Abstract:
BACKGROUND:The aim of this study is to evaluate the performance of the first certified regional trauma network in Germany, the Trauma Network Eastern Bavaria (TNO) addressing the following specific research questions: Do standard and maximum care facilities produce comparable (risk-adjusted) levels of patient outcome? Does TNO outperform reference data provided by the German Trauma Register 2008? Does TNO comply with selected benchmarks derived from the S3 practice guideline? Which barriers and facilitators can be identified in the health care delivery processes for polytrauma patients? METHOD/DESIGN:The design is based on a prospective multicenter cohort study comparing two cohorts of polytrauma patients: those treated in maximum care facilities and those treated in standard care facilities. Patient recruitment will take place in the 25 TNO clinics. It is estimated that n = 1.100 patients will be assessed for eligibility within a two-year period and n = 800 will be included into the study and analysed. Main outcome measures include the TraumaRegisterQM form, which has been implemented in the clinical routine since 2009 and is filled in via a web-based data management system in participating hospitals on a mandatory basis. Furthermore, patient-reported outcome is assessed using the EQ-5D at 6, 12 and 24 months after trauma. Comparisons will be drawn between the two cohorts. Further standards of comparisons are secondary data derived from German Trauma Registry as well as benchmarks from German S3 guideline on polytrauma. The qualitative part of the study will be based on semi-standardized interviews and focus group discussions with health care providers within TNO. The goal of the qualitative analysis is to elucidate which facilitating and inhibiting forces influence cooperation and performance within the network. DISCUSSION:This is the first study to evaluate a certified trauma network within the German health care system using a unique combination of a quantitative (prospective cohort study) and a qualitative (in-depth facilitator/barrier analysis) approach. The information generated by this project will be used in two ways. Firstly, within the region the results of the study will help to optimize the pre-hospital and clinical management of polytrauma patients. Secondly, on a nationwide scale, influential decision-making bodies, such as the Ministries of Health, the Hospital Associations, sickness funds, insurance companies and professional societies, will be addressed. The results will not only be applicable to the region of Eastern Bavaria, but also in most other parts of Germany with a comparable infrastructure. TRIAL REGISTRATION:VfD_Polyqualy_12_001978 , 10.Jan.2013; German Clinical Trials Register DRKS00010039 , 18.02.2016.
journal_name
BMC Health Serv Resjournal_title
BMC health services researchauthors
Koller M,Ernstberger A,Zeman F,Loss J,Nerlich M,Trauma Network Eastern Bavaria (TNO).doi
10.1186/s12913-016-1468-5subject
Has Abstractpub_date
2016-07-11 00:00:00pages
242issn
1472-6963pii
10.1186/s12913-016-1468-5journal_volume
16pub_type
杂志文章abstract:BACKGROUND:Societal preferences have to be taken into consideration to ensure difficult healthcare decisions are legitimate and acceptable. It has been interesting to ascertain whether attitudes towards the principles of public healthcare resources allocation are homogenous. In particular, it has been thought provoking...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/s12913-015-1210-8
更新日期:2015-12-18 00:00:00
abstract:BACKGROUND:Liver function tests (LFTs) are routinely performed in primary care, and are often the gateway to further invasive and/or expensive investigations. Little is known of the consequences in people with an initial abnormal liver function (ALF) test in primary care and with no obvious liver disease. Further inves...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/1472-6963-7-54
更新日期:2007-04-16 00:00:00
abstract:BACKGROUND:In Brazil, health is fundamental human right guaranteed by the Constitution of 1988, which created the Brazilian Universal Health System (Sistema Único de Saúde - SUS). The SUS provides medications for outpatient care via policy of pharmaceutical assistance (PA) programmes. Despite the advances in PA policie...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/s12913-017-2430-x
更新日期:2017-07-19 00:00:00
abstract:BACKGROUND:Inadequate antenatal care (ANC) can lead to missed diagnosis of danger signs or delayed referral to emergency obstetrical care, contributing to maternal mortality. In developing countries, ANC quality is often limited by skill and knowledge gaps of the health workforce. In 2011, the Mentorship, Enhanced Supe...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/s12913-018-2939-7
