Publications (32)49.73 Total impact
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Article: The "Bologna Process" in European higher education: impact of bachelor's and master's degrees on German medical education.
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ABSTRACT: The introduction of the Bologna Process, in particular the implementation of a tiered structure of study programs and degrees, imposes quite some changes in most European higher education systems. The purpose of this article is to introduce some major points of the Bologna Process with regard to medical education in Germany and Europe and to reflect the process of the adoption of a two-cycle bachelor-master system in medicine. International positions and perspectives of professionals, students, and politicians are discussed which underline the complexity and dynamics of the whole process in contemporary higher education. A short reflection to key aspects of the two-cycle system, and student mobility is provided. Higher education in the whole health care sector may benefit from the Bologna objectives leading to a more permeable, comparable, and compatible medical education system across Europe.Teaching and Learning in Medicine 04/2010; 22(2):142-7. · 0.75 Impact Factor -
Article: The role and duties of scientific medical societies: The German Society of Dermatology from the member's perspective.
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ABSTRACT: The German Society of Dermatology is a scientific medical society that represents the interests of German-speaking dermatology. One recommendation of a strategic planning mission was to increase the involvement of society members. Based on an empirical approach (questionnaire survey) a systematic member inquiry was performed which focused on the motives for membership, the image of the society,the use of provided services,and expectations and needs. Items regarding profession and health politics, continuous education and specialist training, and scientific representation and research promotion were considered in equal measure. In total, 931 usable questionnaires were available with a response rate of 28.4%. Various single results could be integrated in a subsequent strategic dialogue.The German Society of Dermatology is regarded as active and powerful in scientific issues and promotion of research. However, numerous expectations have been expressed to strengthen future activities in professional and health care related issues. Needs and demands differ if members are scientifically active or rather not. A scientific society in general acts in a permanent area of conflict and has to deal with multiple positions and interests.Thereby members' needs and demands may vary dependent on individual and professional backgrounds. Members who are not scientifically active should be more integrated in the society while at the same time the society's aims should be coordinated with that of the Berufsverband (organization of practicing dermatologists). Better networking is required both within the society and with outside groups. In addition, the primary aims and objectives of the society should be made even clearer to all interested parties.Journal der Deutschen Dermatologischen Gesellschaft 09/2009; 8(1):20-31. · 1.47 Impact Factor -
Article: Predisposing factors of actinic keratosis in a North-West German population.
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ABSTRACT: The growing incident rates of skin cancer and their corresponding precursor lesions, e.g. actinic keratosis (AK), among Caucasians have become an important public health problem. A multicenter case-control study was conducted to identify the risk factors of AK of a prototypical Central European population. The study population comprised a total of 331 cases and 383 controls. Using multivariate analysis we identified ten independent variables predicting the AK risk. The five most crucial were age (OR 1.11; 95% CI 1.08-1,14), gender (OR 3.92; 95% CI 2.42-6.36), history of previous skin malignancies (OR 6.47; 95% CI 3.21-13.03), pale skin phototype (OR 2.5; 95% CI 1.53-4.06), and sun exposure for occupational reasons (OR 1.72; 95% CI 1.01-2.92). Additionally, sun exposure for recreational reasons, denial of the use of sunscreens, painful sunburn episodes before the age of 20, and a familial history of skin malignancies are also significant independent correlates of AK. Our epidemiological data suggest that constitutional susceptibility and sunlight exposure are equally involved in the onset of AK. Additional prophylactic and educational efforts should focus on increasing sun protection policies and educational programs especially aimed at outdoor workers, men, fair skinned individuals and patients with a history of previous skin malignancies. These measures should be able to reduce the excessive incidence rates of AK among Caucasians in Central Europe.European journal of dermatology: EJD 06/2009; 19(4):345-54. · 2.53 Impact Factor -
Article: G-DRG Version 2009: new developments.
