Literature DB >> 24384726

[Rationalization and rationing at the bedside. A normative and empirical status quo analysis].

D Strech1.   

Abstract

BACKGROUND: The topic of bedside rationing is increasingly discussed in Germany. Further need for clarification exists for the question how bedside rationing (e.g., in the area of overcare) can be justified despite coexistent inefficiencies. DISCUSSION: This paper outlines and analyses the relationship of waste avoidance and rationing from an ethical perspective. Empirical findings regarding the status quo of bedside rationing and rationalization are presented. These normative and empirical explorations will then be further specified regarding opportunities for future physician-driven activities to tackle overuse.
CONCLUSION: The self-government partners in Germany should communicate more explicitly within their communities and to the public how and with which benchmarks they aim to reduce inefficient health care (overuse) in an appropriate manner. Physician-driven activities such as the "Choosing Wisely®" initiative in the USA could provide a first step to raise the awareness for overuse among physicians as well as in the public.

Mesh:

Year:  2014        PMID: 24384726     DOI: 10.1007/s00063-013-0279-2

Source DB:  PubMed          Journal:  Med Klin Intensivmed Notfmed        ISSN: 2193-6218            Impact factor:   0.840


  14 in total

1.  [Health services research: essential for allocation decisions - joint statement].

Authors:  H Pfaff; H Abholz; G Glaeske; A Icks; M Klinkhammer-Schalke; G Nellessen-Martens; E A M Neugebauer; C Ohmann; M Schrappe; H-K Selbmann; R Stemmer
Journal:  Dtsch Med Wochenschr       Date:  2011-10-12       Impact factor: 0.628

2.  [Is there health care rationing in German hospitals? How exactly do we know and why should it not be the most important question?].

Authors:  D Strech; G Marckmann
Journal:  Dtsch Med Wochenschr       Date:  2010-07-20       Impact factor: 0.628

Review 3.  Overuse of health care services in the United States: an understudied problem.

Authors:  Deborah Korenstein; Raphael Falk; Elizabeth A Howell; Tara Bishop; Salomeh Keyhani
Journal:  Arch Intern Med       Date:  2012-01-23

4.  [Prioritisation in health care: learning from international experiences].

Authors:  Georg Marckmann
Journal:  Z Evid Fortbild Qual Gesundhwes       Date:  2009

5.  From an ethics of rationing to an ethics of waste avoidance.

Authors:  Howard Brody
Journal:  N Engl J Med       Date:  2012-05-02       Impact factor: 91.245

Review 6.  How physicians allocate scarce resources at the bedside: a systematic review of qualitative studies.

Authors:  Daniel Strech; Matthis Synofzik; Georg Marckmann
Journal:  J Med Philos       Date:  2008-02

Review 7.  'Rationing' health care. Not all definitions are created equal.

Authors:  P A Ubel; S D Goold
Journal:  Arch Intern Med       Date:  1998-02-09

8.  Why the ethics of parsimonious medicine is not the ethics of rationing.

Authors:  Jon C Tilburt; Christine K Cassel
Journal:  JAMA       Date:  2013-02-27       Impact factor: 56.272

9.  The role of ethics committees and ethics consultation in allocation decisions: a 4-stage process.

Authors:  Daniel Strech; Samia Hurst; Marion Danis
Journal:  Med Care       Date:  2010-09       Impact factor: 2.983

10.  [Extent and impact of bedside rationing in German hospitals: results of a representative survey among physicians].

Authors:  D Strech; M Danis; M Löb; G Marckmann
Journal:  Dtsch Med Wochenschr       Date:  2009-06-04       Impact factor: 0.628

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  1 in total

1.  [Quo vadis, modern intensive care medicine? Outdated considerations regarding risks and side effects].

Authors:  G Duttge
Journal:  Med Klin Intensivmed Notfmed       Date:  2016-01-27       Impact factor: 0.840

  1 in total

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