DOI: https://doi.org/10.17193/HNU.ZFPG.07.02.2021-08 

DOI: https://doi.org/10.3238/zfa.2020.0414-0421 

DOI: http://www.ncbi.nlm.nih.gov/pubmed/28561201 

Abstract: BACKGROUND In 2010, the first government-approved physician assistant (PA) program was introduced at the Baden-Wuerttemberg Cooperative State University Karlsruhe (DHBW). There are not sufficient data regarding the scope of practice and salary of our graduates. Therefore, the aim of the present study was to obtain information regarding these. METHODS The survey included all graduates (2 classes, n=27). A specific questionnaire was developed, including 37 questions e. g. on the current employment status, scope of practice, salary and job satisfaction regarding the PA program and career. A descriptive analysis of the data was carried out using SPSS. RESULTS 25 graduates participated in the survey (96.1%); the average age of participants was 32.2 years (25-53 years). 88% (n=22) were employed as a PA, most of them worked in internal medicine (n=11) or surgery (n=9). Responsibilities that are often or very often assigned to the PAs are preparing final documents, taking over a coordinating role in the therapeutic team, as well as participation in taking patient medical history and conducting physical examinations. In two-thirds of respondents, the gross monthly base salary (full-time position) was about 3000 euros. 77.3% (n=17) of graduates were generally satisfied or very satisfied with their current situation. CONCLUSIONS It appears that graduates of the DHBW are well integrated into the staff structure of hospitals, as far as the scope of practice and average salary are concerned. Further studies on the integration of this new profession in Germany and on their extended scope of practice in comparison to established healthcare professions will be conducted. HINTERGRUND Seit 2010 wird an der Dualen Hochschule Baden-Württemberg (DHBW) Karlsruhe der Studiengang Physician Assistant/Arztassistenz (PA) angeboten. Tätigkeiten, Einsatzbereiche und gehaltliche Eingruppierungen der Absolventen im Anschluss sind bisher nur unzureichend bekannt. Ziel der vorliegenden Studie war es Informationen hierüber zu erhalten. METHODEN Alle Absolventen (2 Jahrgänge, n=27) sollten schriftlich befragt werden. Der hierfür entwickelte Erhebungsbogen umfasste 37 Fragen u. a. zur aktuellen Beschäftigungssituation, Tätigkeiten, Gehalt und zur Zufriedenheit mit Studium und Beruf. Es erfolgte eine deskriptive Analyse der Daten mittels SPSS. ERGEBNISSE 25 Absolventen beteiligten sich an der Erhebung (96,1%); das Durchschnittsalter der Teilnehmer lag bei 32,2 Jahren (25–53 Jahre). 88% (n=22) waren als PA eingestellt, die meisten arbeiteten in der Inneren Medizin (n=11) oder der Chirurgie (n=9). Tätigkeiten, die häufig bzw. sehr häufig von den PA durchgeführt werden sind Vorbereitung von Entlassdokumenten, Übernahme einer Koordinationsfunktion im therapeutischen Team, aber auch die Mitwirkung bei Anamnese und körperlicher Untersuchung. Bei zwei Drittel der Befragten lag bei einer Vollzeittätigkeit das monatliche Bruttogrundgehalt über 3000 Euro. Insgesamt fanden 77,3% (n=17) der Absolventen ihre aktuelle Situation zufriedenstellend bzw. sehr zufriedenstellend. SCHLUSSFOLGERUNG Die Absolventen der DHBW fügen sich offensichtlich hinsichtlich ihres Tätigkeitsspektrums und der Gehaltsstruktur gut in das Personalgefüge der Kliniken ein. Weitere Studien zur Akzeptanz dieser in Deutschland neuen Berufsgruppe sowie zur Abgrenzung zu etablierten Gesundheitsfachberufen folgen.

DOI: http://www.ncbi.nlm.nih.gov/pubmed/29721654 

Abstract: BACKGROUND In Germany, physician assistant (PA) is a comparatively young profession. The concept paper by the German Medical Association (BÄK) and the Federation of Statutory Health Insurance Physicians (KBV) from 2017 defines the new occupational profile in detail. In contrast, there is hardly any information on the day to day working life of a PA in Germany OBJECTIVE: The aim of this study was to map the employment reality of the PA graduates of the study program of the Baden-Wuerttemberg Cooperative State University Karlsruhe. MATERIAL AND METHODS Graduates of the PA study program were interviewed using the web-based evaluation system EvaSys V7.1 (Electric Paper Evaluationssysteme GmbH, Lüneburg, Deutschland) in the spring of 2018. The information was evaluated descriptively. RESULTS The response rate was 70% (48 out of 69 graduates), 44 graduates were employed as a PA and 27 worked in a surgical department. The core tasks of the surgically active PA, which were often performed to varying frequency included assisting surgery and the performance of simple wound closures. In addition, activities in the areas of documentation, communication and information sharing were emphasized. The average salary of a surgical PA was 3718 €. This amount was rated by 44.4% as appropriate or very appropriate. The current occupational situation for 81.5% of the study participants was much better or better than expected before the start of their PA studies. Overall satisfaction was very high: 85.1% of the graduates were satisfied to very satisfied. CONCLUSION The graduates' level of job satisfaction is remarkable. Many of the activities mentioned in the concept paper of the BÄK and KBV were carried out frequently or very frequently by the PA. Nonetheless, the PA profession has significant development potential, especially in the realm of surgical PAs.

