Institute of Social Medicine and Epidemiology

Given the demographic developments and the associated increase in social and healthcare services along with their costs, aspiring doctors are faced not only with providing medical care to patients, but also with the question of a sustainable and equitable distribution of resources in the healthcare system. This gives increasing importance to the fields of health economics and social medicine.

The cross-sectional area Q3 is dedicated to the teaching of health economics, health systems and public health care in medical studies since the revision of the medical licensing regulations in 2022.

The project addresses the question of how teaching of health economics, healthcare systems, and public health must be structured to be simultaneously engaging and effectively prepare students for their future professional career.

Project member: Dr. med. Annina Althaus

DIPEx - Database of Individual Patients' Experiences

The experience of other affected persons is of main importance in coping with illness. However, not much is known about ways in which scientifically investigated and publically available narratives of individual illness are used. One aim of DIPEx Oncology was to make such illness-related experiences of patients with prostate, breast and colorectal cancer available at krankheitserfahrungen.de, and to evaluate this service with a special focus on strengthening patient competence (Giesler et al. 2017). Interview data are further analysed, e.g. in regard to cancer patients’ information needs (Blödt et al. 2018).

• Federal Ministry of Health (National Cancer Plan)

• Krebsallianz (https://www.krebsallianz.de)

• DIPEx Germany

• University of Freiburg

• Joachim Weis (University of Freiburg, Tumor Biology Clinic)

• Juergen M. Giesler (Unversity of Freiburg, Institute of Medical Biometrics and Statistics)

• Psychoonkology (Comprehensive Cancer Center, Charité)

• Interdisciplinary Breast Center (Charité)

• Interdisciplinary Prostate Center (IPZ) (Charité)

• Stiftung Männergesundheit – Men’s Health Foundation

• Blödt S, Kaiser M, Adam Y et al: Understanding the role of health information in patients’ experiences: secondary analysis of qualitative narrative interviews with people diagnosed with cancer in Germany. BMJ Open

• Giesler JM, Keller B, Repke T, Leonhart R, Weis J, Muckelbauer R, Rieckmann N, Müller-Nordhorn J, Lucius-Hoene G, Holmberg C: Effect of a Website That Presents Patients’ Experiences on Self-Efficacy and Patient Competence of Colorectal Cancer Patients: Web-Based Randomized Controlled Trial. JMIR

• Lucius-Hoene G, Holmberg C, Meyer T (Eds.): Illness Narratives in Practice: Potentials and Challenges of Using Narratives in Health-related Contexts. 2018. Oxford, United Kingdom: Oxford University Press.

Doing Health - Health Literacy in Early Childhood Allergy Prevention (HELICAP)

What are we researching?

The overarching goal of Doing Health is to examine the social practices of parenting within which children's health is negotiated in young families, from pregnancy to the first year of the child’s life. In short, Doing Health will analyze how knowledge and behaviors about what makes a healthy environment for a child are negotiated and reproduced in the lives of young families.

What are the aims of the project?

1. To analyze how different forms of knowledge come together to shape the care practices of families as they negotiate allergy prevention;
2. to describe the complex systemic forces in which health practices are embedded and to understand how expert knowledge is reflected in or modified by other forms of knowledge;
3. to increase understanding of how medical information, allergy prevention guidelines and tacit, everyday knowledge interact in structuring families' care practices

Duration: 36 Month

Funding Body: The German Research Council (Deutsche Forschungsgemeinschaft)

Research Partners: HELICAP is a collaborative project comprised of leading researchers at six locations across Germany. In addition to the Brandenburg Medical School Theodor Fontane, the project includes research groups at the Otto von Guericke University Magdeburg, the University of Education at Freiburg, the University of Regensburg, the Hannover Medical School and the Mainz University Medical Center.

Further information can be found at: www.helicap.org

Dr. Joshua Paul

Post-doctoral Research Fellow

Institute for Social Medicine and Epidemiology

Brandenburg Medical School Theodor Fontane

Steinstr. 66/67, House 4

D-14776 Brandenburg an der Havel

Email: joshua.paul@mhb-fontane.de

SGB-REHA: Cross-sectoral gerontopsychiatric treatment and rehabilitation in nursing homes

The number of people in need for care in Germany will continue to grow in the following years. The risk for older people to stay in nursing homes long-term is especially high after hospitalization. The project SGB-REHA regionally implements and evaluates a cross-sectoral multiprofessional rehabilitation concept for older people in long-term care facilities.

In a qualitative pilot study, an innovation for therapeutic care with rehabilitative elements (Haus Ruhrgarten, Mühlheim) was analyzed and a potential best practice model developed. Central elements of the concept are, i.a., individual planning and monitoring of rehabilitative measures, therapeutic care provided by nurses, training for staff, and an extended therapy offer. Fundamental principle is the interdisciplinarity of nursing, medicine, pharmacy, therapy, and social work. The therapeutic-rehabilitative care measures aim at improving residents’ competences in activities of daily living, cognitive capacities, and quality of life, and even a return to their own homes. Further goals are the reduction of medication, hospital admissions, and treatment costs, and an improved quality of life for relatives and work satisfaction for staff members.