更新日期:2018-02-23 00:00:00
abstract:BACKGROUND:Communication between patients with limited English proficiency (LEP) and telephone triage services has not been previously explored. The purpose of this study was to determine the utilization characteristics of a primary care triage call center by patients with LEP. METHODS:This was a retrospective cohort ...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/s12913-017-2651-z
更新日期:2017-11-09 00:00:00
abstract:BACKGROUND:In low- and middle-income countries (LMICs), addressing the high prevalence of mental disorders is a challenge given the limited number and unequal distribution of specialists, as well as scarce resources allocated to mental health. The Mental Health Gap Action Programme (mhGAP) and its accompanying Interven...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/s12913-017-1992-y
更新日期:2017-01-17 00:00:00
abstract:BACKGROUND:The Health Literacy Questionnaire (HLQ) has nine scales that each measure an aspect of the multidimensional construct of health literacy. All scales have good psychometric properties. However, it is the interpretations of data within contexts that must be proven valid, not just the psychometric properties of...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/s12913-017-2254-8
更新日期:2017-04-27 00:00:00
abstract:BACKGROUND:The main objective of this methodological manuscript was to illustrate the role of using qualitative research in emergency settings. We outline rigorous criteria applied to a qualitative study assessing perceptions and experiences of staff working in Australian emergency departments. METHODS:We used an inte...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/s12913-018-2915-2
更新日期:2018-02-17 00:00:00
abstract:BACKGROUND:Delay in cancer diagnosis may be important for cancer prognosis. Large individual variations in the duration of delay have been observed. This study examines whether patients' socioeconomic characteristics are predictors of long patient-, doctor- and system-related delay in cancer diagnosis. METHODS:Danish ...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/1472-6963-8-49
更新日期:2008-02-28 00:00:00
abstract:BACKGROUND:Regular health visits for parents with young children provide an opportunity for developmental surveillance and anticipatory guidance regarding common childhood problems and help to achieve optimal developmental progress prior to school entry. However, there are few published reports from Australian cultural...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/s12913-017-2143-1
更新日期:2017-03-22 00:00:00
abstract:BACKGROUND:Diabetic retinopathy (DR) is the commonest cause of preventable blindness in working age populations, but up to 98% of visual loss secondary to DR can be prevented with early detection and treatment. In 2012, an innovative outreach DR screening model was implemented in remote communities in a state of Austra...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/s12913-017-2045-2
更新日期:2017-02-22 00:00:00
abstract:BACKGROUND:Common mental disorders are the most prevalent of all mental disorders, with the highest burden in terms of work absenteeism and utilization of health care services. Evidence-based treatments are available, but recognition and treatment could be improved, especially in the occupational health setting. The si...
journal_title:BMC health services research
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1186/1472-6963-7-29
更新日期:2007-02-27 00:00:00
abstract:BACKGROUND:With increased international migration, language barriers are likely becoming more relevant in primary care. The aim of this study was to investigate the language barrier in paediatric and adult primary care, present its consequences, reveal how it is overcome, as well as highlight the use of and potential u...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/s12913-019-4164-4
更新日期:2019-06-27 00:00:00
abstract:BACKGROUND:Numerous drugs used in the treatment of psychiatric disorders are substrates of cytochrome P450 enzymes and are potential candidates for drug-drug interactions (DDIs). METHODS:Claims data of a German statutory health insurance company from severely mentally ill patients who registered in an integrated care ...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/s12913-016-1724-8
更新日期:2016-09-08 00:00:00
abstract:BACKGROUND:Over the last decade, active surveillance has proven to be a safe approach for patients with low-risk prostate cancer. Although active surveillance presents several advantages for both patients and the health care system, all eligible patients do not adopt this approach. Our goal was to evaluate the factors ...
