{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,27]],"date-time":"2026-01-27T08:53:24Z","timestamp":1769504004052,"version":"3.49.0"},"reference-count":23,"publisher":"Georg Thieme Verlag KG","issue":"07","license":[{"start":{"date-parts":[[2023,6,15]],"date-time":"2023-06-15T00:00:00Z","timestamp":1686787200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Gesundheitswesen"],"published-print":{"date-parts":[[2023,7]]},"abstract":"<jats:title>Zusammenfassung<\/jats:title><jats:p>\n          Einleitung Der deutschen Krankenhauslandschaft mangelt es an einer\n                    gezielten Versorgungssteuerung, was u.\u2009a. an der unzureichenden Nutzung\n                    von durch die Deutsche Krebsgesellschaft (DKG) zertifizierten Krebszentren zu\n                    erkennen ist. So werden allzu viele Patient*innen au\u00dferhalb von\n                    Krebszentren und damit schlechter behandelt. Um dem zu begegnen, k\u00f6nnte\n                    die Behandlung in Anlehnung an D\u00e4nemark auf spezialisierte\n                    Krankenh\u00e4user begrenzt werden und die vorliegende Studie ermittelt die\n                    Auswirkungen auf die Fahrzeiten von Patient*innen am Beispiel des\n                    kolorektalen Karzinoms.<\/jats:p><jats:p>\n          Methoden Die Analysen f\u00fcr das Jahr 2018 basieren auf Daten der\n                    strukturierten Qualit\u00e4tsberichte (sQB) und von bei der AOK versicherten\n                    Patient*innen, bei denen eine Resektion des Kolons oder Rektums erfolgt\n                    ist. Dar\u00fcber hinaus wurden Angaben der DKG bez\u00fcglich einer\n                    vorhandenen Zertifizierung eines Darmkrebszentrums genutzt. Die Fahrzeit wurde\n                    definiert als Zeit, die Patient*innen mit einem durchschnittlichen PKW\n                    bei durchschnittlichem Verkehr vom Mittelpunkt der Postleitzahl (PLZ) ihres\n                    Wohnorts zu den Koordinaten des Krankenhauses ben\u00f6tigen. Die Koordinaten\n                    der Krankenh\u00e4user und die Mittelpunkte der PLZ wurden \u00fcber eine\n                    Abfrage der Google API ermittelt. Die Berechnung der Fahrtzeiten wiederum\n                    erfolgte unter Zuhilfenahme eines lokalen Open Routing Machine Servers.\n                    F\u00fcr die statistischen Analysen und kartographischen Darstellungen wurden\n                    die Statistikprogramme R und Stata verwendet.<\/jats:p><jats:p>\n          Ergebnisse In 2018 wurde fast die H\u00e4lfte aller\n                    Patient*innen mit Kolonkarzinom im n\u00e4chstgelegenen Krankenhaus\n                    behandelt, wobei davon ca. 40% in einem zertifizierten Darmkrebszentrum\n                    behandelt wurden. Insgesamt fanden nur ca. 47% aller Behandlungen in\n                    einem zertifizierten Darmkrebszentrum statt. Die Fahrtzeit zum gew\u00e4hlten\n                    Behandlungsort lag insgesamt bei durchschnittlich 20 Minuten. Sie war etwas\n                    geringer (18 Minuten), wenn kein zertifiziertes Zentrum gew\u00e4hlt wurde,\n                    und etwas l\u00e4nger (21 Minuten) f\u00fcr diejenigen, deren Behandlung\n                    in einem zertifizierten Darmkrebszentrum stattfand. Die Modellierungen von\n                    Umverteilungen aller Patient*innen nur zu zertifizierten Zentren ergab\n                    eine durchschnittliche Fahrtzeit von 29 Minuten.<\/jats:p><jats:p>\n          Schlussfolgerung Bei einer Steuerung der Behandlung hin zu spezialisierten\n                    Krankenh\u00e4usern w\u00e4re eine wohnortnahe Behandlung weiterhin\n                    gew\u00e4hrleistet. Unabh\u00e4ngig von einer Zertifizierung lassen sich\n                    besonders in Ballungsgebieten Parallelstrukturen erkennen, die auf ein\n                    Umstrukturierungspotential hinweisen.<\/jats:p>","DOI":"10.1055\/a-2055-9599","type":"journal-article","created":{"date-parts":[[2023,6,15]],"date-time":"2023-06-15T22:47:15Z","timestamp":1686869235000},"page":"657-666","source":"Crossref","is-referenced-by-count":2,"title":["Spezialisierte Behandlung von Darmkrebs in zertifizierten\n                    Krebszentren: M\u00fcssen Patient*innen wirklich weitere Wege auf\n                    sich nehmen?"],"prefix":"10.1055","volume":"85","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1932-6217","authenticated-orcid":false,"given":"Elke","family":"Berger","sequence":"additional","affiliation":[{"name":"Fachgebiet Management im Gesundheitswesen, Technische\n                    Universit\u00e4t Berlin, Fakult\u00e4t VII Wirtschaft und Management,\n                    Berlin, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christoph","family":"Reichebner","sequence":"additional","affiliation":[{"name":"Fachgebiet Management im Gesundheitswesen, Technische\n                    Universit\u00e4t Berlin, Fakult\u00e4t VII Wirtschaft und Management,\n                    Berlin, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Astrid","family":"Eriksen","sequence":"additional","affiliation":[{"name":"Fachgebiet Management im Gesundheitswesen, Technische\n                    Universit\u00e4t Berlin, Fakult\u00e4t VII Wirtschaft und Management,\n                    Berlin, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Meik","family":"Hildebrandt","sequence":"additional","affiliation":[{"name":"Fachgebiet Management im Gesundheitswesen, Technische\n                    Universit\u00e4t Berlin, Fakult\u00e4t VII Wirtschaft und Management,\n                    Berlin, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Kuklinski","sequence":"additional","affiliation":[{"name":"School of Medicine, Universit\u00e4t St Gallen School of Medicine,\n                    St Gallen, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Reinhard","family":"Busse","sequence":"additional","affiliation":[{"name":"Fachgebiet Management im Gesundheitswesen, Technische\n                    Universit\u00e4t Berlin, Fakult\u00e4t VII Wirtschaft und Management,\n                    Berlin, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2023,6,15]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"31","DOI":"10.5771\/1611-5821-2020-4-5-31","article-title":"Zentralisierung und Spezialisierung. 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