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      Intersektoralität im Fokus – Strategien und aktuelle Forschungsprojekte zur Versorgung geriatrischer Personen Translated title: Focusing on intersectorality—strategies and current research projects for the care of geriatric people

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          Abstract

          In Anbetracht des demografischen Wandels wurde bereits die Notwendigkeit zur intersektoralen Versorgung der alternden Bevölkerung identifiziert. Die Strategien zur Umsetzung sind vielfältig und setzen an verschiedenen Hebeln an, die jeweils unterschiedliche Sektorenüberschneidungen voraussetzen. Der Artikel bietet einen Überblick über bereits abgeschlossene und noch laufende Projekte zur Versorgung geriatrischer Patienten. Dabei wird deutlich: Der Aufbau von Netzwerken als unverzichtbare Basis für Intersektoralität kann nicht in direkten Interventionseffekten messbar gemacht werden und erschwert somit den Kosten-Nutzen-Nachweis. Ebenso zeigt sich, dass einige Forschungsprojekte bei der Überführung in die Regelversorgung durch finanzielle und personelle Engpässe scheitern.

          Brauchen wir in Deutschland ein Umdenken oder weniger innovationsbezogene Förderlinien zur besseren Implementierung und Erforschung bereits existierender Konzepte? Internationale Vorbilder wie Japan machen klar: Die Kostenreduktion bei der Versorgung der alternden Bevölkerung sollte langfristig betrachtet werden und bedarf kurzfristig erhöhter Finanzvolumina. Für eine nachhaltige Implementierung von sektorenübergreifenden Ansätzen im Alltag sollte deshalb die Versorgungsforschung fest(gefahren)e Strukturen, Abläufe und Finanzierungen neu ordnen. Durch Verknüpfung der unzähligen Projekte und Ideen verschiedener Bereiche könnte in Zukunft eine Realisierung des Anspruchs der intersektoralen Versorgung geriatrischer Patienten erreicht werden.

          Translated abstract

          In view of the demographic change, the need for intersectoral care of the aging population has already been identified. The strategies for implementation are diverse and address different approaches, each of which requires different sectors to overlap. This article provides an overview of already completed and ongoing projects for the care of geriatric patients. It becomes apparent that the development of networks as an indispensable basis for intersectoral care cannot be measured in terms of direct intervention effects and therefore makes it difficult to prove the cost-benefit. It is also evident that some research projects fail to be implemented into standard care due to financial and staff shortages.

          Do we need a rethinking in Germany or less innovation-related funding lines for better implementation and research of existing concepts? International role models such as Japan show that cost reduction for the care of the aging population should be considered in the long term, which requires increased financial volumes in the short term. For a sustainable implementation of cross-sectoral approaches into everyday life, research should therefore reorganize tight and/or entrenched structures, processes, and financing. By linking the countless existing projects and integrating ideas from different sectors, future demands of intersectoral geriatric care may be achieved.

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          What makes intersectoral partnerships for health promotion work? A review of the international literature

          Abstract A Health in All Policies approach requires creating and sustaining intersectoral partnerships for promoting population health. This scoping review of the international literature on partnership functioning provides a narrative synthesis of findings related to processes that support and inhibit health promotion partnership functioning. Searching a range of databases, the review includes 26 studies employing quantitative (n = 8), qualitative (n = 10) and mixed method (n = 8) designs examining partnership processes published from January 2007 to June 2015. Using the Bergen Model of Collaborative Functioning as a theoretical framework for analyzing the findings, nine core elements were identified that constitute positive partnership processes that can inform best practices: (i) develop a shared mission aligned to the partners’ individual or institutional goals; (ii) include a broad range of participation from diverse partners and a balance of human and financial resources; (iii) incorporate leadership that inspires trust, confidence and inclusiveness; (iv) monitor how communication is perceived by partners and adjust accordingly; (v) balance formal and informal roles/structures depending upon mission; (vi) build trust between partners from the beginning and for the duration of the partnership; (vii) ensure balance between maintenance and production activities; (viii) consider the impact of political, economic, cultural, social and organizational contexts; and (ix) evaluate partnerships for continuous improvement. Future research is needed to examine the relationship between these processes and how they impact the longer-term outcomes of intersectoral partnerships.
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            Which hospitalisations are ambulatory care-sensitive, to what degree, and how could the rates be reduced? Results of a group consensus study in Germany.

            Much has been written lately regarding hospitalisations for ambulatory care-sensitive conditions (ACSH) and their strengths and weaknesses as a quality management indicator. The idea underlying ambulatory care-sensitive conditions (ACSC) is that effective treatment of acute conditions, good management of chronic illnesses and immunisation against infectious diseases can reduce the risk of a specified set of hospitalisations.
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              Implementation process and challenges for the community-based integrated care system in Japan

              Background Since 10 years ago, Japan has been creating a long-term vision to face its peak in the number of older people that will be reached in 2025 when baby boomers will turn 75 years of age. In 2003, the government set up a study group called “Caring for older people in 2015” which led to a first reform of the Long-Term Care Insurance System in 2006. This study group was the first to suggest the creation of a community-based integrated care system. Reforms Three measures were taken in 2006: ‘Building an active ageing society: implementation of preventive care services’, ‘Improve sustainability: revision of the remuneration of facilities providing care’ and ‘Integration: establishment of a new service system’. These reforms are at the core of the community-based integrated care system. Discussion The socialization of long-term care that came along with the ageing of the population, and the second shift in Japan towards an increased reliance on the community can provide useful information for other ageing societies. As a super ageing society, the attempts from Japan to develop a rather unique system based on the widely spread concept of integrated care should also become an increasing focus of attention.
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                Author and article information

                Contributors
                mhertwig@ukaachen.de
                Journal
                Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz
                Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz
                Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz
                Springer Berlin Heidelberg (Berlin/Heidelberg )
                1436-9990
                1437-1588
                13 March 2024
                13 March 2024
                2024
                : 67
                : 5
                : 595-604
                Affiliations
                [1 ]Klinik für Anästhesiologie, Uniklinik RWTH Aachen (NRW), ( https://ror.org/02gm5zw39) Aachen, Deutschland
                [2 ]Zentrum für klinische Akut- und Notfallmedizin, Uniklinik RWTH Aachen (NRW), ( https://ror.org/02gm5zw39) Aachen, Deutschland
                [3 ]Klinik für Altersmedizin, Uniklinik RWTH Aachen (NRW), ( https://ror.org/02gm5zw39) Aachen, Deutschland
                Article
                3851
                10.1007/s00103-024-03851-3
                11093782
                38478025
                ce8dd1a6-a62c-4b2d-a51b-b58550d3883d
                © The Author(s) 2024

                Open Access Dieser Artikel wird unter der Creative Commons Namensnennung 4.0 International Lizenz veröffentlicht, welche die Nutzung, Vervielfältigung, Bearbeitung, Verbreitung und Wiedergabe in jeglichem Medium und Format erlaubt, sofern Sie den/die ursprünglichen Autor(en) und die Quelle ordnungsgemäß nennen, einen Link zur Creative Commons Lizenz beifügen und angeben, ob Änderungen vorgenommen wurden.

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                History
                : 3 September 2023
                : 19 January 2024
                Funding
                Funded by: Universitätsklinikum RWTH Aachen (8915)
                Categories
                Originalien und Übersichten
                Custom metadata
                © Robert Koch-Institut 2024

                demographie,intersektorale versorgung,hochaltrige,telemedizin,versorgungsnetzwerk,demographics,intersectoral care,oldest-olds,telemedicine,care network

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