@phdthesis{Tomasevic2002,
  author    = {Tomasevic, Klaudia},
  title     = {Die medizinische Versorgung von Kindern Mitte des 19. Jahrhunderts am Beispiel von W{\"u}rzburg},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-3865},
  school      = {Universit{\"a}t W{\"u}rzburg},
  year      = {2002},
  abstract  = {Mitte des 19. Jahrhunderts gab es in Deutschland im Vergleich zu vielen seiner Nachbarstaaten nur sehr wenige Heil- und Krankenanstalten speziell f{\"u}r Kinder. Die Anerkennung der Kinderheilkunde als eigenes Fachgebiet an den deutschen Universit{\"a}ten verlief sehr langsam. Untersucht man die historische und soziologische Situation in Deutschland sowie den Entwicklungsstand der Medizin im 19. Jahrhundert genauer, so wird deutlich, warum hier solche aus heutiger Sicht r{\"u}ckst{\"a}ndige Verh{\"a}ltnisse herrschten. Wie sich anhand von Originaldokumenten belegen l{\"a}sst, wurde in W{\"u}rzburg f{\"u}r deutsche Verh{\"a}ltnisse recht fr{\"u}h der Vorstoß unternommen, an der Universit{\"a}t eine "Separatanstalt" f{\"u}r kranke Kinder zu errichten und die P{\"a}diatrie als eigenes Lehrfach einzuf{\"u}hren. Am 7. Juli 1841 erreichte den Senat und die Fakult{\"a}t der Universit{\"a}t W{\"u}rzburg ein K{\"o}niglich Bayerisches Dekret, das die Errichtung einer klinischen Anstalt f{\"u}r Kinder und eine damit verbundene Abhaltung von Vorlesungen {\"u}ber Kinderkrankheiten vorsah. Das prim{\"a}re Vorhaben der Fakult{\"a}t, eine "stabile" Kinderklinik zu er{\"o}ffnen, wurde jedoch aufgrund von Finanzierungsproblemen f{\"u}r mehrere Jahre aufgeschoben. Stattdessen wurde 1844 eine "billigere" ambulante Kinderklinik er{\"o}ffnet und Franz von Rinecker, ein sehr engagierter Professor, zu deren Leiter und zum Prof. f{\"u}r Kinderkrankheiten ernannt. Erst am 1. Nov. 1850 kam es zur offiziellen Gr{\"u}ndung einer stabilen Kinderklinik mit 12-15 Betten. Da andieser Institution jedoch sowohl die Universit{\"a}t als auch das Juliusspital, eine sehr m{\"a}chtige und mit der Universit{\"a}t verschwisterte Stiftung, beteiligt waren, kam es sowohl vor als auch nach der Gr{\"u}ndung zu großen Interessenskonflikten und Machtk{\"a}mpfen.Das Resultat war, dass die Universit{\"a}t und der von ihr ernannte Vorstand, Franz von Rinecker, letztendlich nur einen sehr geringen Einfluss in der Kinderklinik hatten, die außerdem bereits 1872 wieder ihre Eigenst{\"a}ndigkeit verlor. Die "stabile" Kinderklinik wurde an die Innere Medizin abgetreten, die ambulante Kinderklinik fiel an die allgemeine Poliklinik zur{\"u}ck. Erst 1915, also {\"u}ber 40 Jahre sp{\"a}ter, erlangte die W{\"u}rzburger P{\"a}diatrie wieder ihre Eigenst{\"a}ndigkeit, die mit dem Ordinariat f{\"u}r Hans Rietschel ab 1923 vervollst{\"a}ndigt wurde. Das Schicksal der p{\"a}diatrischen Anstalten in W{\"u}rzburg ist bezeichnend f{\"u}r die damalige Zeit: Die deutsche P{\"a}diatrie steckte noch in ihren Kinderschuhen und befand sich im st{\"a}ndigen Kampf gegen die Dominanz von Allgemeiner Poliklinik und Innerer Medizin.},
  subject      = {W{\"u}rzburg},
  language  = {de}
}
@article{RoseDammGreineretal.2014,
  author    = {Rose, Markus A. and Damm, Oliver and Greiner, Wolfgang and Knuf, Markus and Wutzler, Peter and Liese, Johannes G. and Kr{\"u}ger, Hagen and Wahn, Ulrich and Schaberg, Tom and Schwehm, Markus and Kochmann, Thomas F. and Eichner, Martin},
  title     = {The epidemiological impact of childhood influenza vaccination using live-attenuated influenza vaccine (LAIV) in Germany: predictions of a simulation study},
  series = {BMC Infectious Diseases},
  volume    = {14},
  journal   = {BMC Infectious Diseases},
  number    = {40},
  issn      = {1471-2334},
  doi       = {10.1186/1471-2334-14-40},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-117563},
  year      = {2014},
