Berlin: More Children, Less Early Detection

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Doctors newspaper online, 05.09.2019

    

        
        
        

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Berlin

Staffing problems at the Public Health Service affect school examinations.

BERLIN. The number of screening examinations in kindergartens and day-care centers by the Public Health Service (ÖGD) of Berlin has hardly increased in the past ten years, despite the steady increase in population. The Senate attributes this to the personnel problems in the ÖGD

"In light of the difficult recruitment of children and adolescents, it is a good thing that the total number of examinations carried out annually in 2017, at 12,568, was more than 11,618 in 2008," said State Secretary for Health Martin Matz in response to a written request by CDU MP Tim-Christopher Zeelen.

However, Matz considers the large differences between districts to be "unsatisfactory". They would suggest a different emphasis of the respective health authorities, so Matz on. In comparison with other districts, the numbers of examinations in the large districts of Friedrichshain-Kreuzberg and Neukölln seem to be consistently low.

In the similarly prolific Pankow, in 2017, in comparison to 2008, more than twice as many examinations took place. In Spandau and Charlottenburg-Wilmersdorf in 2017 only a fraction of the investigations of the previous year were made. The Senate also attributes such fluctuations to the personnel situation.

Irrespective of this, the figures presented document the need for these investigations. Because of the 12,568 children who were examined in 2017, the doctors of the Berlin ÖGD 1829 recommended children to further examinations based on previously unknown findings. There has been a consistent increase in the number of dental examinations of kindergarten children, from 49,737 in the school year 2008/2009 to 77,636 in the school year 2016/2017. This increase is associated with a decrease in abnormalities. The proportion of children in need of treatment fell in almost all districts across Berlin, averaging 20.7 percent in 2008 to 16.8 percent. (ami)

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Doctors newspaper online, 02.09.2019

    

        
        
        

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Model project "Lebensluft"

A long-term project for resuscitation of ventilation achieves good results with multi-professional therapy. The patients draw new "life air" – and they are required to do a lot.

By Ilse Schlingensiepen

KREFELD. The model project "Lebensluft" for resuscitation is designed to last for eight years, but after only three years it becomes clear that more than half of the patients who need to be artificially ventilated today can benefit from intensive multi-professional therapy be weaned from the ventilators.

The initiators therefore advocate enabling as many patients as possible to make such a leap in quality of life. "Lebensluft" is a joint project of the Helios Klinikum Krefeld and the AOK Rheinland / Hamburg, which started in mid-2016 after two years of preparation. The target group are patients who, at least temporarily, continue to rely on artificial respiration after therapy in a weaning unit, ie a special weaning unit, as well as patients who have been treated in hospitals without a weaning unit.

These people are often provided with care by respiratory care homes in respiratory care homes, nursing homes, or at home. Manuel Streuter. The chief physician of the lung clinic at Helios Klinikum has developed the concept for "Lebensluft".

"There is often a lack of capacity, knowledge and experience to get patients away from the ventilators," he says. This left untapped potential, which was a very unsatisfactory situation for doctors. The Krefeld Hospital has set up a special residential unit for long-term invasive-ventilated patients. The care concept includes nursing care, therapeutically activating care, respiratory therapy, physiotherapy, occupational therapy and speech therapy. Doctors are in the background with uncertainties and problems ready and take over the supervision, explains Streuter.

The program demands a lot from the patient. "It is almost comparable to the condition training in competitive sports." The patients are on average eight to twelve weeks on the ward. By the end of July, 145 patients had been treated there, and 87 were able to be discharged home independently.

"Our expectations were exceeded," says Matthias Mohrmann, CEO of AOK Rheinland / Hamburg. Originally, it was assumed that "living air" enabled one third of the patients to live without ventilation. "It is our wish and will that we get what we have achieved here into the standard care," he emphasizes. His fund will continue the project beyond the eight years. The clinic receives a special compensation for the care provided by the AOK. "It's not more than what we pay for intensive care every day, but there's no chance of weaning."

Insured persons of other funds have already been provided with individual commitments. "The project was always designed to open it to other health insurances and service providers," says clinic managing director Alexander Holubars. In the Helios Klinikum Wuppertal, a comparable station was opened four weeks ago.

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