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Gesundheitssysteme als epidemiologischer Gegenstand – oder: Wie wissen wir, wie effektiv Gesundheitssysteme sind?

Health systems as an epidemiological topic—or how do we know how effective health systems are?

  • Leitthema: Berliner Gespräche zur Sozialmedizin: The future of epidemiology
  • Published:
Bundesgesundheitsblatt - Gesundheitsforschung - Gesundheitsschutz Aims and scope

Zusammenfassung

Dieser Beitrag betrachtet das Thema Gesundheitssysteme, insbesondere ihre Effektivität in Bezug auf eine Verbesserung der Bevölkerungsgesundheit und der sie erklärenden systembezogenen Variablen, mit epidemiologischer Brille. Es zeigt sich, dass sich die Fragestellungen und methodischen Ansätze in diesem Feld nicht wesentlich von denen anderer epidemiologischer Forschungsfelder unterscheiden. Methodisch sind längsschnittliche Analysen den oftmals durchgeführten querschnittlichen überlegen; Exposition und zuschreibbare Resultate müssen sorgfältig definiert sein. Ein geeigneter Ansatz ist der der medizinisch vermeidbaren Mortalität. Inhaltlich wird demonstriert, dass die „Exposition Gesundheitssystem“ einen deutlich positiven Einfluss auf die Gesundheit der Bevölkerung hat.

Abstract

The article looks at health systems – especially their effectiveness in improving population health – from an epidemiological perspective. It demonstrates that research questions and methodologies do not substantially differ from other areas of epidemiological research. Longitudinal designs are superior to the frequently conducted cross-sectional approaches; exposition and outcome parameters need to be carefully defined. A useful approach is “avoidable mortality” which separates medically amenable causes of death from other ones. The article demonstrates that the “exposition health system” has a clearly beneficial effect on population health.

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  1. Fachgebiet Management im Gesundheitswesen, Technische Universität Berlin, Sekr. EB2, Straße des 17. Juni 145, 10623 , Berlin

    R. Busse

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Busse, R. Gesundheitssysteme als epidemiologischer Gegenstand – oder: Wie wissen wir, wie effektiv Gesundheitssysteme sind?. Bundesgesundheitsbl. 49, 611–621 (2006). https://doi.org/10.1007/s00103-006-1292-x

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  • DOI: https://doi.org/10.1007/s00103-006-1292-x

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