Abstract
The main focus of the paper is on the description of the development and current state
of research and implementation of patient-centered care (PCC) and shared decision
making (SDM) after fifteen years of substantial advances in health policy and health
services research.
What is the current state of SDM in health policy?
The “Patients’ Rights Act” from 2013 standardizes all rights and responsibilities within the framework of medical
treatment for German citizens and legal residents. This comprises the right to informed
decisions, comprehensive and comprehensible information for patients, and decisions
based on a clinician-patient-partnership.
What is the current state of SDM interventions and patient decision support tools?
SDM training programs for healthcare professionals have been developed. Their implementation
in medical schools has been successful. Several decision support tools – primarily
with support from health insurance funds and other public agencies – are to be implemented
in routine care, specifically for national cancer screening programs.
What is the current state of research and routine implementation?
The German government and other public institutions are constantly funding research
programs in which patient-centered care and shared decision-making are important topics.
The development and implementation of decision tools for patients and professionals
as well as the implementation of CME trainings for healthcare professionals require
future efforts.
What does the future look like?
With the support of health policy and scientific evidence, transfer of PCC and SDM
to practice is regarded as meaningful. Research can help to assess barriers, facilitators,
and needs, and subsequently to develop and evaluate corresponding strategies to successfully
implement PCC and SDM in routine care, which remains challenging.
Zusammenfassung
Hauptfokus des Beitrags ist die Darstellung der Entwicklung und des derzeitigen Standes
bezüglich Implementierung und Beforschung einer patientenzentrierten Versorgung und
der partizipativen Entscheidungsfindung (PEF) nach 15 Jahren substanzieller Fortschritte
in der Gesundheitspolitik und Versorgungsforschung in diesem Bereich.
Welchen Stand hat PEF in der Gesundheitspolitik?
Das Gesetz für Patientenrechte von 2013 regelt alle Rechte und Verantwortlichkeiten
bezüglich medizinischer Behandlungsmaßnahmen für deutsche Bürger und legale Einwohner.
Es umfasst sowohl das Recht auf informierte Entscheidungen, verständliche Informationen
und die Vermittlung an Patienten als auch medizinische Entscheidungen, die partnerschaftlich
von Ärzten (und anderen Gesundheitsberufen) und Patienten getroffen werden.
Wie steht es mit PEF-Interventionen und Instrumenten zur Unterstützung von Patientenentscheidungen?
Spezifische Trainingsprogramme zur partizipativen Entscheidungsfindung für medizinische
Fachkräfte wurden entwickelt und erfolgreich in der medizinischen Ausbildung implementiert.
Einige medizinische Entscheidungshilfen wurden - hauptsächlich mit Unterstützung von
Krankenkassen oder im Auftrag öffentlicher Institutionen - erstellt und befinden sich
derzeit in der Implementierung, insbesondere für die nationalen Screeningverfahren
für Krebserkrankungen.
Wie ist der aktuelle Stand der Forschung? Wie steht es mit der routinemäßigen Umsetzung?
Die Bundesregierung und andere öffentliche Träger fördern konstant Forschungsprogramme,
in denen Patientenorientierung und PEF einen Schwerpunkt bilden. Es sind jedoch verstärkte
Anstrengungen im Bereich der Entwicklung und Implementierung von Entscheidungshilfen
für Patienten sowie der Implementierung von Trainingsprogrammen für Fachkräfte notwendig.
Wie sieht die Zukunft aus?
Mit der Unterstützung der Gesundheitspolitik und gestärkt durch wissenschaftliche
Belege wird der Transfer einer patientenzentrierten Versorgung und einer partizipativen
Entscheidungsfindung in das deutsche Versorgungssystem als bedeutsam eingeschätzt.
Forschung kann dabei unterstützen, Barrieren, förderliche Bedingungen und Bedarfe
zu erfassen. Daraus können Strategien entwickelt werden, um die Übertragung in die
Routineversorgung zu evaluieren. Dies bleibt eine Herausforderung für die Zukunft.
Keywords
Schlüsselwörter
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Article info
Publication history
Published online: May 22, 2017
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© 2017 Published by Elsevier Inc.
