Integrating Telemedical Supervision, Responder Apps, and Data-Driven Triage: The RuralRescue Model of Personalized Emergency Care.

: This study aimed to evaluate a regional implementation project for rural emergency care (RuralRescue) and to examine how its components and outcomes may support personalized approaches in emergency medicine. While not originally designed as a personalized medicine intervention, the project combined digital, educational, and organizational innovations that enable patient-specific adaptation of care processes. : Conducted in the rural district of Vorpommern-Greifswald (Mecklenburg-Western Pomerania, Germany), the intervention included (1) standardized cardiopulmonary resuscitation (CPR) training for laypersons, (2) a geolocation-based first responder app for medically trained volunteers, and (3) integration of a tele-emergency physician (TEP) system with prehospital emergency medical services (EMSs).

Implementation of a tele-paediatric network in hospitals in a rural region: A mixed methods implementation study.

Background: In rural states, paediatric capacities and competencies are concentrated in urban centres due to demographic change and economical pressure. This results in greater distances, longer waiting times and multiple examinations for rural-dwelling children seeking healthcare. A regional tele-paediatric network (RTP-Net) was implemented to improve the access of children to paediatric care by providing videoconferencing and digital health information exchange between paediatricians from hospitals with different sizes and degrees of specialization.

Economic methods and spatial scales in One Health: Results from a scoping review.

Introduction: COVID-19 and other zoonoses indicate the close connection between human, animal, and environmental health. This interdependency underscores the need for a comprehensive One Health approach. However, the One Health concept is sometimes reduced to combating zoonoses and antimicrobial resistance, neglecting the spatial and environmental dimensions.

Long-term outcomes of community-based intensive care treatment following neurological early rehabilitation- results of a multicentric German study.

Background: Weaning from mechanical ventilation (MV) and tracheal cannula (TC) during neurological early rehabilitation (NER) is mostly successful. However, some patients leave NER with TC/MV, requiring home-based specialized intensive care nursing (HSICN). Data on medical and demographic characteristics and long-term outcomes of these patients are limited.

Modelling epidemiological and economics processes - the case of cervical cancer.

Different types of mathematical models can be used to forecast the development of diseases as well as associated costs and analyse the cost-effectiveness of interventions. The set of models available to assess these parameters, reach from simple independent equations to highly complex agent-based simulations. For many diseases, it is simple to distinguish between infectious diseases and chronic-degenerative diseases.

Sector-Wide Approach (SWAp) in Healthcare-A Mixed-Methods Assessment of Health SWAps in Nepal and Bangladesh.

Background: The sector-wide approach (SWAp) is an instrument of cooperation between external development partners (EDPs) and the government of a country. Its main purpose is the coordination, alignment and harmonisation of activities between EDPs and between EDPs and the respective government by covering the entire sector with one major programme.

Methods: The main objective of this paper is to analyse the performance of the SWAps in two countries and draw conclusions about the appropriateness of SWAps as financing instruments in the healthcare sector under certain conditions.

Expensive today but cheaper tomorrow: lifetime costs of an active middle ear implant compared to alternative treatment options.

Background: When choosing between different treatment options, implants often appear too costly. However, this perspective does not take future costs into account. This article evaluates lifetime costs for different surgical interventions to treat hearing loss.

The impact of the health microinsurance M-FUND on the utilization of health services among migrant workers and their dependents in Thailand: A case-control study.

Background: Even though Thailand has launched multiple migrant health policies, migrants still face various barriers in accessing health care. To some extent, these barriers may be reduced by health microinsurance. The M-FUND is a low-cost, not-for-profit health protection scheme for migrant workers in Thailand, created by Dreamlopments Social Enterprise and Foundation to support sustainable access to quality healthcare services for migrants.

Changes in MRI Workflow of Multiple Sclerosis after Introduction of an AI-Software: A Qualitative Study.

The purpose of this study was to explore the effects of the integration of machine learning into daily radiological diagnostics, using the example of the machine learning software mdbrain (Mediaire GmbH, Germany) in the diagnostic MRI workflow of patients with multiple sclerosis at the University Medicine Greifswald. The data were assessed through expert interviews, a comparison of analysis times with and without the machine learning software, as well as a process analysis of MRI workflows. Our results indicate a reduction in the screen-reading workload, improved decision-making regarding contrast administration, an optimized workflow, reduced examination times, and facilitated report communication with colleagues and patients.

Efficiency of Obstetric Services in Germany-The Role of Variation and Overheads.

The number of obstetric departments in German hospitals has declined in the last decades. In particular, rural hospitals are challenged to sustain their delivery services. In this paper, we analyse the role of variation and overheads of obstetric departments from the perspective of current and future German hospital financing.

Improving the technical efficiency of public health centers in Cambodia: a two-stage data envelopment analysis.

Background: Cambodia is undergoing a series of reforms with the objective of reaching universal health coverage. Information on the causes of inefficiencies in health facilities could pave the way for a better utilization of limited resources available to ensure the best possible health care for the population.

Objectives: The purpose of this study is to evaluate the technical efficiency of health centers and the determinants for inefficiencies.

Extending universal health coverage to informal workers: A systematic review of health financing schemes in low- and middle-income countries in Southeast Asia.

