Christian E Schmidt

GHD

Objectives The main aim of this work was to analyze the cost-effectiveness of an integrated care concept (NICC) that combines telemonitoring with the support of a care center in addition to guideline therapy for patients. Secondary aims were to compare health utility and health-related quality of life (QoL) between NICC and standard of care (SoC)....

Importance Healthcare concepts for chronic diseases based on tele-monitoring have become increasingly important during COVID-19 pandemic. Objective To study the effectiveness of a novel integrated care concept (NICC) that combines tele-monitoring with the support of a call centre in addition to guideline therapy for patients with atrial fibrillati...

Zusammenfassung Hintergrund und Ziel der Arbeit In dieser Studie wurden die Studierenden der Generationen Y und Z des Studiengangs Humanmedizin an der Georg-August-Universität Göttingen hinsichtlich ihrer Präferenzen am Arbeitsplatz und der Wahl eines Arbeitgebers befragt. Material und Methoden Die Befragung wurde 2016 über einen Onlinefragebogen...

Background: Cardiovascular diseases are the major cause of death globally and represent a major economic burden on health care systems. For patients with heart failure, atrial fibrillation or therapy-resistant hypertension, we have developed a novel integrated care concept (NICC) which combines telemedicine with intensive support by a care center,...

Background: Detection of atrial fibrillation (AF) after cryptogenic stroke (CS) has therapeutic implications, but the most effective type and optimal duration of monitoring have still to be defined. This study that involved patients with CS or transient ischemic attack (TIA), all of whom carried an implantable cardiac monitor (ICM), sought to asse...

Background: Hospital revenues generated by diagnosis-related groups (DRGs) are in part dependent on the coding of secondary diagnoses. Therefore, more and more hospitals trust specialized coders with this task, thereby relieving doctors from time-consuming administrative burdens and establishing a highly professionalized coding environment. Howeve...

Background: Cardiovascular diseases are the major cause of death globally and represent a major economic burden on health care systems. Positive effects of disease management programs have been shown for patients with heart failure (HF). Remote monitoring and telemonitoring with active intervention are beneficial in atrial fibrillation (AF) and th...

Background: Otorhinolaryngology (ENT) departments are strongly affected by current changes in the reimbursement schemes for inpatients. The study was designed to investigate these effects on the ENT Department in Rostock and selected comparison clinics, as well as to outline solutions. Methods: We analyzed diagnosis-related group (DRG) reports o...

Background: Cut-throat competition, cost pressure, generation Y, shortage of qualified staff and feminisation influence human resources management in visceral surgery. The assessment of the current situation by chief surgeons (CS) as well as proof of transferability of strategies from industry and service business (ISB) have not yet been investigat...

The economic situation in German Hospitals is tense and needs the implementation of differentiated controlling instruments. Accordingly, parameters of revenue development of different organizational units within a hospital are needed. This is particularly necessary in the revenue and cost-intensive operating theater field. So far there are only bar...

Research into ageing and its underlying molecular basis enables us to develop and implement targeted interventions to ameliorate or cure its consequences. However, the efficacy of interventions often differs widely between individuals, suggesting that populations should be stratified or even individualized. Large-scale cohort studies in humans, sim...

Background: The assurance of high standards of care is a major requirement in German hospitals while cost reduction and efficient use of resources are mandatory. These requirements are particularly evident in the high-risk and cost-intensive operating theatre field with multiple process steps. The cleaning of operating rooms (OR) between surgical...

The guarantee of quality of care and patient safety is of major importance in hospitals even though increased economic pressure and work intensification are ubiquitously present. Nevertheless, adverse events still occur in 3–4 % of hospital stays and of these 25–50 % are estimated to be avoidable. The identification of possible causes of error and...

Background Due to demographic change there is a significant shortage of highly qualified personnel in gynecology and obstetrics. This lack of qualified personnel has led to competition for personnel between hospitals and departments. When analyzing the circumstances of the competition, doctors of generation Y are important. Recruitment and retentio...

