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Background: With the entry into force of sect. 132g of the Social Code Book [SGB] V in 2018, nursing homes and homes for persons with disabilities providing integration support in Germany can get reimbursed by the statutory health insurance funds for advance care planning (ACP) services. The aim of this feasibility study was to evaluate the number of service records to be submitted, examine the containing information about the consultation process, and assess their potential for research., Methods: We analyzed aggregated data from a large German statutory health insurance fund (AOK Lower Saxony) for 2018-2022 on the contracts concluded for ACP. In addition, anonymized service records from nursing homes and homes for persons with disabilities providing integration support from 2020 to 2022 (no records available for 2018 and 2019) were evaluated descriptively. These records contained information on the type and duration of the consultation process, as well as the number of consultations conducted. Furthermore, facility-specific information was available for facilities with at least one service record, including the number of care places and the number of consultants meeting the qualification requirements of sect. 132g SGB V., Results: In 2018-2022, n = 101 ACP contracts were concluded between the n = 1,415 nursing homes located in Lower Saxony and the state associations representing the interests of the health insurance providers (homes for integration support: n = 104). For the years with service records available (2020-2022), n = 134 contracts were signed. Of these facilities, n = 50 (37 %) had at least one service record, and only one facility (2 %) had more than one facilitator. Of the total n = 230 service records, 97 % documented a first-time consultant process. The process had a mean duration of 33 days and included an average of 2.9 consultant sessions. 13 % of the processes were completed in one day and almost 90 % after three months., Discussion/conclusion: We found a low number of (1) signed ACP contracts, (2) facilitators in the facilities, and (3) service records available at the health insurance company. However, service records are only one part of ACP. This is why, overall, service records in their current form appear to be of poor usability in the context of both scientific research and the further development of ACP., (Copyright © 2024. Published by Elsevier GmbH.)

Introduction: Implantation of a left ventricular assist device (LVAD) requires extensive aftercare. It is largely unclear how aftercare should be designed from the patients' perspective. Implications can be developed based on an examination of the healthcare context. Its main components are mapped on five tiers in the Human Factors of Home Health Care Model by Henriksen, Joseph, and Zayas-Caban (2009). Using this model, the present study explores the patient perspective on the context of healthcare after an LVAD implantation., Methods: We employed a qualitative cross-sectional study, in which LVAD patients participated in semi-structured interviews. The transcribed interviews were analyzed using content analysis. First, relevant meaning units were identified and deductively categorized into the model. Then, categories of care-related aspects were developed inductively within each of the model tiers., Results: We interviewed 18 patients aged 33 to 78 years who had been living with the LVAD between a few weeks and more than 10 years. Twenty-eight categories related to care aspects were developed within the model tiers: 3 categories on patient characteristics (e.g., self-management skills), 3 on caregiver characteristics (e.g., professionalism), 11 healthcare-related tasks and requirements (e.g., wound management), 8 on factors of the physical environment (e.g., controllability), medical devices and technologies (e.g., carrying systems for external components), and cultural, social and community environment (e.g., interaction with peers), as well as 3 on external environmental factors (e.g., healthcare infrastructure)., Discussion: The present study represents the first investigation focusing on aspects of the healthcare context influencing healthcare quality and safety from the perspective of LVAD patients in Germany. LVAD aftercare covers a broad and complex range of tasks. For this, patients, caregivers and healthcare professionals need specific knowledge, which is lacking in various respects. In the first place, this is compensated by the patients' own initiative and the personal care provided by the VAD outpatient clinics., Conclusion: Three key recommendations to optimize aftercare from the patient perspective are derived: Patients would benefit from a more flexible and decentralized aftercare concept, to which telemedicine could contribute. LVAD-specific expertise among general healthcare providers is perceived as insufficient by patients and could be strengthened through training and counseling services. The broad scope of tasks and the high level of responsibilities in LVAD aftercare pose challenges for patients and their families, which could be addressed through continuous information and training programs., (Copyright © 2024. Published by Elsevier GmbH.)

Background: Early career researchers in health services research work in an interdisciplinary field of research. So far, information on early career researchers in health services research has only been available from surveys of individual disciplines, which do not adequately reflect the concerns in the field of health services research. Therefore, a working group of the German Network for Health Services Research (DNVF) conducted a first survey. The following research questions can be answered on the basis of the data obtained: (1) Which socio-demographic aspects characterize early career researchers in health services research? (2) What is the professional biographical background of early career researchers in health services research? (3) What are the research fields of early career researchers? (4) What are the career perspectives of early career researchers?, Method: The survey among early career researchers was conducted as an online survey in January/February 2019. The study was addressed to individuals currently working as early career researchers in health services research in Germany. The online survey was conducted using a standardized questionnaire. Participants were recruited through the DNVF access points and by snowball sampling., Results: 336 early career researcher aged between 23 and 57 participated in the online survey study, 102 of whom held a doctorate. The majority were employed as scientific staff (58%) and were in temporary employment (75%); 69% of them were emplyed at a university, followed by health care institutions (17%) and non-university research institutions (16%). About one-third of the respondents (36%) completed a vocational training prior to their studies. Of the participants, 50% said they were strongly or very strongly aspiring to a professional career in academia, 43% at a non-university research institution, and 30% at a university of applied sciences., Discussion: The results of the online survey show the heterogeneity in terms of age and professional biography of early career researchers in health services research. Few researchers have permanent positions. However, the majority of respondents would like to have a professional future at a university, a research institute or a university of applied sciences. Further studies should be conducted to determine (possible) career paths taken by young scientists in health services research., Conclusion: There is still scope for improvement in the promotion of early career researchers., (Copyright © 2023. Published by Elsevier GmbH.)

Patient involvement (PI) in research is increasingly required as a means to improve relevance and meaningfulness of research results. PI has been widely promoted by the National Institute for Health Research in England in the last years. In Germany, widespread involvement of patients in research is still missing. The methods used to realize PI have been developed mainly in English research contexts, and detailed information on how to involve patients in systematic reviews is rare. Therefore, the aim of the study was that patients contribute and prioritize clinically relevant outcomes to a systematic review on meta-cognitive interventions, and to evaluate a patient workshop as well as patients' perceptions of research involvement. Seven patients with experience in psychiatric care participated in our workshop. They focused on outcomes pre-defined in the review protocol (e.g., meta-cognitive or cognitive changes, symptomatology, quality of life), neglected other outcomes (like satisfaction with treatment, acceptability), and added relevant new ones (e.g., scope of action/autonomy, applicability). Altogether, they valued the explicit workshop participation positively. However, some suggested to involve patients at an earlier stage and to adapt the amount of information given. Further systematic reviews would benefit from the involvement of patients in the definition of other components of the review question (like patients or interventions), in the interpretation of key findings or in drafting a lay summary., (Copyright © 2017. Published by Elsevier GmbH.)