journal_title:BMC health services research
pub_type: 杂志文章,多中心研究
doi:10.1186/s12913-018-3273-9
更新日期:2018-06-08 00:00:00
abstract:BACKGROUND:Risperidone long-acting injection (LAI) is mostly administered twice weekly to people with schizophrenia by nurses at community mental health centres (CMHC) or through mobile outreach visits. This study estimates the cost of resource utilisation associated with the administration of risperidone LAI and the p...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/1472-6963-11-236
更新日期:2011-09-26 00:00:00
abstract:BACKGROUND:Poles constitute the largest group of migrants in Norway. Research confirms a steady inflow and a minimal outflow of Polish migrants. One of the key aspects of migrants' structural integration is access to health care services. This study explored barriers to and facilitators of Polish migrants' access to No...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/s12913-016-1715-9
更新日期:2016-09-01 00:00:00
abstract:BACKGROUND:Innovative and sustainable programs are required to support the well-being of stroke survivors. Peer support is a potentially low cost way to enhance well-being of recent stroke survivors and the well-being and community reintegration of their peer supporters. This article describes the perceptions of stroke...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/1472-6963-14-256
更新日期:2014-06-16 00:00:00
abstract:BACKGROUND:Workplace bullying has adverse effects on nurses' productivity and emotional well-being and increases nurses' desire to leave their jobs. Bullying is a common phenomenon that has been reported worldwide. Emergency Department (ED) nurses are particularly exposed to bullying as a result of their job stressors ...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/s12913-019-4268-x
更新日期:2019-07-03 00:00:00
abstract:BACKGROUND:Prevalence studies usually depend on self-report of disease status in survey data or administrative data collections and may over- or under-estimate disease prevalence. The establishment of a linked data collection provided an opportunity to explore the accuracy and completeness of capture of information abo...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/1472-6963-13-481
更新日期:2013-11-19 00:00:00
abstract:BACKGROUND:Recognizing the importance of increased patient participation in healthcare decisions leads decision makers to consider effective ways to incorporate patient perspectives in Health Technology Assessment (HTA) processes. The implementation of local health HTA units in university hospitals in Quebec provides a...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/1472-6963-9-54
更新日期:2009-03-27 00:00:00
abstract:BACKGROUND:A novel point-of-care ultrasound (PoCUS) training program was developed to train rural healthcare providers in Kenya on the Focused Assessment with Sonography for Trauma (FAST), thoracic ultrasound, basic echocardiography, and focused obstetric ultrasonography. The program includes a multimedia manual, pre-c...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/s12913-018-3196-5
更新日期:2018-08-06 00:00:00
abstract:BACKGROUND:Pay for performance schemes are increasingly being implemented in low income countries to improve health service coverage and quality. This paper describes the context within which a pay for performance programme was introduced in Tanzania and discusses the potential for pay for performance to address health...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/1472-6963-14-392
更新日期:2014-09-16 00:00:00
abstract:BACKGROUND:The objective of this paper is to identify the key conditions that positively affect the use of e-health services in Central Eastern Europe (CEE) countries. CEE countries after the political and economic transformation in 1989/90 implemented slightly different national health care models. The research questi...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/s12913-020-5034-9
更新日期:2020-03-04 00:00:00
abstract:BACKGROUND:In 2011, South Africa improved its ability to test for rifampicin-resistant TB (RR-TB) by introducing GeneXpert MTB/RIF. At the same time, the South African National TB program adopted a policy decentralized, outpatient treatment for drug resistant (DR-) TB. We aim to analyze the impact of these changes on l...
journal_title:BMC health services research
pub_type: 杂志文章,多中心研究
doi:10.1186/s12913-018-3762-x
更新日期:2018-12-17 00:00:00
abstract:BACKGROUND:In 2008, the Swedish government introduced a National Rehabilitation Program, in which the government financially reimburses the county councils for evidence-based multimodal rehabilitation (MMR) interventions. The target group is patients of working age with musculoskeletal disorders (MSD), expected to retu...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/s12913-016-1948-7
更新日期:2017-01-07 00:00:00
abstract:BACKGROUND:International studies have shown a contribution of psychiatric comorbidity to high utilization rates in out-of-hour primary care (OOHC). Up to now, the impact of psychiatric comorbidity in German OOHC remains unclear. Therefore, we aimed to investigate reasons for encounter (RFE), possible psychiatric comorb...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/s12913-017-2749-3
更新日期:2017-11-28 00:00:00
abstract:BACKGROUND:Chronic diseases are rapidly increasing and are currently the major cause of death and disability worldwide. Patients with chronic diseases experience many challenges including medicine-related problems. However, there is limited information about the home management of medicines among these patients. This s...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/1472-6963-12-323
更新日期:2012-09-18 00:00:00
abstract:BACKGROUND:Delivery of community-based prevention services for HIV, malaria, and diarrhea is a major priority and challenge in rural Africa. Integrated delivery campaigns may offer a mechanism to achieve high coverage and efficiency. METHODS:We quantified the resources and costs to implement a large-scale integrated p...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/1472-6963-11-346
更新日期:2011-12-21 00:00:00
abstract:BACKGROUND:Job satisfaction is an important predictor of an individual's intention to leave the workplace. It is increasingly being used to consider the retention of health workers in low-income countries. However, the determinants of job satisfaction vary in different contexts, and it is important to use measurement m...
journal_title:BMC health services research
pub_type: 杂志文章,多中心研究
doi:10.1186/s12913-016-1558-4
更新日期:2016-07-27 00:00:00