Schmidt CE, Lips Th (2015) Der Nabel der Region. Vernetzte Versorgungsstrukturen in Rostock. Führen und wirtschaften, 5:340-343.

Der Krankenhausmarkt Deutschland befindet sich im Wandel. Dieser Wandel wird vor allem durch die Ambulantisierung der Medizin getrieben, die letztlich dem medizinisch-technologischen Fortschritt geschuldet ist. Das betrifft auch die Gynäkologie und Geburtshilfe und birgt Chancen und Risiken für den niedergelassenen Frauenarzt.

Background Treatment of patients with multimorbidity is challenging. A rational reduction of long-term drugs can lead to decreased mortality, less acute hospital treatment, and a reduction of costs. Simplification of drug treatment schemes is also related to higher levels of patient satisfaction and adherence. The POLITE-RCT trial will test the eff...

Background: The aim of this study was to develop a valid tool for internal process analysis of stroke management in order to identify possible improvements. Method: 939 stroke patients were classified into DRG diagnoses. Specific parameters known to influence the length of stay were analysed. Subgroup analyses were carried out in patients with T...

Background The current situation in hospitals is characterized by financial limitations and simultaneously by increasing demands on quality and safety. The operative interface between anesthesia and transfusion medicine affects both factors. Aim A detailed analysis was performed to evaluate the process quality at this operative interface at the Uni...

The current situation in hospitals is characterized by financial limitations and simultaneously by increasing demands on quality and safety. The operative interface between anesthesia and transfusion medicine affects both factors. A detailed analysis was performed to evaluate the process quality at this operative interface at the University Hospita...

Der Fachkräftemangel in Medizin und Pflege hat sich in den letzten Jahren erheblich zugespitzt. Heute gibt es kaum noch eine Klinik, die nicht über einen Mangel an Ärzten oder Fachpflegekräften klagt. Aber wie kann es gelingen, Mitarbeiter zu motivieren, zufrieden an ihrem Arbeitsplatz zu bleiben?

Critical incidents in clinical medicine can have far-reaching consequences on patient health. In cases of severe medical errors they can seriously harm the patient or even lead to death. The involvement in such an event can result in a stress reaction, a so-called acute posttraumatic stress disorder in the healthcare provider, the so-called second...

Surgery on the temporal bone is technically challenging due to its complex anatomy. Precise anatomical dissection of the human temporal bone is essential and is fundamental for middle ear surgery. We assessed the possible application of a virtual reality temporal bone surgery simulator to the education of ear surgeons. Seventeen ENT physicians with...

While positive short-term effects of the use of safety checklists have previously been reported by personnel, it is unclear to which extent these effects are maintained for a long-term period. The aim of the present study was to evaluate perioperative safety standards and the quality of interprofessional cooperation from the viewpoint of the involv...

Hintergrund Der Fachkräftemangel in Medizin und Pflege löst einen Wettbewerb aus. Bei der Analyse der Wettbewerbsbedingungen ist die sog. Generation Y bedeutsam. Diese Mitarbeiter sind mehrheitlich weiblich und stellen höhere Anforderungen an Arbeitgeber als bisherige Generationen. Daher sind Kenntnisse dieser Ansprüche für die erfolgreiche Anwerbu...

BACKGROUND: The shortage of qualified doctors and nurses has led to a competition between hospitals. Analyzing the circumstances of the competition, nurses and doctors of so-called generation Y are important. These employees are mainly female and have different requirements compared to previous generations. Therefore, knowledge of these requirement...

Hintergrund: Der Fachkraftemangel in Deutschland hat zu einem Wettbewerb zwischen Krankenhausern gefuhrt. Dabei ist die Rekrutierung junger Mitarbeiter von besonderer Bedeutung. Die Qualitat der Ausbildung scheint der wichtigste Faktor fur die Wahl einer Klinik zu sein, wobei die Eignung der Bewerber abnimmt. Fur die Hals-, Nasen- und Ohrenheilkund...

