Biomedical subjects

W Streich

Publications and source records attributed to W Streich.

3 recordsLinked to original sources

PubMed2004

[Shared decision making].

BACKGROUND AND OBJECTIVE: The demand for integration of patients in medical decisions becomes more and more obvious. Little is known about whether patients are willing and ready to share therapeutic decisions. So far information is lacking, whether existing communication skills of both -- patients and physicians -- are sufficient for shared decision making (SDM). This paper presents new data on patients perspectives regarding SDM. METHODS: Standardized survey of 3058 German speaking people (1565 females, 1493 males), aged 18-79 years, a population based random sample of an access panel (pool of german households available for specific surveys) regarding the following topics: medical decision making in practice, communication skills and behaviour of physicians. RESULTS: A majority of patients approved the model of SDM. However, some subgroups of patients, especially older patients, were less interested in the concept of SDM. Necessary communication skills which may help patients to participate in decision making were used rather scarcely. Patients who approved the model of SDM more often experienced a common and trustful exchange of information. CONCLUSION: Most patients favour the concept of SDM. The communication skills necessary for this process are to be promoted and extended. Research on patients' preferences and their participation in health care reform should be intensified. Academic and continuous medical education should focus on knowledge transfer to patients.

Adolescent↗

PubMed1996

[Rendering public health reports in cities and regions--results of a model trial in Brandenburg and North Rhine-Westphalia].

The purpose of health reporting is to give orienting advices for health policy at regional and local level. In fact, there are only few communities and districts engaged in health reporting. A pilot project run in North Rhine-Westphalia and Brandenburg tried to fill the gap by developing and examining methods and procedures of producing regional health reports. Therefore a system of report topics was drawn up which allowed gradual processing and division of work between the five participating local health departments. Each health department chose three topics to be dealt with during a two-year phase of practice. Those working on the project individually advised and supported planning and realisation of the reports. The "health reporter" in the local health department should organize the production of the reports together with experts. Because of lack of experience or fear of not being accepted in an organizing role this person mainly functioned as author of the report. This had a negative effect on quality and continuity of the work. It can however be regarded as a success of the pilote scheme that this development will be continued in form of a broader planned project supported by the Ministry of Employment, Health and Social Affaires of Northrhine-Westphalia.

Adult↗

PubMed1996

[Legitimizing and responsibilities of public health reports: public health reports or social court reports?].

Since 1970 various initiatives have been taken to improve the information bases of health reporting. However, the efforts made up to now by the Länder, the Federal Government and its corporate bodies are characterised by a lack of experience and shortage of resources; moreover, they are viewed with a critical eye by the public and in the political area. In this contribution the authors describe various topics and delimitations of a health reporting system which go far beyond health statistics and health programmes altogether. The chances of a national health reporting system are based on the assumption that an objective judgement based on expert knowledge and science will be possible and that beyond all particularistic interests, expert knowledge can be organised in a democratic process. Public health reporting varies between two extremes: On the one hand, the current reporting in the media on health-related subjects which is characterised by disagreement among experts, particularistic interests and emotions, and on the other hand the national health reporting, which, on the platform of policy marketing and political image shaping, is suspected of degenerating to a kind of "royal court reporting". A health reporting system based on expert knowledge and characterised by topics with relevance to health policy, expert quality of its information and neutrality to particularistic interests, should go beyond these two extremes. Given the political conditions of budgeting and distribution conflicts, health reporting has to deal with two main aspects: effectiveness and efficiency of employed resources and with the problems of a fair distribution of these resources to provide equal chances in the health sector. What cannot be solved, by questions of procedure, however, is the problem of truth and objective knowledge as well as the problem of confidence. If the general public lacks confidence in national expert knowledge, a society discourse will not lead to political results. Additionally, the argument that medicine is of little importance for health is used to categorically reject a rational investigation of needs and thus to reduce the health system to the status of a modern religious doctrine. Proceeding on the assumption that due to systematic thinking and acting in the field of science, effective medicine symbolises one of the paradigms of progress, then health reporting system can be justified despite the precarious objective knowledge, provided such reporting generates the confidence it deserves thanks to its quality standards and seriousness.

Cost-Benefit Analysis↗