Zusammenfassung Ziel der Studie Zur Frage der Umsetzung der gesetzlichen Vorgaben im Arbeits- und Gesundheitsschutz sowie im Betrieblichen Eingliederungsmanagement in Deutschland weisen einzelne Studien aus den letzten Jahren auf teilweise erhebliche Mängel hin. Ziel dieser Übersichtsarbeit ist eine nach Unternehmensgrößen und im Zeitverlauf differenzierte, quantitative Analyse der Erfüllung gesetzlicher Vorgaben im betrieblichen Arbeits- und Gesundheitsschutz sowie im Betrieblichen Eingliederungsmanagement in deutschen Betrieben. Methodik Es wurde im Oktober 2019 in den Datenbanken PubMed, PsycInfo und WISO eine systematische Literaturrecherche deutsch- und englischsprachiger, repräsentativer Befragungen zu Umsetzungsquoten des Arbeits- und Gesundheitsschutzes sowie des Betrieblichen Eingliederungsmanagements in Deutschland durchgeführt. Ein Update der Studienlage erfolgte im Oktober 2020. Querverweise sowie graue Literatur wurde ebenfalls in die Suche mit einbezogen. Die Bewertung erfolgte durch 2 unabhängige Gutachter. Ergebnisse Es konnten 16 relevante Studien identifiziert werden. Für die arbeitsmedizinische und sicherheitstechnische Betreuung zeigt sich im Zeitverlauf ein leichter Rückgang der Umsetzungsquoten. Hinsichtlich des Betreuungsmodells lässt sich feststellen, dass mit steigender Mitarbeiterzahl sowohl die Regelbetreuung als auch die bedarfsorientierte Betreuung zunimmt. Im Zeitverlauf und über alle Unternehmensgrößen hinweg steigen die Umsetzungsquoten der Gefährdungsbeurteilung (inkl. Beurteilung psychischer Belastungen) kontinuierlich an. Auch die Umsetzungsquoten der Betriebsbegehungen und des Betrieblichen Eingliederungsmanagements können über die Zeit einen Zuwachs verzeichnen. Schlussfolgerung Trotz steigender Umsetzungsraten in vielen Teilbereichen des betrieblichen Arbeits- und Gesundheitsschutzes bzw. des Betrieblichen Eingliederungsmanagements innerhalb der letzten 20 Jahre zeigt sich insgesamt, dass eine flächendeckende Umsetzung gesetzlicher Vorgaben noch nicht erreicht ist. Für die zukünftige Konzeption von Studien in diesem Bereich indizieren die Ergebnisse eine Vereinheitlichung der methodischen Vorgehensweisen. Für den Erhalt der Beschäftigungsfähigkeit der Arbeitnehmerinnen und Arbeitnehmer stellt die Umsetzung gesetzlicher Vorgaben eine wichtige Voraussetzung dar.
Teachers are facing various job demands with psychosocial aspects being fundamental due to the nature of the occupation. Although teachers' work is associated with different psychosocial health risks, little is known on how to identify and tackle those. Thus, a systematic literature search as per the PRISMA statement was conducted via MEDLINE (PubMed), PSYNDEX (PubPsych), and ScienceDirect. Two reviewers independently screened 2261 titles and abstracts and 169 full-texts. According to the inclusion criteria established a priori , articles from peer-reviewed journals (English or German) on psychosocial risk management in teachers were incorporated. Despite a comprehensive and sensitive search, only four publications could be identified, outlining a process to implement risk management and different assessment tools. Taken together, data presented in the articles were scarce. Recommendations for process steps and the assessment of psychosocial risks can be derived from the findings. To implement effective psychosocial risk management in the teaching profession, further research is needed, though. Effective and practicable approaches, which are accepted by the target group, should be further developed and investigated. Relevant causes of occupational strain in the teaching profession must be identified and assessed reliably. Low-threshold interventions should be implemented, and the outcome must be evaluated afterward.
A567assess whether the drug costs stated in BIA matches to real costs. Methods: Twelve HID obtained CED in 2013. The drug costs were identified in BIA of eleven HID. Real costs of General Health Insurance Company (VZP) were found out for each HID in the first year of therapy. As VZP holds 60% of the health insurance market, the data were extrapolated to the whole population. The differences between estimated and real drug costs were analysed and a correlation between this differences and drug characteristics justifying their HID status were investigated. Results: The estimated costs were exceeded in five cases (overrun between 31-332%). In six cases real costs did not achieve the estimation (12-91% of estimated costs). Concerning effectiveness and safety characteristics of investigated drugs, within seven drugs granted as HID because of absence of an alternative drug, four exceeded the estimation. One of two drugs granted as HID because of adverse effects reduction compared with current treatment exceeded the estimation. Remaining two drugs did not achieve the estimation, one was granted HID because of mortality reduction, another because of higher effectiveness compared with current treatment. ConClusions: However HID costs estimated in BIA are submitted in order to predict costs of public health insurance, the analysis did not prove their validity and contribution to a reasonable decision making. Despite the fact that BIA is a mandatory requirement and it is cost and time consuming, its role is formal only and its premises have neither practical impact nor they are subject of further review.
Lay Summary Workplace health promotion (WHP) is often faced with low-participation rates despite high relevance. This limits the potential for creating positive effects for the organization and its staff. Therefore, we investigated the barriers perceived by employees themselves using a representative sample (regarding age, gender and education) in Germany. Data were collected using a quantitative online questionnaire and then analyzed regarding underlying patterns. We found that there are different barrier types, and their importance differs depending on demographic criteria of the participants and the organizations they work for. These results can help organizations to reduce participation barriers to WHP for their staff.
In Germany, use of WAI and the WPAI in as many early intervention approaches as possible will help improve the database, allowing better comparability. However, the focus of further research must be to develop an optimized instrument from elements of WAI and WPAI, in order to be able to measure ability to work as well as the effects of an intervention on preservation or restoration of the ability to work, regardless of the setting.
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