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Z Evid Fortbild Qual Gesundhwes. 2017 Jun;123-124:46-51. doi: 10.1016/j.zefq.2017.05.006. Epub 2017 May 22.

The long way of implementing patient-centered care and shared decision making in Germany.

Author information

1
University Medical Center Hamburg-Eppendorf, Department of Medical Psychology, Hamburg, Germany; Agency for Quality in Medicine (ÄZQ), Berlin, Germany. Electronic address: m.haerter@uke.uni-hamburg.de.
2
University Medical Center Hamburg-Eppendorf, Department of Medical Psychology, Hamburg, Germany.
3
University Medical Center Hamburg-Eppendorf, Department of Medical Psychology, Hamburg, Germany; Dartmouth College, The Dartmouth Institute for Health Policy and Clinical Practice, Hanover, NH, USA.
4
University of Marburg, Department of General Practice, Marburg, Germany.
5
University Medical Center Hannover, Institute for Epidemiology, Social Medicine and Health Systems Research, Hannover, Germany.
6
University Medical Center Heidelberg, Department of General Internal Medicine and Psychosomatics, Heidelberg, Germany.
7
Scientific Institute for Benefit and Efficiency in Health Care, Techniker Krankenkasse (TK), Hamburg, Germany.
8
Ostbayerische Technische Hochschule Regensburg, Faculty of Social and Health Sciences, Regensburg, Germany.
9
Institute for Quality and Efficiency (IQWiG) in Health Care, Cologne, Germany.

Abstract

The main focus of the paper is on the description of the development and current state of research and implementation of patient-centered care (PCC) and shared decision making (SDM) after fifteen years of substantial advances in health policy and health services research. What is the current state of SDM in health policy? The "Patients' Rights Act" from 2013 standardizes all rights and responsibilities within the framework of medical treatment for German citizens and legal residents. This comprises the right to informed decisions, comprehensive and comprehensible information for patients, and decisions based on a clinician-patient-partnership. What is the current state of SDM interventions and patient decision support tools? SDM training programs for healthcare professionals have been developed. Their implementation in medical schools has been successful. Several decision support tools - primarily with support from health insurance funds and other public agencies - are to be implemented in routine care, specifically for national cancer screening programs. What is the current state of research and routine implementation? The German government and other public institutions are constantly funding research programs in which patient-centered care and shared decision-making are important topics. The development and implementation of decision tools for patients and professionals as well as the implementation of CME trainings for healthcare professionals require future efforts. What does the future look like? With the support of health policy and scientific evidence, transfer of PCC and SDM to practice is regarded as meaningful. Research can help to assess barriers, facilitators, and needs, and subsequently to develop and evaluate corresponding strategies to successfully implement PCC and SDM in routine care, which remains challenging.

KEYWORDS:

Gesundheitspolitik; Implementierung; Patientenbeteiligung; health policy; implementation; partizipative Entscheidungsfindung; patient involvement; patient-centered care; patientenzentrierte Versorgung; shared decision making

PMID:
28546055
DOI:
10.1016/j.zefq.2017.05.006
[Indexed for MEDLINE]

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