledge of and attitudes towards the new regulations, little information is available on status-specific differences. This article examines the extent to which knowledge and evaluation of health policy measures is influenced by social determinants. The analysis draws on a survey conducted by the National Association of Statutory Health Insurance Physicians (Kassenärztliche Bundesvereinigung, 2009) based on a sample representative of the German population. In this context, 2 032 respondents aged between 18 and 79 years were interviewed on health-care policy issues. Results of bivariate analysis and logistic regression show that knowledge of the reform measures is significantly associated with educational level, age, and nationality. For example, respondents with the lowest level of formal education have an approximately four times higher risk as those with a higher level of formal education of not knowing about the health fund, and non-Germans have around twice the risk as Germans of not knowing about the reform measures. The main difference to emerge in respondents' EVALUATION of the reform measures is between East and West Germans. West Germans are significantly more likely than East Germans to evaluate the reform measures in negative terms. These status-specific differences in respondent knowledge can be attributed at least to some extent to the information asymmetry between patients and physicians/health-care providers. There is an urgent need for policy makers and care providers to render the reform measures transparent, accessible and comprehensible - especially to disadvantaged groups - to facilitate their effective implementation and positive evaluation.

[Cooperation between physicians and self-help groups in the system of ASHIP. Practical experience]. / Kooperation von Arzteschaft und Selbsthilfe im KV-System. Praxiserfahrungen.

In recent years, there has been increased cooperation between doctors' associations and patient self-help groups. Much of this cooperation is dependent on the engagement and involvement of individuals. However, a far reaching, established type of cooperation is still lacking. Several studies show that there are many advantages to be gained from working with self-help organizations. In Germany, ambulatory medical care is managed by the Association of Statutory Health Insurance Physicians (ASHIP). In order to develop the cooperation between patient self-help groups and ASHIP physicians, several information centers (KOSA) for these groups have been established. These information centers support direct communication between patient self-help groups and physicians by means of selective measures, specialist events and expert forums. A cooperation handbook is available for doctors and psychotherapists detailing case studies of the experiences of KOSA members. In addition to these information centers, cooperation is supported by patient advisory boards, round table discussions and symposia.

[More power for patients: the patients' forum--a joint platform for the medical profession and patient self-help groups]. / Mehr Power für Patienten: Patientenforum--Gemeinsame Plattform von Arzteschaft und Patientenselbsthilfe.

New ways of cooperation between doctors and representatives of patients are followed with the help of the patients' forum which was founded on the initiative of the German Medical Association. Members of the German Association 'Help for the Handicapped People', the 'Forum of the Chronic Ill and Handicapped People' of the 'Equal Charitable Organisation' (Paritätischer Wohlfahrtsverband), the 'German Association of Self-Help Groups' as well as representatives of the committees and the management of the German Medical Association and the National Association of Statutory Health Insurance Physicians form the patients' forum. The major aim of this cooperation is to discuss the possibilities and the ways to improve the quality in health care. A direct participation of patients' representatives is for the moment planned in the evaluation of the quality of medical information for the lay public. In cooperation with the Agency for Quality in Medicine--a joint institution of the German Medical Association and the National Association of Statutory Health Insurance Physicians--the quality of information on health care that is published in the internet should be examined. The patients' information service which was developed by the Agency for Quality in Medicine and is found under www.patienten-information.de is the basis for this examination.