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For multiple sclerosis (MS), a disease that was de facto untreatable just a few decades ago, various treatment options are now available. The disease is still not curable, although it can now be treated and managed well. However, this progress is accompanied by the fact that certain therapies are becoming more complex and riskier and, due to a lack of structures in outpatient care, do not always reach patients to the extent required. This study addresses this challenge and aims to improve the quality of care for people with MS through a complex intervention. At the same time, the dissertation provides a valuable contribution to the understanding of methodological requirements for the evaluation of complex interventions in health care reality in the context of organization-based health services research. The complex intervention combines a structural intervention as well as a process intervention and is implemented in 28 neurological study centers nationwide. The structural intervention supports the centers in reducing the existing restrictions in terms of personnel, equipment and space. The process intervention uses the Delphi method to iteratively develop a generic consensus-based process for the implementation of more complex infusion therapies in order to address existing uncertainties and inefficiencies in the care process. The evaluation of the effectiveness of the intervention confirms the applicability of the approach and the effectiveness of the two intervention components as well as their interaction based on qualitative and quantitative data from three data collection points. As a result, a quantitatively measurable improvement in the reality of care can be shown. The study serves as a basis for further studies and shows explicit recommendations for the further development of the care system.
keywordsAlemtuzumab Betriebswirtschaftslehre Delphi Evaluation Gesundheitsmanagement Infusionstherapien Komplexe Intervention MS-Patienten Multiple Sklerose Neurologie Ocrelizumab Prozessinvervention Prozessoptimierung Versorgungsforschung
Ihr Werk im Verlag Dr. Kovač
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