Ute Karbach

• Dr. rer. pol.
• Head of Department at University of Cologne

Der Artikel präsentiert die vom Innovationsausschuss beim Gemeinsamen Bundesausschuss geförderte OpenNOTES-Studie. Im Rahmen der Studie wird die Möglichkeit einer patientenseitigen, digitalen Einsicht in die klinischen Behandlungsnotizen ihrer Gesundheitsdienstleister (Open Notes) untersucht. Während international positive Effekte von Open Notes au...

Background Guidelines recommend the identification of potential mental and/or cognitive disorders (MCD) in patients with coronary heart disease (CHD). However, compliance with these guidelines appears to be lacking in primary care. A minimal invasive intervention was tailored with experts for the primary care setting to increase the identification...

BACKGROUND Digital patient portals (PP) are platforms that enhance patient engagement and promote active involvement in healthcare by providing remote access to personal health data. Although many hospitals are legally required to offer these portals, adoption varies widely among patients, often influenced by socio-demographic and socio-economic de...

Background The European healthcare system is reliant on its digital transformation to deal with challenges like rising expenditures or workforce shortage. The digital transformation is inevitably accompanied by the implementation of electronic medical records (EMR) and the ongoing adaptation of existing ones. Systematic reviews indicate that this p...

Purpose The European health data space promises an efficient environment for research and policy-making. However, this data space is dependent on high data quality. The implementation of electronic medical record systems has a positive impact on data quality, but improvements are not consistent across empirical studies. This study aims to analyze d...

A major function of patient-physician-communication is building a trustful relationship and a therapeutic alliance between patient and physician. However, building trustful relationships to patients is subject to ambivalences. There are role expectations including affective neutrality, that stand in contrast to this function. Moreover, translation...

Background German hospitals are legally obliged to implement digital patient portals within the next years. Systematic reviews show that the use of patient portals may be associated with improved patient-centeredness and workflows. However, mandatory digital healthcare innovations are sometimes not used by the target group as planned or even comple...

Zusammenfassung Dieser Beitrag in der Zeitschrift „Gruppe. Interaktion. Organisation. (GIO)“ beleuchtet das bedingt durch die Komplexität von Rahmenbedingungen, Inhalten und Intentionen widerspruchsvolle Handlungsfeld Sozialer Arbeit im Kontext von Modellprojekten. Es wird der Frage nachgegangen, welche Spannungsfelder und eventuell resultierende P...

Die Versorgungsforschung stellt per Definition ein fachübergreifendes Forschungsgebiet dar. Entsprechend vielfältig gestaltet sich die praktische Tätigkeit in der Versorgungsforschung mit unterschiedlichsten methodischen wie auch theoretischen Herangehensweisen. Das folgende Kapitel gibt einen Überblick möglicher Ausbildungswege in die Versorgungsf...

Zusammenfassung Hintergrund Jedes Jahr wird in Deutschland bei durchschnittlich ca. 2200 Kinder und Jugendliche eine onkologische Erkrankung diagnostiziert. Bislang gibt es kaum Angebote einer ambulant-aufsuchenden Versorgung für diese Patientengruppe. Im Rahmen eines Pilotprojektes werden an Krebs erkrankte Kinder und Jugendliche von einem interdi...

Background Electronic medical records (EMR) are considered a key component of the health care system’s digital transformation. The implementation of an EMR promises various improvements, for example, in the availability of information, coordination of care, or patient safety, and is required for big data analytics. To ensure those possibilities, th...

Background Understanding how to implement innovations in primary care practices is key to improve primary health care. Aiming to contribute to this understanding, we investigate the implementation of a clinical decision support system (CDSS) as part of the innovation fund project AdAM (01NVF16006). Originating from complexity theory, the practice c...

Background The German healthcare system is still poorly digitized. With the Hospital Future Act, the government now mandates hospitals to implement an institutional electronic medical record (EMR). While multiple benefits are described for its adoption, knowledge on its impact on actual documentation is lacking. However, a documentation that is of...

The phenomenon of speechlessness has hardly been considered in the literature from a psychological point of view. Previous research on speechlessness is limited to the fields of neurology, medicine or psychopathology. The present review aims to consider speechlessness from a psychological perspective distinct from pathology, and to highlight its ob...