Hintergrund: Es gibt einen erheblichen Fachkraftemangel im Bereich von Medizin und Pflege, den entscheidenden Berufsgruppen eines Krankenhauses. Besonders betroffen sind erlosstarke Bereiche wie der OP_- Bereich und die Intensivstationen. Dieser Fachkraftemangel lost einen Wettbewerb um Fachkrafte aus. Bei der Analyse der Wettbewerbsbedingungen ist...

Hintergrund: Die demographische Entwicklung in Deutschland fuhrt dazu, dass die Bevolkerung in Deutschland von heute 82 Mio. auf 74 Mio. Einwohner bis 2050 schrumpft. Damit wird der schon bestehende Fachkraftemangel in Medizin und Pflege weiter aggraviert. Neben einer Intensivierung der Rekrutierungsmasnahmen und damit auch des Wettbewerbs um Fachk...

Demographic changes in Germany are leading towards a decrease of the population from the current 82 million to 74 million in the year 2050. As a consequence the shortage of qualified staff will be aggravated and intensifying recruiting efforts will increase competition among employers. An alternative is to utilize the potential of jobholders older...

The shortage of medical specialists in Germany has led to increased competition between hospitals, particularly in the recruitment of young skilled doctors. The quality of training appears to be the critical factor in a clinic's recruiting process. At the same time, the suitability of candidates is decreasing. There is currently no data on the suit...

Hintergrund Der Fachkräftemangel in Deutschland hat zu einem Wettbewerb der Krankenhäuser untereinander geführt, insbesondere bei der Rekrutierung junger Mitarbeiter. Die Qualität der Ausbildung scheint der wichtigste Faktor für die Wahl einer Klinik zu sein. Gleichzeitig nimmt die Eignung der Bewerber ab. Für die Hals-, Nasen- und Ohrenheilkunde (...

Medical advances in diagnosis and therapy, especially in medical technology, lead to differenciated and more complex strategies in therapy with higher risks. Patients show higher expectations concerning the results of a therapy and claim more often that a mistake in treatment has been made. This makes patients turn to arbitration boards more often....

Zusammenfassung Hintergrund Die Gesundheitsbranche wird im Jahr 2020 von einem starken Arbeitskräftemangel betroffen sein. Die Alterung der Belegschaft ist hier ein wichtiger Treiber für den Fachkräftemangel. Dieses Alterungsrisiko wird jedoch in den bisherigen Zeithorizonten der Personalplanung von 1 bis 2 Jahren nicht sichtbar. Daher ist die pros...

At present, besides well-known financial problems, German hospitals are facing a serious lack of qualified medical staff. Given these facts, it is of great importance, especially in work load burdened disciplines, such as cardiovascular anaesthesiology, to retain highly qualified medical staff. Here, human resource development measures offer valuab...

The healthcare market is facing a serious shortage of qualified personnel in 2020. Aging of staff members is one important driver of this human resource deficit but current planning periods of 1-2 years cannot compensate the demographic effects on staff portfolio early enough. Therefore, prospective human resource planning is important to avoid los...

There is a significant shortage of highly qualified personnel in medicine, especially skilled doctors and nurses. This shortage of qualified labor has led to competition between hospitals. Analyzing the circumstances of the competition, nurses and doctors of the so-called generation Y are of importance. Recruitment and retention of these staff memb...

Veränderungen betreffen jeden Teil der Wirtschaft, also auch Krankenhäuser. Seit einigen Jahren ist jedoch der Wandel im Krankenhausmarkt für alle Beteiligten erkennbarer geworden. Offensichtliche Ursachen für diesen Wandel sind die ansteigende Technisierung, der Bettenabbau, die veränderte Demografie, die Einführung der DRGs und die Krankenhausfin...

