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Background: Health issues caused or exacerbated by a heavy workload are one reason for leaving the nursing profession early. Little is known about the effect and the application of health-related retention strategies in the nursing sector as well as the attitudes of the management and officers of human resources (HR) toward this topic., Methods: This survey is part of the project "ZAFH care4care". HR directors and management at all nursing institutions within one region of Southern Germany (Region Bodensee-Oberschwaben) were contacted and interviewed via questionnaire (PAPI) (N=207). The survey was the quantitative part of a sequential, mixed methods study within an exploratory design. Overall, 59 responses were received and analysed using descriptive and bivariate statistics., Results: Among the nursing institutions surveyed, a shortage of qualified nurses and the resulting heavy workload on remaining staff proved to be common problems. In addition, every fifth nursing institution reported nurses leaving the occupation for reasons of health. The application of health promotion strategies was considered largely successful in retaining staff, but approaches related to structural prevention seemed to be given little consideration., Conclusions: The strong correlation between heavy workload and high rates of absenteeism, sick days, and occupational dropout among nurses highlights the need for health promotion initiatives within the field of nursing. Management and HR directors, in cooperation with other stakeholders, play a key role in fostering a healthy working environment., Competing Interests: Die Autorinnen/Autoren geben an, dass kein Interessenkonflikt besteht., (Thieme. All rights reserved.)

The present contribution discusses the utilization of the healthcare system by elderly patients in Germany. First, the paper focuses on the detailed characterization of a group of people aged 60 years or more (N = 73,454). Second, the objective is to analyze the data for high utilization of healthcare services by older men and women. The analysis is based on data regularly recorded by a German health insurance agency for the year 2000. High utilization is operationalized by a 10% cutoff for users with the highest number of treatments, highest costs and/or other criteria depending on the respective health service sector. The insured group investigated received approximately 1.4 million prescriptions, producing costs of 42 million E. High utilizers account for 32% of all prescriptions and 44% of the costs, respectively. At the same time, the age groups with the highest prescription rates do not cause the highest costs: So the relationship between age and prescription drug expenses as well as between age and prescription rates does not display an arithmetically increasing pattern. Within the timeframe investigated 26,000 hospital treatments were accounted for by 21.75% of the elderly under research. In total, they caused expenses of 88 million E. High utilization in the hospital sector was operationalized by four criteria. Sex- and age-specific analysis of high utilization of hospital treatment revealed that the four different criteria apply to different insured groups. In summary, the high utilization of healthcare services appears to be a multidimensional phenomenon.