Background The adoption of digital health technologies can improve the quality of care for polypharmacy patients, if the underlying complex implementation mechanisms are better understood. Context effects play a critical role in relation to implementation mechanisms. In primary care research, evidence on the effects of context in the adoption of di...

BACKGROUND Electronic medical records (EMR) are considered a key component of the health care systems digital transformation. The implementation of an EMR promises various improvements e.g. in the availability of information, coordination of care, or patient safety and is required for big data analytics. To ensure those possibilities of an EMR, the...

Purpose The paper intends to do a scoping review of people with intellectual disabilities in emergency care where this group seems to face access barriers and discrimination. It analyses the conceptual and methodological framework for studies examining the former. Methods A scoping review is conducted. The studies’ quality is assessed via a checkl...

Zusammenfassung Ziel der vorliegenden Arbeit war es, Empfehlungen für ein Kerncurriculum für Masterstudiengänge der Versorgungsforschung zu erarbeiten. Hierzu wurde im ersten Schritt eine standardisierte Online-Befragung von Hochschullehrenden durchgeführt. Im zweiten Schritt wurden die Modulhandbücher der existierenden Studiengänge in Bezug auf ih...

Objectives Patients with autoimmune inflammatory rheumatic diseases (AIRD) often have lower vaccination coverage rates compared with the general population, despite being disproportionately affected by infectious complications. We aim to systematically review the literature regarding vaccination willingness and hesitancy in AIRD. Methods A scoping...

Background The Implementation Leadership Scale (ILS) was developed to assess leadership behavior with regard to being proactive, knowledgeable, supportive, or perseverant in implementing evidence-based practices (EBPs). As part of a study on the implementation of a digitally supported polypharmacy management application in primary care, the origina...

The major impact on healthcare through the ongoing digital transformation and new technologies results in opportunities for improving quality of care. Electronic patient records (EPR) are a substantial part in this transformation, even though their influence on documentation remains often unclear. This review aims to answer the question of which ef...

Background Patients with chronic inflammatory rheumatic diseases (CIRD) remain underrepresented in receiving vaccinations despite being disproportionately affected by infectious complications. Objectives To systematically review the literature regarding vaccination willingness and vaccination hesitancy in CIRD patients with focus on the perspectiv...

Aims For any orthodontic-orthognathic treatment, it is crucial that patients are provided with enough and proper information in order to make evidence-based decisions- not only prior to treatment start, but also throughout the course of therapy. Thus, the objectives of this qualitative study were to identify information needs of patients undergoing...

Background The health care innovation “MamBo – people with multimorbidity in outpatient care: patient-focused and needs-oriented healthcare management” aims to improve the efficiency and quality of care for multimorbid patients by delegating tasks (e.g. taking over house calls or coordinating specialist appointments) to a monitoring and coordinatio...

Hintergrund: Seit 2015 können Medizinische Versorgungszentren für Erwachsene mit Behinderung (MZEB) ermächtigt werden. Die ambulante Behandlung in diesen Einrichtungen ist spezialisiert auf die besonderen Bedarfe von Erwachsenen mit geistiger und schwerer Mehrfachbehinderung und soll eine ausreichende Versorgung im Sinne des gestuften Modells der G...

Hintergrund und Stand (inter)nationaler Forschung: Um die medizinische Versorgungssituation von MgsmB im ambulanten Bereich zu verbessern, wurde 2015 im Rahmen des gkv-Versorgungsstärkungsgesetzes (GKV-VSG § 119c SGB-V) die Möglichkeit geschaffen, so genannte Medizinische Behandlungszentren für Erwachsene mit geistiger Behinderung oder schweren Meh...

Hintergrund und Stand (inter)nationaler Forschung: Mit dem Practice Change and Development Modell (PCM) wurde nachhaltiger Wandel von Arztpraxen konzeptualisiert. Praxen werden als komplexe, adaptive Systeme verstanden, die durch vier sich wechselseitig beeinflussende Faktoren determiniert werden: Innere Eigenschaften, die zu Wandel befähigen (1. C...

Purpose: In order to design a patient-centered discharge process, the entire process is visualized in Value Stream Mapping. The duration of the process steps and waiting times are measured and presented. As a team, health professionals discuss problems and agree on suitable solutions. Methods: After applying Value Stream Mapping, we conducted ei...