Der Krankenhausmarkt wird sich in den nächsten 5 Jahren im Wettbewerb um qualifiziertes Personal entscheiden, denn 80 % der Krankenhäuser in Deutschland gaben in einer Untersuchung der Bundesärztekammer (Kopetsch 2010) an, derzeit offene Stellen im ärztlichen Dienst nicht besetzen zu können. Damit haben sich die offenen Stellen von 2007 bis 2009 fa...

Zusammenfassung Das Thema Prozessmanagement im Krankenhaus hat in den vergangenen Monaten besondere Aufmerksamkeit erlangt. Dazu haben u. a. Presseberichte über medizinische Behandlungsfehler beigetragen. Als Folge sind verstärkt Instrumente des Risikomanagements (z. B. „clinical incident reporting“) im Krankenhaus zur Anwendung gekommen. Diese Ins...

Growing attention has been drawn to patient safety during recent months due to media reports of clinical errors. To date only clinical incident reporting systems have been implemented in acute care hospitals as instruments of risk management. However, these systems only have a limited impact on human factors which account for the majority of all er...

Hospitals consider themselves to be exposed to intense competition for patient admissions. Yet their competitive performance is only rarely assessed in terms of patient satisfaction. Following agreed guidelines, formulated on the basis of interdisciplinary research, the University Clinical Centre (2,500 beds, 10,000 employees) of Schleswig Holstein...

Background Customer satisfaction in German hospitals is becoming more important because of increasing competition in the healthcare market. Because the majority of patients with ear-nose-throat (ENT) problems are treated in an outpatient setting, this competition is not only taking place among hospitals but also among specialists in private practic...

Personelle Engpässe, Qualitätssicherung und Benchmarking erfordern ein Konzept zur Facharztweiterbildung. Unser Programm dauert 2,5 Jahre und umfasst: 1. Erarbeitung des nötigen Facharztwissens durch den Assistenten im Selbststudium. 2. Eine Fortbildungsveranstaltung/Woche nach Lehrplan, ein Facharztseminar/Monat zur Besprechung von Fallbeispielen....

Studies measuring quality of life (QoL) during orthodontic treatment are rare in Germany. Therefore, the aim of the present study was to measure the impact of orthodontic treatment on QoL and to develop a reliable instrument for measuring this. The study was conducted in a large orthodontic practice and was designed as a prospective cross-sectional...

Einleitung: Kolorektale Karzinome gehoren sowohl bei Mannern als auch bei Frauen zu den haufigsten Krebserkrankungen. Insgesamt steigt die Inzidenz kolorektaler Karzinome in der Bundesrepublik leicht an, der Inzidenzgipfel liegt derzeit im 7. und 8. Dezennium. Ziele: Verschiedene in letzter Zeit veroffentlichte Untersuchungen beschaftigen sich mit...

Tissue eosinophilia is a hallmark of nasal polyposis and its pathogenesis is an area of high interest. RANTES and eotaxin are both known to recruit eosinophils, however, the mechanisms triggering their induction are still uncertain, and viral infections have been suggested to be involved in this process. Therefore, we investigated whether rhinoviru...

Nasal polyposis is mostly associated with eosinophilia of mucosal tissue. This points to the implication of CC chemokines in nasal eosinophilia. Recently the CC chemokine eotaxin-2 (CCL24) was identified. This study was initiated to localize the cellular source, analyze expression of mRNA, and quantify protein synthesis of CCL24. Specimens of nasal...

Der deutsche Krankenhausmarkt befindet sich zurzeit in einer tief greifenden Umbruchphase. Hohe Intransparenz und starke Regulierungen des Gesundheitssystems ohne ökonomische Ressourcenoptimierung sind zukünftig nicht mehr finanzierbar. Steigende Ausgaben und eine steigende Nachfrage der Gesundheitsleistungen, auch aufgrund immer älter werdenden Pa...