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ABSTRACT: The update of the G-DRG system for the year 2009 has been successfully negotiated. Like in the past years, changes are minimal and not dramatic, but they significantly enhance the quality of the DRG system. Once again, the German DRG system demonstrates its versatility and reliability for clinical reimbursement purposes. In the field of dermatology, several improvements or enhancements can be identified; the average case mix index that declined in the past years should now rise by 0.5 percent for 2009. Oncology cases are affected especially by this increase. Some refinements advanced for several years by the German Dermatologic Society (DDG) have been recognized --complex therapies like vacuum wound therapy, isolation due to multi-resistant infections and multiple primary tumors now have better cost weights. Although there still remain some minor problems like reimbursement of cost-intensive treatments, German dermatology is in summary very well prepared for the year 2009.Journal der Deutschen Dermatologischen Gesellschaft 05/2009; 7(4):318-27. · 1.47 Impact Factor -
Article: Development of lengths of stay and DRG cost weights in dermatology from 2003 to 2006.
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ABSTRACT: The G-DRG per case payments are calculated annually on the basis of present output and cost data provided from German hospitals. The economic valuation of dermatology-related DRGs depends largely on inpatients' length of stay. At present, longitudinal analyses of dermatologic hospital data considering the development of length of stay under DRG conditions are not available. A multicenter, longitudinal study of clinical data from hospitals with different care levels was performed (n = 23). Frequent and relevant dermatologic diagnoses were grouped and analyzed over a time period of four years (2003-2006). The development of lengths of stay and of G-DRG cost weights were studied in detail. Descriptive statistical methods were applied. After introduction of DRG, the data reveal a) reduction of length of stay in inpatient dermatology and b) after an initial abrupt rise, DRG valuation of dermatologic groups moderately decreased over time. Both trends changed most rapidly in the early years but reached a stable niveau in 2006. The study furthermore points out that not only length of stay, but also other type of costs influence DRG calculations. German dermatology reflects the international trend showing reductions of length of stay after introduction of a DRG-based hospital funding system. The DRG calculation and valuation of inpatient services depend on the duration of hospital stay. However, increasing per diem costs resulting from higher performances of every inpatient bed day are also taken into account. Further reduction of length of stay must not threaten the quality of inpatient care in dermatology.Journal der Deutschen Dermatologischen Gesellschaft 03/2009; 7(8):680-7. · 1.47 Impact Factor -
Article: [G-DRG Version 2008: Facts and analyses].
Journal der Deutschen Dermatologischen Gesellschaft 07/2008; 6(6):483-91. · 1.47 Impact Factor -
Article: G‐DRG Version 2008: Fakten und Analysen
Journal der Deutschen Dermatologischen Gesellschaft 05/2008; 6(6):483 - 491. · 1.47 Impact Factor -
Article: Dermatologic subspecialties in German inpatient dermatology:a national survey.
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ABSTRACT: In German-speaking countries, the specialty of dermatology is characterized by a large amount of subspecialties. Data providing information whether and to what extent these subspecialties are represented in German dermatology departments and clinics is not available. A national questionnaire survey was performed to determine the extent of involvement of dermatological subspecialties in dermatologic hospitals.Methods of descriptive statistics were applied. Overall, 90 dermatologic departments participated in this survey with a response rate of 78.3 %.The subspecialties allergology, dermatooncology,and dermatologic surgery are represented in over 90 % of departments; the sub-specialties andrology, aesthetic dermatology, dermatopathology, microbiology,phlebology,photobiology,proctology, and wound healing are represented in over 50 % of clinics. Furthermore, the subspecialties allergology, dermato-oncology, photobiology, and dermatopathology have strong research or academic representation. The present survey demonstrates that dermatologic subspecialties are widely represented in dermatologic departments and clinics not only by individuals with specialty training but also by those in higher academic posts. This demonstrated high expertise should be maintained in German dermatology and could be promoted by academic programs.Journal der Deutschen Dermatologischen Gesellschaft 04/2008; 6(9):735-40. · 1.47 Impact Factor -
Article: Evaluating hospital service quality from a physician viewpoint.
