[New job profiles for medical assistants (MFA) in care provision for elderly people - project in the framework of the funding initiative of the German Medical Association (Bundesärztekammer) for research on care provision].

AIM OF THE STUDY: Against the background of the discussion on the delegation of medical tasks to medical/physician assistants (Medizinische Fachangestellte/MFA) in order to avoid imminent shortages in the care provision by general practitioners (GPs), the aim of the study was to evaluate such a delegation. The delegation of tasks was based on the additional professional qualification/speciality training of medical/physician assistants (MFA) following the curriculum "ambulatory care of elderly people" of the German Medical Association (Bundesärztekammer/BÄK). 2 such projects of additional professional qualification of MFA and tasks delegation were evaluated. The projects were supported by the German Medical Association (BÄK) and implemented by the Scientific Institute of the German Medical Doctors (Wissenschaftliches Institut der Ärzte Deutschlands/WIAD) and the Chamber of Physicians of Schleswig-Holstein (Ärztekammer Schleswig-Holstein/ÄK S-H) from October 2008 until December 2010.
METHODOLOGY: The common evaluation of both projects applied a multi-perspective approach and was mainly based on the data collected by questioning MFA, GPs and patients. These data were complemented with the results collected during experts' interviews and internal evaluations of the additional professional qualification. In total, 61 medical practices, 65 MFA and 669 patients were included.
RESULTS: The curriculum mentioned has proven its worth; the additional qualification broadened the field of competence of the trained MFA. The implementation of the delegation concept in the medical practices is unproblematic, enhances the team spirit, relieves the GPs of some of their workload and strengthens the binding to patients. In the ambulatory care of elderly people, the following diagnoses/diagnosis groups are the most relevant for the delegation of tasks: dementia, nutrition-related diseases, apoplexy, coronary heart diseases, hypertension and peripheral vascular diseases. Tasks were delegated in the following fields: diagnostics, therapy, control/monitoring, medicines control, prevention measures, assessment of living environment, health status, mobility, etc. BENEFITS FOR THE PATIENTS: Improvement of compliance, stabilisation of the care status, improved monitoring through home visits for immobile patients (quick-parameter checks, awareness of living conditions), etc.
CONCLUSION: The implementation of the model in the care provision by general practitioners to elderly people is recommended without reservations. Legal and economic barriers (above all: insufficient compensation of home visits) should be resolved rapidly. © Georg Thieme Verlag KG Stuttgart · New York.