To determine how quality of life changes over time and to assess gender-related differences in quality of life of rectal cancer patients we conducted a 5-year study. Little is known about how quality of life (QoL) changes over time in patients after surgery for rectal cancer, and whether gender of the patients is associated with a different percept...

German hospitals face growing economic pressure. Due to the reimbursement system with diagnosis-related groups (DRGs), revenues from capitation fees have to be earned by each clinic. This leads to minimization of resources for every single case. Cost effectiveness is also realised through shorter hospital stays, reduction of hospital beds and a ste...

German hospitals face growing economic pressure. Due to the reimbursement system with diagnosis-related groups (DRGs), revenues from capitation fees have to be earned by each clinic. This leads to minimization of resources for every single case. Cost effectiveness is also realised through shorter hospital stays, reduction of hospital beds and a ste...

Previous studies have suggested that sexuality following surgery for rectal cancer is better in women than in men and differs with type of surgery in terms of impact on Quality of Life. However, the findings were inconsistent. The aim of the presented study was to address these issues. 570 patients that had undergone surgery for rectal cancer in ou...

In recent years Germany has faced a growing economization and competition among hospitals. To protect their interests hospitals have to operate similarly to other commercial businesses. Academic hospitals face difficult circumstances in this competition. They have to facilitate research and education activities which require additional financial an...

In various studies, type of surgery, age, and gender had different impact on sexuality and quality of life in patients with rectal cancer. This study was designed to investigate how sexuality and quality of life are affected by age, gender, and type of surgery. A total of 516 patients who had undergone surgery for rectal cancer in our department fr...

Study results on quality of life (QoL) between patients receiving an anterior resection (AR) or abdominoperineal resection (APR) for rectal cancer vary greatly. A main reason is grounded in unequal methodology. The aims of this study were to assess differences in perceived QoL over time among patients treated with AR or APR with a recommended study...

Some studies indicate that age at the time of surgery has a general effect on outcomes. The impact of age on the quality of life (QOL) of patients with rectal cancer, however, has not been investigated. The present study was conducted to address this issue. Over a 5-year period the European Organization for Research and Treatment of Cancer (EORTC)-...

Only few studies have investigated the impact of surgery for rectal cancer on sexual function. Little of that research included quality of life (QoL) aspects and hardly any study analyzed the impact of age, gender and type of surgery on sexual function. The aim of the presented study was to address these issues. Over a 5 y period, EORTC-QLQ-C-30 an...

The term "quality of life" was first mentioned in 1920 in economic journals and became an issue in the early 1960s in North America. Initially it became accepted in social sciences and later in medicine. The development of generic measures began in the early 1970s and continues today. Disease-specific measures were introduced in the 80th and 90th....

In recent years Germany has faced a growing economization and competition among hospitals. To protect their interests hospitals have to operate similarly to other commercial businesses. Academic hospitals face difficult circumstances in this competition. They have to facilitate research and education activities which require additional financial an...

Internal transfer pricing system (ITPS) of anaesthesia services is established to guarantee a close connection of delivered service and the budget of the department of anaesthesia. In most cases a time-based system is used with the pricing unit being calculated as the quotient from the enumerator "costs" divided by the denominator "anaesthesia time...

Postoperative survival and complication rates have traditionally been the standard parameters of outcome after oncologic surgery. In tumors with poor patient survival, such as esophageal cancer, studies about quality of life are rare. The objectives of this study were to assess outcomes in terms of quality of life in patients with esophageal cancer...

Poor countries tend to have worse health outcomes than better-off countries. Within countries, poor people have worse health outcomes than better-off people. This association between poverty and ill-health reflects causality running in both directions. Building on accordant evidence, the report on “Macroeconomics and Health” detects several key fin...

Internal transfer pricing system (ITPS) of anaesthesia services is established to guarantee a close connection of delivered service and the budget of the department of anaesthesia. In most cases a time-based system is used with the pricing unit being calculated as the quotient from the enumerator “costs” divided by the denominator “anaesthesia time...