Introduction Clinically complex patients often require multiple medications. Polypharmacy is associated with inappropriate prescriptions, which may lead to negative outcomes. Few effective tools are available to help physicians optimise patient medication. This study assesses whether an electronic medication management support system (eMMa) reduces...

Background To investigate patients’ perspectives on polypharmacy and the use of a digital decision support system to assist general practitioners (GPs) in performing medication reviews. Methods Qualitative interviews with patients or informal caregivers recruited from participants in a cluster-randomized controlled clinical trial (cRCT). The inter...

Background The need for and usage of electronic patient records within hospitals has steadily increased over the last decade for economic reasons as well as the proceeding digitalization. While there are numerous benefits from this system, the potential risks of using electronic patient records for hospitals, patients and healthcare professionals m...

The purpose of this paper is to investigate the role of positive affect in the association between multimorbidity and depressive symptoms. We used four consecutive waves (2008-2017) from the of the nationally representative German Ageing Survey (DEAS). We applied the mediational g-formula with inverse-probability weighting techniques and we also...

This study provides insights into the longitudinal relation between multimorbidity, mental wellbeing, and social support. The analysis used the German Sociomedical Panel of Employees, a study of the German working population aged 40 to 54. In the context of multimorbidity, this population has been little studied. Multimorbidity is significantly ass...

Background The health care innovation "MamBo – people with multimorbidity in outpatient care: patient-focused and needs-oriented healthcare management” aims to improve the efficiency and quality of care for multimorbid patients by delegating tasks (e.g. taking over house calls or coordinating specialist appointments) to a monitoring and coordinatio...

Zusammenfassung Ziel der Studie Ziel dieser Untersuchung war es, die derzeit akkreditierten Versorgungsforschungsstudiengänge in Deutschland im Hinblick auf ihre Strukturdaten und Inhalte zu analysieren. Methodik Im Rahmen eines deskriptiven qualitativen Designs wurden die aktuellen Studienverlaufspläne, die Modulhandbücher und die Steckbriefe akkr...

Objective Recent studies from Germany show that a small amount of breast and gynecological cancer patients participate in multidisciplinary tumor conferences (MTCs) at some cancer centers. One reason for the variation by center might be the providers’ attitudes about and experiences with MTC patient participation (MTCpp), which has not been analyze...

Objective: Formative evaluation of the implementation process for a digitally supported intervention in polypharmacy in Germany. Qualitative research was conducted within a cluster randomized controlled trial (C-RCT). It focused on understanding how the intervention influences behavior-related outcomes in the prescription and medication review pro...

Objective: Formative evaluation of the implementation process for a digitally supported intervention in polypharmacy in Germany. Qualitative research was conducted within a cluster randomized controlled trial (C-RCT). It focused on understanding how the intervention influences behavior-related outcomes in the prescription and medication review proc...

Background: With demographic change, the number of noncommunicable diseases, chronic diseases and multimorbidity is increasing, and so is the demand for health services. This represents a further challenge for the healthcare system. An adequate and efficient treatment of multimorbid patients requires a well-structured, informed and cross-indicated...

Objective: Breast cancer is the most common cancer among women worldwide, increasing the relevance of an efficient and successful care process. As length of stay (LOS) in the hospital decreases, patients' satisfaction with the LOS varies. We hypothesize that successful discharge planning can improve this evaluation. Methods: Data of 4,390 female...

Objective: To compare experiences and expectations of general practitioners (GPs) concerning the implementation and use of a digitally supported pharmacotherapy-management-system. Methods: Conducting four focus-group-discussions with GPs (N= 19) in a cluster-randomized-controlled trial named AdAM (registry: clinicaltrials.gov; identifier: NCT034303...

Introduction: Patients with end-stage kidney failure can be treated either by transplant or by dialysis, which can be administered as haemodialysis (HD) or peritoneal dialysis (PD). Although they are equivalent therapeutic options in terms of mortality, the percentage of patients in Germany treated with PD is currently very low (∼6%) compared with...

Susanne Fuß und Ute Karbach geben praxisnahe Anleitungen zur Transkription von wissenschaftlichen Interviews für die qualitative Sozialforschung. Das Grundlagen-Handbuch führt in die Praxis der sozialwissenschaftlichen Transkription ein. Es richtet sich an Studierende oder wissenschaftlich tätige Personen, die zum ersten Mal Interviews oder Gruppen...

