Background Workplace health promotion and primary prevention interventions are highly prevalent. However, their effectiveness remains mostly unclear. Aim This article compiles and summarizes the results of current reviews concerning the effectiveness of health promotion and primary prevention interventions in the workplace. Subjects and methods Studies were selected from four electronic databases on the basis of the following criteria:(1) Meta-analysis or systematic reviews, (2) published in international peer-reviewed journals (3) between 1 January 2004 and 30 June 2008 (4) in English or German (5) that examined the effectiveness of workplace health promotion and primary prevention interventions. Results Seventeen reviews met the inclusion criteria and were subsequently categorized into the following areas of intervention: stress, physical activity and nutrition, organizational development, smoking, and ergonomics and back pain. Singular interventions showed limited effectiveness. Workplace interventions aimed at helping individuals reported substantially greater effects than workplace interventions aimed at the workforce as a whole; here, methodological influences play an important role. Conclusions The greatest results are achievable through comprehensive multimodal (or systemic) programs including relational and behavioral elements. Future research is needed in the conception of methodologically sound and setting-appropriate study designs.

From the general practitioner's perspective, interprofessional and doctor-patient communication are highly important for a good medication overview as well as dealing with uncertainties in daily medical care. Simply improving evidence for the care of patients with multi-morbidities in the form of meta-guidelines would not be sufficient to overcome the effects of the many other influencing factors.

Ziel: Zusammenstellung des Forschungsstands zur gesundheitsökonomischen Evaluation der Substitutionstherapie mit Methadon, Buprenorphin sowie zur heroingestützten Therapie. </P><P> Methode: Literatur-Recherche in den einschlägigen Datenbanken mit Beschränkung auf vollständige gesundheitsökonomische Evaluationsstudien der letzten 10 Jahre. </P><P> Ergebnis: Sowohl die beiden Substitutionstherapien als auch die heroingestützte Behandlung sind kosteneffektive Interventionen. Die spezifischen Einsatzmöglichkeiten der jeweiligen Therapien sind noch nicht eindeutig geklärt, so dass diese Substitutionsverfahren nicht alternativ zur Anwendung gelangen können. Die Studienlage im Bereich der gesundheitsökonomischen Evaluation der Substitutionstherapie Opiatabhängiger ist unzureichend. </P><P> Schlussfolgerungen: Nach vorliegenden Studien sind die hier betrachteten Substitutionsverfahren aus gesundheitsökonomischer Sicht zu empfehlen. Zur weiteren Spezifikation der jeweiligen Einsatzmöglichkeiten sind weitere Evaluationsstudien wünschenswert.

The social insurance systems in Germany are about to face radical changes, predominantly due to demographic developments. The solution might be an increasing self-responsibility of the population. The suitability of this health economical concept is to be verified for health insurance. The starting point of the health economic debate, discussing the issue of responsibility, is its description, and therefore the health of populations and the fundamental determinants for the maintenance of health and for illness. This is followed by a theoretical health economic discussion on the question whether insurants and patients are suitable market partners shoulder the responsibility transferred to them. The description of empiric evidence of the effects of co-payment questions the concept of self-responsibility and finally leads to discussing the individual versus social responsibility for health and illness.

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