Achieving universal health coverage (UHC) is a priority of most low- and middle-income countries, reflecting governments' commitments to improved population health. However, high levels of informal employment in many countries create challenges to progress toward UHC, with governments struggling to extend access and financial protection to informal workers. One region characterized by a high prevalence of informal employment is Southeast Asia.

Sustaining medical research - the role of trust and control.

Background: Medical research is increasingly interdisciplinary. However, not all projects are successful and cooperation is not always sustained beyond the end of funding. This study empirically assesses the effect of control and trust on the sustainability of interdisciplinary medical research in terms of its performance and satisfaction.

Health impact of borders: general reflections and a case study from the Polish-German border.

Background And Objective: Political, economic, communicative and cultural borders still limit the accessibility of acute healthcare services for patients so that they frequently have to accept longer distances to travel to the next provider within their own country. In this paper, we analyze the impact of borders and opening of borders on acute medical care in hospitals and on patients in border regions.

Methods: We develop a conceptual framework model of cross-border healthcare and apply it to the Polish-German border area.

Impact of low-value medications on quality of life, hospitalization and costs - A longitudinal analysis of patients living with dementia.

Introduction: This study aimed to analyze the impact of low-value medications (Lvm), that is, medications unlikely to benefit patients but to cause harm, on patient-centered outcomes over 24 months.

Methods: This longitudinal analysis was based on baseline, 12 and 24 months follow-up data of 352 patients with dementia. The impact of Lvm on health-related quality of life (HRQoL), hospitalizations, and health care costs were assessed using multiple panel-specific regression models.

Digital transition in rural emergency medicine: Impact of job satisfaction and workload on communication and technology acceptance.

Background: Tele-emergency physicians (TEPs) take an increasingly important role in the need-oriented provision of emergency patient care. To improve emergency medicine in rural areas, we set up the project 'Rural|Rescue', which uses TEPs to restructure professional rescue services using information and communication technologies (ICTs) in order to reduce the therapy-free interval. Successful implementation of ICTs relies on user acceptance and knowledge sharing behavior.

The Flipped Break-Even: Re-Balancing Demand- and Supply-Side Financing of Health Centers in Cambodia.

Supply-side healthcare financing still dominates healthcare financing in many countries where the government provides line-item budgets for health facilities irrespective of the quantity or quality of services rendered. There is a risk that this approach will reduce the efficiency of services and the value of money for patients. This paper analyzes the situation of public health centers in Cambodia to determine the relevance of supply- and demand-side financing as well as lump sum and performance-based financing.

Clinical and economic burden of surgical site infections in inpatient care in Germany: A retrospective, cross-sectional analysis from 79 hospitals.

Background: Surgical site infections (SSI) present a substantial burden to patients and healthcare systems. This study aimed to elucidate the prevalence of SSIs in German hospitals and to quantify their clinical and economic burden based on German hospital reimbursement data (G-DRG).

Methods: This retrospective, cross-sectional study used a 2010-2016 G-DRG dataset to determine the prevalence of SSIs in hospital, using ICD-10-GM codes, after surgical procedures.

Direct cost of cochlear implants in Germany - a strategic simulation.

Background: Despite the current undersupply of cochlear implants (CIs) with simultaneously increasing indication, CI implantation numbers in Germany still are at a relatively low level.

Methods: As there are hardly any solid forecasts available in the literature, we develop a System Dynamics model that forecasts the number and costs of CI implantations in adults for 40 years from a social health insurance (SHI) perspective.

Results: CI demand will grow marginally by demographic changes causing average annual costs of about 538 million €.

Cataract Surgery in Low-Income Countries: A Good Deal!

Cataract is a major cause of blindness worldwide. In particular, in low-income countries, the burden of disease as well as its direct and indirect economic cost are a major challenge for the population and economy. In many cases, it would be possible to prevent or cure blindness with a comparably simple cataract surgery, but many countries lack the resources to strengthen healthcare systems and implement broad cataract surgery programs reaching, in particular, the rural poor.

Strengthening the occupational and social participation of multiple sclerosis patients - design of a multicenter, parallel-group randomized controlled trial (MSnetWork-study).

Background: Multiple Sclerosis is an autoimmune inflammatory disease of the central nervous system that often leads to premature incapacity for work. Therefore, the MSnetWork project implements a new form of care and pursues the goal of maintaining or even improving the state of health of MS patients and having a positive influence on their ability to work as well as their participation in social life. A network of neurologists, occupational health and rehabilitation physicians, psychologists, and social insurance suppliers provide patients with targeted services that have not previously been part of standard care.

Can drones save lives and money? An economic evaluation of airborne delivery of automated external defibrillators.

Background: Out-of-hospital cardiac arrest is one of the most frequent causes of death in Europe. Emergency medical services often struggle to reach the patient in time, particularly in rural areas. To improve outcome, early defibrillation is required which significantly increases neurologically intact survival.

Healthcare Management and Health Economics.

The Universal Declaration of Human Rights stipulates that, "recognition of the inherent dignity and of the equal and inalienable rights of all members of the human family is the foundation of freedom, justice and peace in the world" (Preamble) [...