Background: Discharge management is a central task in hospital management. Mitchell's quality health outcomes model offers a contextual framework to derive expectations about the relationship between indicators of hospital structures and processes with patient experiences of preparation for discharge. Purpose: The aim is to analyze the associati...

Hintergrund: Die Patientensicherheit, Qualität der Versorgung und Arbeitsentlastung für Ärzte stehen im Fokus der Implementierung von digitalen oder elektronischen Entscheidungsunterstützungssystemen in ambulanter und stationärer Versorgung. Wissenschaftliche Studien zeigen eine Verringerung von Medikationsfehlern, jedoch auch negative Bewertungen...

Introduction The last year of life constitutes a particularly vulnerable phase for patients, involving nearly all health and social care structures. Yet, little scientific evidence is available that provides insight into the trajectories including the number and types of care setting transitions, transitions into palliative care and the dying phase...

Zusammenfassung Im Rahmen der BMBF-Ausschreibung „Strukturaufbau in der Versorgungsforschung“ wird das Kölner Kompetenznetzwerk CoRe-Net von verschiedenen Partnern aus der Versorgungspraxis und der Versorgungsforschung aufgebaut. Der Fokus des Netzwerkes liegt auf der Versorgungsentwicklung nach dem Konzept der lernenden Organisationen. Anhand drei...

Aims Structured management programmes deliver optimized care in heart failure patients and improve outcome. We examined the feasibility of including patients with migration background speaking little or no German in a heart failure management programme. Methods and results After adaption of script material and staff to Turkish language we aimed to...

Background Quality improvement within health and social care facilities is needed and has to be evidence-based and patient-centered. Value Stream Mapping, a method of Lean management, aims to increase the patients’ value and quality of care by a visualization and quantification of the care process. The aim of this research is to examine the effecti...

Background: German and Turkish-speaking patients were recruited for a chronic heart failure management program. So far little is known about the special needs and characteristics of Turkish-speaking patients with chronic heart failure; therefore, the aim of this study was to examine sociodemographic and illness-related differences between German a...

Zusammenfassung: Das Gesetz zur Verbesserung der Versorgungsstrukturen in der gesetzlichen Krankenversicherung (GKV-VStG) zielt auf die Sicherung einer wohnortnahen, flächendeckenden und bedarfsgerechten medizinischen Versorgung. Das Ziel ist somit, das Versorgungsangebot am Bedarf auszurichten. Der Begriff „Bedarf“ wird im Bereich der Gesundheitsv...

Background No data exist on the size of the population potentially in need of palliative care in Germany. The aim of this study is to estimate the size of the German population that may benefit from palliative care. Method Based on existing population-based methods (Rosenwax and Murtagh), German death registration data were analyzed and contrasted...

The third and final discussion paper of the German Network of Health Services Research's (DNVF) "Qualitative Methods Working Group" demonstrates methods for the evaluation and quality of qualitative research in health services research. In this paper we discuss approaches described in evaluating qualitative studies, including: an orientation to the...

Eleven months after being interviewed in a study on unmet needs of severely affected multiple sclerosis patients, one participant died by assisted suicide. We reanalyzed the data to find out if our 15 study patients might have brought up the topic of death and dying during episodic interviews that had not primarily addressed this issue. Secondary a...

Background Since 2000, systemic thrombolysis has been the only approved curative and causal treatment for acute ischemic stroke. In 2009, the guidelines of the German Society for Neurology were updated and the therapeutic window for performing thrombolysis was extended. The implementation of new therapies is influenced by many factors. We analyzed...

Buchstäblich wortwörtlich – Eine Einführung in die Transkriptionskunst Wie transkribiere ich ein Interview?Worauf muss ich bei der Aufnahme achten? Und was ist mit dem Datenschutz? Susanne Fuß und Ute Karbach geben praxisnahe Anleitungen zur Transkription von wissenschaftlichen Interviews für die qualitative Sozialforschung. Der Band stellt gängige...

The aim of this exploratory study was to examine how the working conditions and job stress of private practice oncologists (PPOs) affect their interaction with patients. Data for the study were collected through semi-structured interviews with PPOs selected based on purposeful sampling criteria. The data were evaluated using content analysis. Facto...