Using a stepped-wedge design in a randomized controlled study, the implementation of this innovative concept will be tested with residents over 65 years in twelve nursing homes in rural and urban areas of Western Germany. Quantitative assessments on the interventions effectiveness are accompanied by an economic evaluation. The institute of social medicine and epidemiology is responsible for the qualitative evaluation of effects from the perspective of residents and their relatives as well as staff members, and the intervention process evaluation by conducting interviews and participant observations.

Sponsor: Innovationsfonds des Gemeinsamen Bundesausschusses

Project duration: 2022-2026

Consortium: AOK Rheinland / Hamburg (head of consortium), Deutsche Akademie für Gerontopsychiatrie und -psychotherapie e. V., Evangelische Altenhilfe Mülheim gGmbH, Medizinische Hochschule Brandenburg CAMPUS GmbH, Universität Potsdam

Diversity-sensitive medicine (DiverMed) – Development of a longitudinal curriculum for teaching structural competence

1. Brief description of the project

DiverMed is a sub-project of Empowerment for Diversity – Alliance for Equal Opportunities in Healthcare (EmpDiv) and aims to develop a longitudinal curriculum for the Brandenburg Model Medical Degree Programme (BMM) that fosters structural competence and sensitivity to diversity. This promotes an understanding of health and illness as outcomes of social, political and economic structures. The project is theoretically grounded in Nancy Krieger’s eco-social theory and the concept of intersectionality. DiverMed comprises 34 teaching units (TU) delivered as face-to-face sessions, 12 of which take place in the second semester as part of the Health Sciences seminar; the remaining teaching units are spread across the various modules of the Brandenburg Model Medical Degree Programme from the fourth semester onwards. A particular focus is placed on the clinical phase (semesters 8–10). This prepares students for the complexities of diversity, inclusion and equity in healthcare, as well as for the challenging work that doctors in this field often have to undertake. Realistic case studies have been developed that combine clinical and socio-medical content whilst fostering students’ awareness of diversity. The theoretical project approaches offer a nuanced perspective on the impact of diversity on health and the healthcare system and formed the basis for the development of teaching materials designed to promote both reflection and practical action. In addition, two educational films were produced. One educational video deals with Nancy Krieger’s eco-social theory. The second educational film covers the biomedical model. Furthermore, a podcast was produced. In this, experts were interviewed about their experiences of working on the front lines as doctors. All the teaching materials produced have been published on the EmpDiv website (in German).

2. Duration

2023–2025

 
3. Funding bodies

Charité – Universitätsmedizin Berlin
Mercator Foundation
 

4. For further information, see… (in German)

https://www.empowerment-diversitaet.de/ueber-das-programm/

PREDICT

The aim of the PREDICT project, funded by the G-BA Innovation Fund, is to establish a new model of care designed to improve the efficiency of care through pre-hospital triage of patients with suspected non-ST-elevation acute coronary syndrome (NSTE-ACS). Improving the efficiency of care means optimising the allocation of healthcare system resources in the pre-hospital and in-hospital settings without compromising patient safety.

The central element of this new form of care is the pre-hospital triage of patients with suspected ACS using a point-of-care (POC) hs-cTnI test in combination with a web-based algorithm („ACS-Pathfinder“). To this end, additional standardised pre-clinical medical information is collected, and the ACS-Pathfinder is used to determine the risk of myocardial infarction at the scene of the emergency and to make a decision on patient allocation

The primary endpoints analysed are both the effectiveness of the intervention in terms of hospital admissions and patient safety. As part of the process evaluation, further parameters such as the subjective perception of safety and satisfaction with care are assessed qualitatively and quantitatively among both patients and emergency service personnel.

The Institute of Social Medicine and Epidemiology is participating in the PREDICT project as a consortium partner responsible for conducting the process evaluation.

Lead arranger: Leipzig Heart Science gGmbH

Other consortium members: AOK Bundesverband eGbR, Bundesvereinigung der Arbeitsgemeinschaften der Notärzte Deutschlands e. V., Deutsche Herzstiftung e. V., Herzzentrum Leipzig GmbH, Medizinische Hochschule Brandenburg CAMPUS GmbH, Stiftung Institut für Herzinfarktforschung, Universitätsklinikum Hamburg-Eppendorf

Funding period: 10/2025 – 07/2029

Funding reference number: 01NVF24305

Contact persons at the Institute: Dr. Kathrin Gödde and Prof. Christine Holmberg

ReReDi – Responsive Representation in Discourse Processes: Developing Non-Statistical Sampling Strategies Using Artificial Intelligence as an Example

Duration

01.11.2025 – 31.10.2026

Project lead

Prof. Dr. Christine Holmberg
Brandenburg Medical School Theodor Fontane (MHB)
Institute of Social Medicine and Epidemiology
Steinstraße 66–67
D-14776 Brandenburg an der Havel
E-Mail: christine.holmberg@mhb-fontane.de

Project coordination

Tim Holetzek
Brandenburg Medical School Theodor Fontane (MHB)
Institute of Social Medicine and Epidemiology
Steinstraße 66–67
D-14776 Brandenburg an der Havel
E-Mail: tim.holetzek@mhb-fontane.de

Background and objectives of the project

With the growing use of artificial intelligence in the healthcare sector, the question arises as to how decisions regarding the development and deployment of such technologies can be made in a way that is both technically sound and socially accountable. Deliberative processes are intended to help bring together different perspectives and to develop recommendations on socially significant issues such as the use of AI.

