[Evaluating the deployment of VERAHs in family doctor-centred health care in Baden-Wuerttemberg].
BACKGROUND
The contract covering family doctor-centred health care (HzV) in Baden-Wuerttemberg supports and remunerates the deployment of specially trained health care assistants (VERAHs). It is as yet unknown to what extent VERAHs are actually deployed in HzV, what the focus of their work is, what changes and shifts in responsibility have resulted in the practice team, and whether they have relieved the burden on family doctors.


METHODS
A full survey of all VERAHs in HzV practices in Baden-Wuerttemberg was conducted using a questionnaire (response rate over 32 %, N = 294). The questions aimed to gather information on how often and where VERAHs were deployed and on observed changes in their fields of responsibility. The family doctors employing VERAHs also received a questionnaire containing questions related to the changes observed, and additional questions on the delegation of responsibilities to VERAHs.


RESULTS
To an increasing extent, VERAHs take on responsibilities that directly involve the patient, such as home visits agreed on with the doctor, vaccination and drug management, wound management and case management. Thus they take on tasks traditionally reserved for doctors. Both family doctors and VERAHs said that patient health care has improved and that the use of VERAHs helps doctors save time.


CONCLUSIONS
The deployment of VERAHs in family doctor-centred health care leads to the redistribution of responsibilities in the practice and thus relieves physician burden. Chronically ill patients benefit from continuous care and an additional contact person. Health care assistants benefit from new career options.
Institut für Allgemeinmedizin, Johann Wolfgang Goethe-Universität Frankfurt am Main. Electronic address: mergenthal@allgemeinmedizin.uni-frankfurt.de.
Karola
K
Mergenthal
Martin
M
Beyer
Corina
C
Güthlin
Ferdinand M
FM
Gerlach
D000328:Adult; D001291:Attitude of Health Personnel; D002908:Chronic Disease / Q000453:epidemiology / Q000628:therapy*; D003430:Cross-Sectional Studies; D032022:Delegation, Professional / Q000458:organization & administration; D005194:Family Practice / Q000458:organization & administration*; D005260:Female; D006284:Health Plan Implementation / Q000458:organization & administration*; D006801:Humans; D007587:Job Description; D007588:Job Satisfaction; D008297:Male; D008875:Middle Aged; D009313:National Health Programs / Q000458:organization & administration*; D017060:Patient Satisfaction; D018802:Patient-Centered Care / Q000458:organization & administration*; D010823:Physician Assistants / Q000458:organization & administration*; D011795:Surveys and Questionnaires; D016526:Workload
Arztentlastung; Delegation; Family doctor-centred health care (HzV); Hausarztzentrierte Versorgung (HzV); Medizinische Fachangestellte; Qualifizierung; VERAH (Versorgungsassistentin in der Hausarztpraxis); delegation; family practice; health care assistants; qualification