Background: The needs of patients feeling severely affected by multiple sclerosis (MS) have rarely been investigated. However this is essential information to know before care can be improved, including adding palliative care (PC) services where helpful. Since it remains unclear at what point specialized palliative care should begin for this patie...

Der Zusammenhang zwischen Sozialkapital und Patientensicherheit ist bisher nur in wenigen Studien untersucht worden. Das Ziel des Betrags ist es daher, diesen Zusammenhang aus der Perspektive des Krankenhausmanagements zu analysieren. Dazu werden Daten einer 2008 durchgeführten standardisierten schriftlichen Befragung mit insgesamt 1 224 Ärztlichen...

Background: This study aims at investigating ischaemic stroke therapy in Germany by using secondary data. The focus lies on the performance of thrombolysis. Methods: Statutory quality report data for 2010 were obtained. All hospitals (n = 1302) treating patients suffering from an ischaemic stroke either on a neurological, internal, geriatric or...

Background: Managed care is a strategy used to counteract the disintegration of functions and services in healthcare systems. Despite the demonstrated political will to put such models into practice in Germany, barriers to their implementation could not be surmounted in recent years. One reason for this, which should be considered, is that implemen...

In this first part of a 3-part discussion paper the working group "Qualitative Methods" in the German Network of Health Services Research (DNVF) identifies the potentials and opportunities qualitative research methods provide for health services research. Many research questions relevant for health services research require the use of qualitative m...

Background: This is the second part of a 3-part discussion paper by the working group on "Qualitative Methods" in the German network of health services research (DNVF) that shall contribute to the development of a memorandum concerning qualitative health services research. It aims to depict the different types of qualitative research that are cond...

To be able to study the desire for hastened death (DhD) in patients receiving palliative care, research tools reflecting the thoughts of patients are needed. In order to better understand what issues of "life" and "death" mean to patients receiving palliative care in Germany, we analysed their spontaneous comments during a validation study of the G...

Guidelines are one of the means by which health care organizations try to improve health care and lower its cost. Studies have shown, however, that guidelines are still not being adequately implemented. In this exploratory study, we examine the link between physicians' knowledge of and compliance with guidelines: specifically, guidelines for the tr...

Die Frage nach dem Zusammenhang von Gesundheit und Gesellschaft ist grundlegend für die Medizinsoziologie und die Gesundheitswissenschaften. Zur Erklärung dieses Zusammenhangs gibt es verschiedene sozialepidemiologische Modelle. Diese versuchen meist zu klären, ob und wie soziale Faktoren auf die Gesundheit einwirken. Sie sind oft statisch angelegt...

There are two mega-trends in society as well as in the health care system: standardization and individualization. Our hypothesis is that these trends are not fully compatible. They are the reason for many conflicts in health care and in the care of the elderly. On the one hand, evidence-based standards of care can help to enhance disability-free li...

Many people working in human services in Western countries suffer from burnout, characterized by emotional exhaustion, depersonalization, and decreased personal performance. Prevention of emotional exhaustion (the first phase of burnout) constitutes a great challenge because emotional exhaustion may cause increasing turnover rates in staff and lead...

Das Deutsche Netzwerk Versorgungsforschung e. V. (DNVF e. V.) hat am 1. Juli 2009 – getragen von den genannten, im DNVF organisierten Fachgesellschaften und Organisationen – ein Memorandum III „Methoden für die Versorgungsforschung” verabschiedet, das in dieser Zeitschrift publiziert wurde [Gesundheitswesen 2009; 71: 505–510]. Die vorliegende Publi...

On 1 July 2009, the German Network for Health Services Research [Deutsches Netzwerk Versorgungsforschung e. V. (DNVF e. V.)] approved the Memorandum III “Methods for Health Services Research”, supported by the member societies mentioned below and published in this journal (Gesundheitswesen 2009; 71: 505–510). The focus of this part of the Memorandu...

The present explorative study was designed as a qualitative evaluation of the psycho-oncology services (POS) available at a psycho-oncology institution (POI) in Germany. The study focused on barriers to using these services. Seven focus groups and five complementary individual interviews were conducted with POS users, their relatives, and POS non-u...