Healthcare

Health is a key issue in a wide range of political and social areas and will become increasingly relevant in the future. Demographic change, increasing urbanization, growing social inequality and greater environmental pollution are cited as reasons for this. Changes in workplace demands, changes in dietary and leisure habits and socio-cultural pressures such as status insecurities and the processing of growing amounts of information are also frequently cited as health-related factors.

Against the backdrop of this increasing relevance and rising expenditure on health, two trends should be mentioned. On the one hand, prevention and health promotion are becoming more and more important, and on the other, there is increasing pressure for efficiency in all areas of healthcare.

Numerous activities by various stakeholders are aimed at maintaining, improving or restoring the health of individuals or entire groups.

Some of these activities can be assigned to different sectors, such as health promotion, prevention, therapy/disease management, rehabilitation or care. However, activities in other areas of society can also have an impact on health-related behavior or health. Examples include the structural design of cities (cycle paths, exposure to pollutants, etc.) or the health skills taught at school (e.g. knowledge of the food pyramid).

The relevant actors in the health sector range from politics, public administration, statutory and private health insurance companies to foundations and non-profit non-governmental organizations and also include profit-oriented production and service companies (e.g. hospitals, nursing services, but also gyms and manufacturers of food supplements or fitness trackers).

The measures, services and products or interventions in the social or physical environment, the adoption of laws or the definition of health goals set by the actors can also be assessed on the basis of the question of what health benefits they bring with them.

This question and possible methods for certifying effectiveness are at the heart of the discussion in the Healthcare Working Group.

Challenges in the evaluation of health-related measures arise not only from the definition of health as physical, mental and social well-being, but also from the type of measures that promise to be effective. For example, complex measures (e.g. in the field of prevention and health promotion) are considered particularly effective if they involve different actors in the sense of a participatory approach and can be characterized as individual and outreach. However, their evaluation is methodologically challenging, as reproducibility and the separation of control and intervention groups are severely limited.

The working group therefore discusses various quantitative and qualitative methods in relation to an evidence prism that forms a useful framework for health promotion and complex interventions in general. In this framework, the different types of evidence are not viewed hierarchically, but depending on the object of investigation and the interest in knowledge, a different type of study may be "the best". Thus, interpretative and reconstructive research (e.g. qualitative case studies), observational studies (such as epidemiological studies), the systematic processing of practical knowledge, studies with mixed-method designs or the use of cluster randomization in experimental designs are examples of our methodological discourse.

(Self-description as of 22.09.2016)

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