Abstract: Der Physician Assistant (PA) etabliert sich als neues Berufsbild im deutschen Gesundheitswesen. Ziel ist die regelhafte Delegation bestimmter bisher ärztlicher Tätigkeiten an besonders qualifiziertes nicht-ärztliches Personal. In Deutschland bietet als einzige Hochschule die staatliche Duale Hochschule Baden-Württemberg ein Studium an, welches erfolgreichen Absolventen neben dem akademischen Abschluss (B.Sc.) zusätzlich auch die Weiterbildungsbezeichnung Staatlich anerkannter Arztassistent/Physician Assistant> verleiht. Die Evaluation durch das Deutsche Krankenhausinstitut (DKI) belegt eine hohe Praxisbewährung von Studium und anschließender beruflicher Tätigkeit. Die Physician Assistants führen auf Delegation hin überwiegend traditionell ärztliche und arztentlastende Aufgaben aus. Sie werden in sehr hohem Maße fachadäquat eingesetzt und haben ein genuines Tätigkeits- und Einsatzprofil. Von den ärztlichen Kollegen im Krankenhaus wird die Qualität der PA-Tätigkeiten positiv bewertet. Vieles spricht dafür, dass sich das im angloamerikanischen und benachbarten europäischen Raum bereits seit Jahrzehnten anerkannte Berufsbild mittel- bis langfristig auch in Deutschland etablieren wird.

DOI: https://doi.org/10.1093/eurpub/cks067 

Abstract: BACKGROUND Increased migration volume and different Hepatitis B prevalence between immigration and emigration countries have changed the Hepatitis B virus (HBV) epidemiology considerably in Northern and North-Western European migrants-receiving countries. Due to the difference in migration status monitoring, the HBV infection data on migrants are not easily comparable among those countries. The study aims were: to compare the migration status indicators used by the national surveillance system in six Northern and North-Western European countries (the Netherlands, Germany, Finland, Denmark, Sweden and the UK); to determine the impact of the migration status on HBV infection by comparing the available data on prevalence and transmission routes of Hepatitis B in the migration and the general population in the six countries; to recommend sensible indicators and pertinent measures for HBV infection surveillance and control in the region. METHODS Literature review, statistical data analysis on migration and HBV infection in the six countries; expert interviews to identify migration status indicators used in national surveillance systems. RESULTS Evident differences were found between the migration and the general population in Hepatitis B prevalence and transmission routes in the six countries. Migration status is monitored differently in six surveillance systems; immigrants from high/intermediate Hepatitis B endemic countries constitute a substantial proportion of HBsAg(+) and chronic cases in all six countries. CONCLUSIONS International migration has an obvious impact on Hepatitis B prevalence in the six countries. It is important to include common migration status indicators and to collect comparable data for HBV infection surveillance in different notification systems.

DOI: https://doi.org/10.1007/s10389-011-0488-1 

DOI: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3262158 

Abstract: BACKGROUND To provide a clear picture of the current hepatitis B situation, the authors performed a systematic review to estimate the age- and region-specific prevalence of chronic hepatitis B (CHB) in Turkey. METHODS A total of 339 studies with original data on the prevalence of hepatitis B surface antigen (HBsAg) in Turkey and published between 1999 and 2009 were identified through a search of electronic databases, by reviewing citations, and by writing to authors. After a critical assessment, the authors included 129 studies, divided into categories: 'age-specific'; 'region-specific'; and 'specific population group'. To account for the differences among the studies, a generalized linear mixed model was used to estimate the overall prevalence across all age groups and regions. For specific population groups, the authors calculated the weighted mean prevalence. RESULTS The estimated overall population prevalence was 4.57, 95% confidence interval (CI): 3.58, 5.76, and the estimated total number of CHB cases was about 3.3 million. The outcomes of the age-specific groups varied from 2.84, (95% CI: 2.60, 3.10) for the 0-14-year olds to 6.36 (95% CI: 5.83, 6.90) in the 25-34-year-old group. CONCLUSION There are large age-group and regional differences in CHB prevalence in Turkey, where CHB remains a serious health problem.