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ABSTRACT: The purpose of this research is to show that referring physicians play a strategic role in health care management. This study aims to evaluate the perception of hospital services by referring physicians and clinicians for quality improvement. DESIGN/METHOD/APPROACH: Referring physicians in private practice and hospital clinicians at a large dermatology academic department providing inpatient and outpatient services at secondary and tertiary care levels were surveyed to determine their perceptions of service quality. A comparative questionnaire survey was established to identify improvement areas and factors that drive referral rates using descriptive and inferential statistics. Referring physicians' (n=53) and clinicians' (n=22) survey results concordantly revealed that timely and significant information about hospital stay as well as accessibility to hospital staff are major points for improvement. Significant differences between both samples were found with respect to inpatient services and patient commendation. Clinicians tended to rate their services and offerings higher than referring physicians (p=0.019). Geographic range was correlated with the frequency of patient commendation (p=0.005) and the perception of friendliness (p=0.039). The number of referred patients was correlated with medical reports' informational value (p=0.042). Although the study has a limited sample size it appears that surveying physicians' perspectives is an essential tool for gathering information about how provided health care services are perceived. Survey results should be useful for continuous quality improvement by regular measuring and reporting to executive boards. Hospitals should pay careful attention to their communication tools, particularly medical reports.International Journal of Health Care Quality Assurance 02/2008; 21(1):75-86. -
Article: [G-DRG version 2007: a short overview].
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ABSTRACT: Just as in the year before, the structure and regulations of the new GDRG version 2007 was successfully agreed on a mutual basis by the national self-governing bodies in the German health care system. Although some problems in high-specialized medicine or day clinic care will remain, the current developments demonstrate once more the learning aptitude of the G-DRG-system. Some beneficial and major changes have been made in 2007, but most of them do not touch dermatology. Additional procedure-based payments have been introduced in 2007 including the parenteral administration of such expensive agents as etanercept and itraconazole. A statistical analysis of cost weights of the year 2006 versus 2007 for two university clinics suggests that in dermatology, the increasing complexity of the G-DRG system partly leads to lower cost weights. Overall in 2007 a remarkable increase of complexity and differentiation throughout the DRG-system can be identified as well as a careful expansion of procedure-based payments.Journal der Deutschen Dermatologischen Gesellschaft 10/2007; 5(9):778-87. · 1.47 Impact Factor -
Article: G‐DRG Version 2007: Ein kurzer Überblick
Journal der Deutschen Dermatologischen Gesellschaft 08/2007; 5(9):778 - 787. · 1.47 Impact Factor -
Article: Underlying diseases and co-factors in patients with severe chronic pruritus: a 3-year retrospective study.
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ABSTRACT: Chronic pruritus is a symptom of many diseases, with studies pending investigating its prevalence or incidence. The aim of this study was to describe the characteristics of the underlying diseases in a large number of patients. A total of 263 patients (110 men, 153 women; age range 8-95 years; mean 55.9 years) were included in the study. The following data were collected from patients presenting over a 3-year period: gender, age, history, skin lesions, laboratory, histological and radiological investigations. An underlying dermatosis was identified in 41.8% of patients, a systemic disease including unidentified neoplasms in 13.3% and a neurological disorder in 0.4%. No disease was found in 44.5% of patients. Among the patients in whom no disease was found, 55.6% of the, mainly elderly, patients had an accumulation of many co-factors, suggesting an own subgroup with multifactorial origin for the pruritus. The distribution and type of secondary scratch lesions gave no clue as to the underlying disease. In conclusion, patients with chronic pruritus present a inhomgeneous collective with different underlying diseases, including malignancy, necessitating thorough investigation.Acta Dermato Venereologica 02/2007; 87(6):510-6. · 3.18 Impact Factor -
Article: G‐DRG Version 2006: Fakten und Neuigkeiten
Journal der Deutschen Dermatologischen Gesellschaft 08/2006; 4(9):772 - 783. · 1.47 Impact Factor -
Article: [Current situation of dermatologic surgery in Germany].
