Suchergebnisse

Die Verfasser legen eine Metaanalyse medizinökonomischer und psychologischer Untersuchungen vor. Sie zeigen, dass das medizinische Konzept der "gefühlten Sicherheit" sich auch auf andere Bereiche übertragen lässt. Die individuellen, auf "Kosten" beruhenden Entscheidungen sind nicht einfach als irrational abzutun. Vielmehr finden sich jeweils Akzeptanzbedingungen, die als Korrelate annäherungsweise die jeweiligen Entscheidungen erklären können. Anhand empirischer Ergebnisse wird gezeigt, dass diese Akzeptanzbedingungen von gefühlter Sicherheit abhängen und diese auch von medialen Repräsentationen der Kosten, der Nähe und Distanz zum Geschehen geprägt ist. (ICE2)

Abstract  Explored are the relationships among personality and emotional reactions, work‐related strain, and experiences of burnout among staff exposed vs. not exposed to violence when caring for people with intellectual disabilities (ID). Questionnaires measuring personality, emotional reactions, strain and burnout, and exposure to violence were distributed to staff (n = 112) working in 22 group homes for people with ID aged 18 years and older in a community in northern Sweden. The results did not show evidence of a direct influence of personality variables on exposure to violence when working with people with ID and no direct relationships were found between exposure to violence and the staff members' personality traits as measured with the Temperament and Character Inventory and Rosenberg's Self‐Esteem Scale. Although the influence of personality traits on how the staff members experienced violence could not be clearly determined, the authors found an association between personality and strain and the risk of burnout in that certain staff exposed to violence felt more emotionally exhausted than did staff who were not exposed. The knowledge of the relationships among violence, personality, and risk of burnout may be important for the understanding which staff need special supports when working with people with ID.

Aim: This paper summarizes the deficiencies and weaknesses of the most frequently used methods for the allocation of health-care resources. New, more transparent and practical methods for optimizing the allocation of these resources are proposed. Method: The examples of quality-adjusted life years (QALYs) and efficiency frontier (EF) are analyzed to describe weaknesses and problems in decisions regulating health-care provision. After conducting a literature search and discussions with an international group of professionals, three groups of professionals were formed to discuss the assessment and appraisal of health-care services and allocation of available resources. Results: At least seven essential variables were identified that should be heeded when applying the concept of QALYs for decisions concerning health-care provision. The efficiency frontier (EF) concept can be used to set a ceiling price and perform a cost-benefit analysis of provision, but different stakeholders—a biostatistician (efficacy), an economist (costs), a clinician (effectiveness), and the patient (value)—could provide a fairer appraisal of health-care services. Efficacy and costs are often based on falsifiable data. Effectiveness and value depend on the success with which a particular clinical problem has been solved. These data cannot be falsified. The societal perspective is generated by an informal cost-benefit analysis including appraisals by the above-mentioned stakeholders and carried out by an authorized institution. Conclusion: Our analysis suggests that study results expressed in QALYs or as EF cannot be compared unless the variables included in the calculation are specified. It would be far more objective and comprehensive if an authorized institution made an informal decision based on formal assessments of the effectiveness of health-care services evaluated by health-care providers, of the value assessed by consumers, of efficacy described by biostatisticians, and of costs calculated by economists.

Klappentext: Die Vereinigung der beiden deutschen Staaten im Jahr 1990 hat deutliche Spuren in der Gesellschaft und der individuellen Psyche der Deutschen hinterlassen. Nach wie vor existieren viele ökonomische, politische und psychologische Unterschiede zwischen Ost- und Westdeutschen. Die Autorinnen und Autoren geben anhand zentraler Forschungsergebnisse der letzten 30 Jahre einen breiten Überblick zu relevanten Themen des Vereinigungs- und Transformationsprozesses. Betrachtet werden unter anderem die Unterschiede in Familien- und Rollenleitbildern, der Einfluss unterschiedlicher Sozialisationsrahmen in der Kindheit sowie Gerechtigkeitsaspekte im Vereinigungsprozess.