The composition of the participating groups is central to the quality of these processes. Selection procedures based solely on statistical representativeness and random sampling fall short when it comes to incorporating the specific experiences, concerns and responsibilities of patient groups.

This is where the concept of responsive representation comes in: the focus is on whether and how representatives of patient groups engage with those affected, are aware of their perspectives, and can provide comprehensible justifications for their actions towards them and the other participants.

ReReDi builds on this understanding of representation and examines how representatives of patient groups can be selected for deliberative processes and supported in their roles in such a way that patient perspectives are brought into debates on technological innovations in healthcare in a way that is transparent, well-founded and accessible to those affected.

Methodological approach

ReReDi is based on a multi-stage qualitative research design in which knowledge transfer, deliberative negotiation processes, and in-depth individual and group discussions are systematically interlinked. At its core is a patient jury, whose members are recruited not via random sampling but on the basis of responsive criteria. The jury first undergoes a structured information phase comprising several digital training sessions on the legal, ethical, technical and health economic aspects of AI use in healthcare. This is followed by a two-day moderated in-person discussion conference, during which the opportunities and risks of AI from the patient’s perspective are systematically addressed and translated into joint positions and recommendations.

The discourse process is scientifically documented through observation logs as well as audio and video recordings. Subsequently, qualitative interviews and, where appropriate, focus groups are conducted with selected jury members to capture individual reflections on role understanding, representational practices and perceived interaction dynamics. A validation phase involving individual, non-organised patients serves to compare key jury findings with the perspectives of those directly affected and to systematically evaluate their feedback.

Expected results

ReReDi will provide both theoretical and empirical foundations for understanding responsive representation and will identify the characteristics and skills representatives need to incorporate the perspectives of those affected into discourse in a credible and accessible manner. The project is expected to produce a consensus-based position paper by the patient jury on the opportunities and risks of AI in healthcare, an empirically grounded catalogue of criteria for the non-statistical, methodologically sound composition of discourse groups, and an application-oriented framework for the methodological design of future discourse processes. The results are to be incorporated into academic publications and provide practical guidance to stakeholders in the healthcare sector, in research and in patient organisations.

Funding body

The project is funded by the Federal Ministry of Research, Technology and Space (BMFTR).

Secondary data analyses on the influence of regional factors on health and healthcare provision

What are we researching?

By analysing large datasets (e.g. routine health insurance data, NAKO data), we aim to investigate associations between regional factors such as socio-economic status and rurality, and health-related outcomes for patients (e.g. those with cardiovascular diseases or receiving cancer care), as well as comparable individual healthcare provision.

What are the project’s objectives?

The main objective is to analyse whether socio-economic deprivation and rurality are associated with health- or care-related outcomes (e.g. survival, rehospitalisation rates or uptake of care).

Further analytical objectives include investigating the extent to which the results can be explained by factors relating to individual medical care or by aspects of regional infrastructure.

Cooperation partners: Verbund Knappschaft-Bahn-See, German National Cohort (NAKO Gesundheitsstudie)

Contact persons: An Dang, Dr. Kathrin Gödde and Susanne Haucke

Publications and conference papers:

• Dang A et al. (2025). Auswirkungen der sozioökonomischen Deprivation auf die Mortalität von Patient*innen mit kardiovaskulären Erkrankungen. Vortrag auf dem 24. Deutschen Kongress für Versorgungsforschung (DKVF), Universitätsklinikum Hamburg-Eppendorf, Hamburg, Deutschland, 22. bis 24. September 2025.
• Dang A et al. (2025). Impact of Socioeconomic Deprivation and Rurality on Mortality in Cardiovascular Patients. Vortrag auf dem 14th EURIPA Rural Health Forum „Rural Reformation: Meeting Wellbeing and Healthcare Needs in Rural Communities“, Lutherstadt Wittenberg, Deutschland, 26. bis 28. Juni 2025.
• Dang A et al. (2024). Auswirkungen der räumlichen sozioökonomischen Deprivation und der Ländlichkeit auf die Mortalität und Re-Hospitalisierung von Patient*innen mit kardiovaskulären Erkrankungen. Vortrag auf dem 5. Brandenburger Kongress für Versorgungsforschung (BKVF), Rüdersdorf bei Berlin, Deutschland, 11. bis 12. November 2024.