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ABSTRACT: Dermatologic surgery has become an increasingly important issue in dermatology in recent years. At present, no current epidemiologic or care-related data on cutaneous surgery procedures in dermatology are available. To determine the extent of cutaneous surgery procedures in dermatological hospitals, a national survey was performed. Both the procedure codes for 2004 based on the OPS-classification and the DRG figures grouped to the major diagnostic category 09 of G-DRG version 2004 were considered in detail. Methods of descriptive statistics were applied. The submitted data reveal that the contributing hospitals provided 164487 cutaneous surgery procedures in the investigation period. The vast majority is represented by extensive procedures and plastic-reconstructive operations, as opposed to less complex surgeries such as simple excisions. Analysis of DRG assignment indicates that surgical procedures account for 44.2% of inpatient cases. The present survey demonstrates that in Germany cutaneous surgery procedures are widely performed by dermatological hospitals and dermatologists. The increasing incidence of melanoma and nonmelanoma skin cancer including precursor lesions will increase the need for dermatologists to perform cutaneous surgery in the future.Journal der Deutschen Dermatologischen Gesellschaft 07/2006; 4(6):477-85. · 1.47 Impact Factor -
Article: Versorgungssituation der operativen Dermatologie in der Bundesrepublik Deutschland
Journal der Deutschen Dermatologischen Gesellschaft 05/2006; 4(6). · 1.47 Impact Factor -
Article: Dermatomyositis associated with malignant melanoma--a marker of poor prognosis?
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ABSTRACT: Dermatomyositis (DM) is an inflammatory connective tissue disorder well recognized as a paraneoplastic syndrome in adults. The objective of this study was to assess the prognosis of DM associated with malignant melanoma (MM). We systematically searched databases (PubMed, MEDLINE, and WEB OF SCIENCE) for articles reporting the concurrence of DM and MM. For the literature study, time of onset of DM in relation to diagnosis of MM (before, concomitant with, or after), stage of MM after restaging (according to the American Joint Committee on Cancer [AJCC] guidelines, 2001), and survival time after diagnosis of DM were recorded. Survival time studies and univariate statistical analyses were performed. Furthermore, we present our own clinical case of a patient with DM concomitantly occurring with regional lymph node metastasis of MM. In 5 cases DM occurred before, in 6 cases concomitantly with, and in 6 cases after progression of MM. Univariate analysis identified the AJCC stage of MM as a significant prognostic factor. Gender, age, and the time interval between onset of DM and progression of melanoma were unrelated. The 1-year actuarial survival rate was 0% for patients with DM when occurring with MM at stage IV and 60% when occurring with MM at stage III (P < .05). The estimated mean survival time was 6.6 months for patients with MM stage IV and 57 months for stage III. The conclusions from this study are limited by the relatively small number of articles that reported the association of MM and DM. DM occurring in patients with MM at stage IV is connected with an extremely poor prognosis, whereas the few reported patients with DM and MM at stage III, including our case, have a prognosis similar to stage III patients without DM.Journal of the American Academy of Dermatology 02/2006; 54(2):221-6. · 3.99 Impact Factor -
Article: [Inpatient dermatology: appropriateness of admissions and G-AEP].
Journal der Deutschen Dermatologischen Gesellschaft 12/2005; 3(11):927-36. · 1.47 Impact Factor -
Article: Pathway management in ambulatory wound care: defining local standards for quality improvement and interprofessional care.
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ABSTRACT: Growing health care costs and changes in health care delivery, such as the adoption of the diagnosis-related groups, have tremendously affected treatment patterns all over the world. Pathway management is suitable to be responsive to the growing operating requirements and to manage effective and efficient medical care in hospitals. Pathways standardise clinical processes for patients with a similar diagnosis, procedure or symptom thereby optimising the quality of treatment and patient satisfaction. They are utilised by a multidisciplinary team with a primary focus on quality and coordination of care. Considering the key strategies of pathway management, an interprofessional team containing physicians and nurses developed and implemented a clinical pathway for ambulatory treatment of chronic wounds. A precise medical protocol was created to standardise routine procedures, to improve the treatment outcome and to provide an integrated documentation that enhances interprofessional collaboration. We designed a modular concept of four different sheets which provide pre-defined standards: (a) medical admission, (b) findings and history, (c) topic and systemic treatment and (d) evaluation of outcome criteria. Variances must be merely written down in detail. After 1 year in clinical practice, we state that the use of a clinical pathway for chronic wound management is an effective method of improving clinical processes and patient outcomes.International Wound Journal 07/2005; 2(2):104-11. · 1.46 Impact Factor -
Article: [G-dRG version 2005: relevant aspects for dermatology].