DOI: https://doi.org/10.1055/s-0028-1109868 

Abstract: BACKGROUND It is estimated that 0.5 to 1 % of the total German population is chronically infected with the hepatitis B virus (HBV). This means that approximately 500 000 chronically infected individuals live in Germany and that around 10 % of them need antiviral treatment. According to an epidemiological calculation, around 42 % of them are migrants. The aim of our study was to gather more information on socio-demographic features of HBV patients and the sero-epidemological status and treatment of these patients. METHODS Data collection was carried out in hepatological practices and outpatient clinics in Germany. We collected data from adult patients with chronic hepatitis B by studying their patient records and interviewing the patients and the responsible physicians. RESULTS Data of 160 patients from 20 different facilities could be collected. 57.5 % of them were male, mean age was 43.7 (range: 19 - 81 years). 61 (38.1 %) were Germans without a migration background, 82 (51.3 %) were first generation migrants and 17 (10.6 %) second generation migrants. We detected significant differences in the level of professional training and employment status between participants with and without migration background. Only 3 % of migrants had a university degree compared to 36.1 % of patients without migration background. In addition, more migrants were unemployed (38.9 % vs. 19.6 %). From all participants 72.4 % were HBeAg-negative. 111 (69.4 %) of all patients received a hepatitis B specific treatment at the time they were interviewed, most of them adefovir (41.5 %) or lamivudin (35.4 %) alone. DISCUSSION The estimated high HBV prevalence in migrants from countries with intermediate to high prevalence is reflected in the high number of patients with migration background in hepatological practices and outpatient clinics. To avoid further HBV infections in this population group and to reduce the HBV prevalence in Germany, the effect of further interventions, like a general HBV screening of all new incoming migrants from intermediate or high endemic areas, their vaccination and if necessary treatment, have to be tested.

DOI: https://doi.org/10.1055/s-0030-1252002 

DOI: https://doi.org/10.1093/eurpub/ckp066 

DOI: http://www.ncbi.nlm.nih.gov/pubmed/18946359 

Abstract: OBJECTIVES A representative serosurveillance study (1995) resulted in an estimate of 0.2% for the HBsAg prevalence in the Netherlands. Some risk groups, especially migrants, were not well represented in the study, which probably led to an underestimation of the true HBsAg prevalence. The aim of this study was to calculate an adjusted HBsAg prevalence estimate for the total Dutch population including these risk groups. METHODS According to their country of origin first-generation migrants (FGM) were classified into groups with low, intermediate and high prevalence using data from the WHO and Statistics Netherlands. The number of chronic HBsAg carriers in different age and population groups was estimated based on studies about age-specific prevalence in different countries. The number of carriers in the indigenous population was estimated using the serosurveillance study. A combination of these estimates led to an estimate of the total prevalence rate in the Netherlands. RESULTS Nearly 10% of the Dutch population are FGM. Of these, about 18% were born in low-endemic, 71% in middle-endemic and 11% in high-endemic countries. The overall prevalence of HBsAg in FGM is estimated to be at 3.77%. Combining these results with the results of the serosurveillance study the HBsAg prevalence in the Dutch population is estimated to be between 0.32 and 0.51%, and when including injecting drug users and mentally handicapped persons the prevalence rates are 0.36 and 0.55%, respectively. CONCLUSION Our results show the high importance of targeting migrants and their close contacts adequately in screening programmes, vaccination and treatment for chronic hepatitis B.

DOI: https://doi.org/10.1055/s-2005-922067 

Abstract: BACKGROUND AND OBJECTIVE Germany is one of the low endemic areas for hepatitis B. There are 7,3 million foreign citizens and 3,2 million migrants from the former USSR and Eastern Europe with German roots, the "Resettlers" (Aussiedler), who migrated to Germany mostly from countries with moderate or high HBsAg prevalence. The aim of this study was to determine the HBsAg prevalence in adult foreign citizens and resettlers compared with that among the adult German population. METHODS Adult foreign citizens and resettlers were categorized according to their country of origin into groups with low, intermediate or high HBsAg prevalence, using data from the WHO. Statistics of the Federal Office for Statistics, the Federal Office for Administration and the Federal Ministry of the Interior were used for the demographic analysis. The number of chronic HBsAg carriers for the different population groups and the whole population was then calculated. RESULTS 84% of the adult migrant population in Germany migrated from countries with intermediate and high HBsAg endemicity. For 2003 we calculated 503 040 HBsAg carriers in Germany. 42% of these have a migratory background, even though migrants represent only 12.7% of the whole population. The risk for chronic infection with HBsAg is 7.1 (4.8-13.2) for the resettlers and is 4.3 (3.0-8.1) times higher for foreign citizens than for the German population. CONCLUSIONS These remarkable differences in prevalence make it important that migrants and their close contacts be vaccinated properly, pregnant women be included in screening programs and cases of chronic hepatitis B be treated adequately.