  abstract  = {Background: Routine annual influenza vaccination is primarily recommended for all persons aged 60 and above and for people with underlying chronic conditions in Germany. Other countries have already adopted additional childhood influenza immunisation programmes. The objective of this study is to determine the potential epidemiological impact of implementing paediatric influenza vaccination using intranasally administered live-attenuated influenza vaccine (LAIV) in Germany. Methods: A deterministic age-structured model is used to simulate the population-level impact of different vaccination strategies on the transmission dynamics of seasonal influenza in Germany. In our base-case analysis, we estimate the effects of adding a LAIV-based immunisation programme targeting children 2 to 17 years of age to the existing influenza vaccination policy. The data used in the model is based on published evidence complemented by expert opinion. Results: In our model, additional vaccination of children 2 to 17 years of age with LAIV leads to the prevention of 23.9 million influenza infections and nearly 16 million symptomatic influenza cases within 10 years. This reduction in burden of disease is not restricted to children. About one third of all adult cases can indirectly be prevented by LAIV immunisation of children. Conclusions: Our results demonstrate that vaccinating children 2-17 years of age is likely associated with a significant reduction in the burden of paediatric influenza. Furthermore, annual routine childhood vaccination against seasonal influenza is expected to decrease the incidence of influenza among adults and older people due to indirect effects of herd protection. In summary, our model provides data supporting the introduction of a paediatric influenza immunisation programme in Germany.},
  language  = {en}
}
@article{GoettlerNieklerLieseetal.2022,
  author    = {Goettler, David and Niekler, Patricia and Liese, Johannes G. and Streng, Andrea},
  title     = {Epidemiology and direct healthcare costs of Influenza-associated hospitalizations - nationwide inpatient data (Germany 2010-2019)},
  series = {BMC Public Health},
  volume    = {22},
  journal   = {BMC Public Health},
  doi       = {10.1186/s12889-022-12505-5},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-265888},
  year      = {2022},
  abstract  = {Introduction Detailed and up-to-date data on the epidemiology and healthcare costs of Influenza are fundamental for public health decision-making. We analyzed inpatient data on Influenza-associated hospitalizations (IAH), selected complications and risk factors, and their related direct costs for Germany during ten consecutive years. Methods We conducted a retrospective cost-of-illness study on patients with laboratory-confirmed IAH (ICD-10-GM code J09/J10 as primary diagnosis) by ICD-10-GM-based remote data query using the Hospital Statistics database of the German Federal Statistical Office. Clinical data and associated direct costs of hospital treatment are presented stratified by demographic and clinical variables. Results Between January 2010 to December 2019, 156,097 persons were hospitalized due to laboratory-confirmed Influenza (J09/J10 primary diagnosis). The annual cumulative incidence was low in 2010, 2012 and 2014 (1.3 to 3.1 hospitalizations per 100,000 persons) and high in 2013 and 2015-2019 (12.6 to 60.3). Overall direct per patient hospitalization costs were mean (SD) 3521 EUR (± 8896) and median (IQR) 1805 EUR (1502; 2694), with the highest mean costs in 2010 (mean 8965 EUR ± 26,538) and the lowest costs in 2012 (mean 2588 EUR ± 6153). Mean costs were highest in 60-69 year olds, and in 50-59, 70-79 and 40-49 year olds; they were lowest in 10-19 year olds. Increased costs were associated with conditions such as diabetes (frequency 15.0\%; 3.45-fold increase compared to those without diabetes), adiposity (3.3\%; 2.09-fold increase) or immune disorders (5.6\%; 1.88-fold increase) and with Influenza-associated complications such as Influenza pneumonia (24.3\%; 1.95-fold), bacterial pneumonia (6.3\%; 3.86-fold), ARDS (1.2\%; 10.90-fold increase) or sepsis (2.3\%; 8.30-fold). Estimated overall costs reported for the 10-year period were 549.6 Million euros (95\% CI 542.7-556.4 million euros). Conclusion We found that the economic burden of IAH in Germany is substantial, even when considering solely laboratory-confirmed IAH reported as primary diagnosis. The highest costs were found in the elderly, patients with certain underlying risk factors and patients who required advanced life support treatment, and median and mean costs showed considerable variations between single years. Furthermore, there was a relevant burden of disease in middle-aged adults, who are not covered by the current vaccination recommendations in Germany.},
  language  = {en}
}