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ABSTRACT: One year after the obligatory implementation of a new hospital funding system based on Diagnosis Related Groups (DRG) the third version of a German DRG-system has been published. It differs significantly from the previous version. Modifications in the classification system and the introduction of further procedure-based payments contribute to a better depiction of specialized clinical services. A number of acknowledged problems which caused great discussion in 2004 have been solved, yielding a more appropriate mapping of clinical services. The algorithms of the major diagnostic categories have been modified and complications, comorbidities and/or multiple procedures will be considered more precisely in selecting a group. However, some inconsistencies concerning highly specialized medical procedures and special features of impatient dermatological care remain. Nevertheless, a great improvement over the previous versions is apparent. The crucial aspects of the G-DRG version 2005 and the accompanying rules and regulations of payment are reviewed in detail with special relevance to dermatology.Journal der Deutschen Dermatologischen Gesellschaft 04/2005; 3(3):169-80. · 1.47 Impact Factor -
Article: G‐DRG Version 2005: Relevante Aspekte für die Dermatologie
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ABSTRACT: ZusammenfassungEin Jahr nach der obligaten DRG-Einführung in den deutschen Krankenhäusern liegt nun die dritte Version eines deutschen DRG-Fallpauschalensystems vor, die sich wiederum sehr deutlich von der Vorgängerversion unterscheidet. Die Veränderungen am Klassifikationssystem sowie die Einführung weiterer Zusatzentgelte tragen dabei zu einer verbesserten Abbildungsqualität vieler Leistungsbereiche bei. Ein großer Teil der bekannten und wiederholt diskutierten Probleme wurde konstruktiv angegangen und Vorschläge bezüglich der Sachgerechtigkeit der Leistungsabbildung umgesetzt. Hierbei sind unter anderem die modifizierten Algorithmen der Hauptdiagnosekategorien und die verstärkte Berücksichtigung von Komplikationen, Begleiterkrankungen und/oder multiplen Prozeduren zu nennen. Es kann allerdings nicht erwartet werden, daß mit der neuen Version die Probleme in der Abbildung spezialisierter Leistungen bzw. die noch bestehenden Probleme der Dermatologie umfassend gelöst wurden. Insgesamt ist aber ein großer Fortschritt bei der Systemgestaltung zu verzeichnen. Die wesentlichen Aspekte der G-DRG Version 2005 und der begleitenden Abrechnungs- und Ausführungsbestimmungen werden mit Blick auf die Dermatologie erläutert.SummaryOne year after the obligatory implementation of a new hospital funding system based on Diagnosis Related Groups (DRG) the third version of a German DRG-system has been published. It differs significantly from the previous version. Modifications in the classification system and the introduction of further procedure-based payments contribute to a better depiction of specialized clinical services. A number of acknowledged problems which caused great discussion in 2004 have been solved, yielding a more appropriate mapping of clinical services. The algorithms of the major diagnostic categories have been modified and complications, comorbidities and/or multiple procedures will be considered more precisely in selecting a group. However, some inconsistencies concerning highly specialized medical procedures and special features of impatient dermatological care remain. Nevertheless, a great improvement over the previous versions is apparent. The crucial aspects of the G-DRG version 2005 and the accompanying rules and regulations of payment are reviewed in detail with special relevance to dermatology.Journal der Deutschen Dermatologischen Gesellschaft 02/2005; 3(3):169 - 180. · 1.47 Impact Factor
Top co-authors
Top Journals
Institutions
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2005–2010
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Westfälische Wilhelms-Universität Münster
- Medical Faculty
Münster, North Rhine-Westphalia, Germany
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2006–2009
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Universitätsklinikum Freiburg
- Department of Dermatology
Freiburg, Lower Saxony, Germany
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2003–2007
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Universitätsklinikum Münster
Münster, North Rhine-Westphalia, Germany
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