Qualität der Gesundheitsversorgung in Deutschland Ein randomisierter simultaner Sechs-Länder-Vergleich aus Patientensicht

@ Sicker adults in Germany suffer many of the same issues and concerns as do sicker adults in Australia, Canada, New Zealand, the United Kingdom, and the USA. However, quality of care in sicker adults in Germany stands out from the other countries in a few key areas: □ 1. Dissatisfaction with the health care system. Almost one in three sicker adults in Germany feels that their health care system should be completely rebuilt. This is comparable to the USA and Australia and higher than in New Zealand, Canada, and the UK. □ 2. Strengths and weaknesses in coordination of care. On the plus side, Germany is doing better than most countries to insure that needed information is available at the time of a patient's scheduled appointment. Also, sicker adults in Germany are more likely than in other countries to have a long-term relationship with their primary care physician and receive less often conflicting informations. However, Germany stands out in the proportion of sicker adults who feel that their doctors have ordered a medical test that they thought was unnecessary because it had already been done. □ 3. Comparatively easy access to outpatient, specialty and emergency care. Though substantial minorities of sicker adults in Germany struggle with access to care as compared to other countries, they find it easier to get afterhours care and have the shortest waits to see a doctor, to see a specialist, to have nonemergency surgery, and to be seen in the emergency room. Along with the USA, German respondents are most satisfied with the amount of choice they have in a surgeon. □ 4. Communication about risks during hospitalizations. Hospitalized sicker adults in Germany are more likely than those in other countries to have the risks of their treatment explained to some extent prior to the procedure. However, German patients are less likely to have the risks of their treatment fully explained than those in other countries. German patients who were given new medications were more likely than patients in other countries to report that they did not have a dear understanding of the purpose of these medications. Further, German patients are more likely than those in other countries to report that their regular doctor rarely or never explains the possible side effects of their medications. □ 5. Failures in hospital discharge planning. Overall, hospitalized sicker adults in Germany face more failures in discharge management than in other countries. Of particular note is that Germany is less likely than all other countries to ensure that hospitalized patients have appointments for follow-up care upon discharge from hospital. □ 6. Hospital-based infections are rare. Hospitalized patients in Germany are less likely than in other surveyed countries to report that they developed an infection while in the hospital. □ 7. Lab notification delays are infrequent. Sicker adults in Germany are less likely than in other surveyed countries to report that they have experienced delays in being notified about abnormal lab test results. □ 8. German doctors are less likely to inform patients about an error. When German patients experience medical and medication errors, they are less likely than are patients in other countries to be told by a doctor or other health care professional that an error had been made.