Posttraumatic stress disorder is associated with a high economic burden. Costs of treatment are known to be high, and cost-effectiveness has been analysed for several treatment options. As no revie... Antecedentes: El trastorno por estrés postraumático está asociado con una alta carga económica. Se sabe que los costos de tratamiento son elevados, y su costo-efectividad ha sido analizado para var... 背景：创伤后应激障碍与高经济负担相关。已知治疗费用很高, 并且已经针对几种治疗方案的成本效益进行了分析。 目标：由于尚无关于创伤后应激障碍经济方面的综述, 本研究旨在对创伤后应激障碍的疾病成本研究及其治疗的经济评估系统地进行综述, 并评估研究质量。 方法：于2017年3月在PubMed, PsychInfo和NHS经济评估数据库进行了系统的文献检索, 最后于2020年2月进行了更新。选取了针...

MHealth interventions in cancer care are being increasingly applied in various settings. Nevertheless, there is a phenomenon wherein individuals show different usage patterns, which could affect the effectiveness of the intervention. In general, it is important to know the predictors of app adherence and usage patterns to improve the design and content (i.e., tailoring). The aim of this scoping review was to provide an overview of predictors of adherence to cancer-related mHealth apps in cancer patients. A systematic literature search was conducted in March 2021 in the electronic databases PubMed, CINAHL, and PsychINFO without limitation in year, focusing on cancer patients undergoing oncological or follow-up treatment using mHealth apps. The initial database search yielded a total of N = 8035 records. After title, abstract, and full-text screening, 10 articles met inclusion criteria. Studies were published between 2013 and 2020. Studies focused on children and adolescents (2/10) as well as adults (8/10). The predictors identified could be categorized into sociodemographic variables, cancer-related factors and others. This study provides an initial insight into relevant predictors of app adherence in cancer patients. However, no clear predictor of increased app adherence was found. Further research of usage patterns is therefore needed so that mHealth interventions can be tailored during development.

Background: Trans and gender-diverse individuals experience adverse health outcomes that might be due, in addition to other factors, to stigma and discrimination in the health care sector. At the same time, the concept of person-centred care acknowledges the role of patient-physician communication in health care outcomes. This study aims to explore patient-physician communication preferences in trans and gender-diverse individuals. Method: A qualitative interview study was conducted, including N = 10 participants between February and March 2022. Participants were interviewed using a semi-structured interview guideline, based on previous knowledge in person-centred care and sample specific communication. Participants were asked about their experiences and wishes in patient-physician centeredness. Analyses were conducting using a qualitative content analysis strategy. Results: Mean age was 29.3 years; n = 6 participants identified themselves within the binary gender concept, while n = 4 identified themselves with a non-binary gender. Communication preferences for patient-physician communication were categorised into four themes: general communication aspects (e.g. active listening); the role of gender during appointments (e.g. appropriate/inappropriate addressing); gender-neutral language (e.g. experiences use of gender neutral language by physicians); own communication style (e.g. early outing and justification). Furthermore, possible contextual factors of patient-physician communication where found (e.g. trusting relationship). Conclusion: Adding knowledge to communication preferences of trans and gender-diverse individuals, this study was able to identify preferences that are specific to the sample as well as preferences that differ from the cis-gendered population. However, it remains unclear how the patient-physician communication preferences affects health care utilization and outcomes. Trial registration: German Clinical Trial Register (DRKS00026249).

Background: Post-traumatic stress disorder is likely to affect clinical courses in the somatic hospital ward when appearing as comorbidity. Thus, this study aimed to assess the costs associated with comorbid post-traumatic stress disorder in a somatic hospital and to analyze if reimbursement appropriately compensated additional costs. Methods: The study used data from a German university hospital between 2011 and 2014, analyzing 198,819 inpatient episodes. Inpatient’s episodes were included for analysis if they had a somatic primary diagnosis and a secondary diagnosis of post-traumatic stress disorder. Costs were calculated based on resource use and compared to reimbursement. Analyses were adjusted for sex, age and somatic comorbidities. Results: N = 219 Inpatient’s episode were found with primary somatic disorder and a comorbid post-traumatic stress disorder. Inpatients episodes with comorbid post-traumatic stress disorder were compared to 34,229 control episodes, which were hospitalized with the same main diagnosis. Post-traumatic stress disorder was associated with additional hospital costs of €2311 [95%CI €1268 - €3355], while reimbursement rose by €1387 [€563 - €2212]. Results indicate that extra costs associated with post-traumatic stress disorder are not fully reimbursed. Male patients showed higher hospital costs associated with post-traumatic stress disorder. On average, post-traumatic stress disorder was associated with an extra length of stay of 3.4 days [2.1–4.6 days]. Conclusion: Costs associated with post-traumatic stress disorder were substantial and exceeded reimbursement, indicating an inadequate reimbursement for somatic patients with comorbid post-traumatic stress disorder.

Background: With rising numbers of elderly people living in nursing homes in Germany, the need for on-site primary care is increasing. A lack of primary care in nursing homes can lead to unnecessary hospitalization, higher mortality, and morbidity in the elderly. The project CoCare (“coordinated medical care”) has therefore implemented a complex health intervention in nursing homes, using inter alia, regular medical rounds, a shared patient medical record and medication checks, with the aim of improving the coordination of medical care. This study reports upon the results of a qualitative study assessing the perceived barriers and facilitators of the implementation of CoCare by stakeholders. Methods: Focus group interviews were held between October 2018 and November 2019 with nurses, general practitioners and GP’s assistants working or consulting in a participating nursing home. A semi-structured modular guideline was used to ask participants for their opinion on different aspects of CoCare and which barriers and facilitators they perceived. Focus groups were analyzed using qualitative content analysis. Results: In total, N = 11 focus group interviews with N = 74 participants were conducted. We found six themes describing barriers and facilitators in respect of the implementation of CoCare: understaffing, bureaucracy, complexity, structural barriers, financial compensation, communication and collaboration. Furthermore, participants described the incorporation of the intervention into standard care. Conclusion: Barriers perceived by stakeholders are well known in the literature (e.g. understaffing and complexity). However, CoCare provides a good structure to overcome barriers and some barriers will dissolve after implementation into routine care (e.g. bureaucracy). In contrast, especially communication and collaboration were perceived as facilitators in CoCare, with the project being received as a team building intervention itself. Trial registration: WHO UTN: U1111–1196-6611; DRKS-ID: DRKS00012703 (Date of Registration in DRKS: 2017 Aug 23).