Regional Variation in the Primary Medical Care of Northern Germany (AVFN)
Regional Variation of Patient Population and Reasons for Consultation in the Primary Medical Care of Northern Germany
調査の概要
詳細な説明
Inappropriate supply and the increasing demand on the health care system have been of concern for health policy in Germany for the last 15 years. Concerning primary care, this especially relates to an undersupply of rural GPs (general practitioners). But there also seem to be other relevant regional differences, e.g. a lower number of house calls in larger cities, a greater number of psychiatric (co-)morbidities in the cities, a greater spectrum of services offered by rural doctors, and a difference in accessing primary and secondary care between the rural and the urban areas. Despite these results, differences between rural and urban areas have not been studied extensively in Germany. Therefore this study aims to explore regional variation of patient populations and their reasons for accessing primary care.
The study is based on standardized interviews with 240 GPs and approximately 1.200 patients in Northern Germany. Questionnaires are based on a preliminary qualitative study and were pretested. The GP's questionnaire comprises characteristics of the GP and the practice, patient types, reasons for consultation and services offered. The patient's questionnaire includes sociodemographic data and past medical history, quality of life, access to the GP, specialists and hospitals, perceived social support, health behaviour and the reasons for their consultations. Data will be analysed by descriptive statistics and different regression modelling strategies adjusted for possible confounders and the GP-induced cluster structure.
研究の種類
入学 (実際)
連絡先と場所
研究場所
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Hamburg、ドイツ、20246
- Department of Primary Medical Care, University Medical Center Hamburg-Eppendorf
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参加基準
適格基準
就学可能な年齢
健康ボランティアの受け入れ
受講資格のある性別
サンプリング方法
調査対象母集団
説明
Inclusion Criteria:
- having consulted the practice within the last 3 months and
- being patient of the practice since at least 36 months (i.e. at least one consultation before 36 or more months)
Exclusion Criteria:
- no capacity to consent (e.g. because of dementia)
- insufficient German language skills to conduct interview
- not able to participate in the interviews (e.g. because of deafness or major depression)
研究計画
研究はどのように設計されていますか？
デザインの詳細
コホートと介入
グループ/コホート |
介入・治療 |
|---|---|
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Primary medical care in rural areas
People living in districts, where less than 50% of the population live in cities with more than 20,000 residents and the population density outside of the cities is below 100 people per km².
Excluding people living in cities with a population of at least 100,000 residents.
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All study participants receive primary care as usual in the respective region
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Primary medical care in region environs
People living in districts, where 50% or more of the population live in cities with more than 20,000 residents and/or population density outside of the cities is above 100 people per km².
Excluding people living in cities with a population of at least 100,000 residents.
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All study participants receive primary care as usual in the respective region
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Primary medical care in in urban areas
People living in cities with a population of at least 100,000 residents.
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All study participants receive primary care as usual in the respective region
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この研究は何を測定していますか？
主要な結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
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Reasons for consultation and utilized services in the GP practice
時間枠：3 months
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Short form of the German version of the International Classification of Primary Care (ICPC) with 38 different services (e.g.
vaccinations, patient education or referrals) and 100 consultation reasons (e.g.
disorders of the upper gastrointestinal tract) in 17 subject areas (e.g.
digestive system).
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3 months
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二次結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
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Patient population in the GP practice
時間枠：3 months
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List of 27 patient types regarding their health care utilization behaviour
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3 months
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Health care utilization
時間枠：3 months
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Frequency of accessing GPs, specialists, general hospitals and rehab hospitals
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3 months
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協力者と研究者
捜査官
- 主任研究者：Martin Scherer, Prof. Dr.、Department of Primary Medical Care, University Medical Center Hamburg-Eppendorf
出版物と役立つリンク
一般刊行物
- Hansen H, Schafer I, Pohontsch NJ, Kazek A, Hardt H, Luhmann D, Scherer M. Regional differences in the patient population of general practices in northern Germany: results of a mixed-methods study. BMJ Open. 2020 Nov 27;10(11):e041762. doi: 10.1136/bmjopen-2020-041762.
- Hansen H, Schafer I, Porzelt S, Kazek A, Luhmann D, Scherer M. Regional and patient-related factors influencing the willingness to use general practitioners as coordinators of the treatment in northern Germany - results of a cross-sectional observational study. BMC Fam Pract. 2020 Jun 17;21(1):110. doi: 10.1186/s12875-020-01180-3.
- Schafer I, Hansen H, Ruppel T, Luhmann D, Wagner HO, Kazek A, Scherer M. Regional differences in reasons for consultation and general practitioners' spectrum of services in northern Germany - results of a cross-sectional observational study. BMC Fam Pract. 2020 Jan 31;21(1):22. doi: 10.1186/s12875-020-1093-6.
- Schafer I, Hansen H, Pohontsch N, Bole L, Wagner HO, Fuhr M, Luhmann D, Scherer M. Regional variation of patient behaviour and reasons for consultation in the general practice of Northern Germany: protocol for an observational study. BMJ Open. 2016 Jun 29;6(6):e010738. doi: 10.1136/bmjopen-2015-010738.
研究記録日
主要日程の研究
研究開始 (実際)
一次修了 (実際)
研究の完了 (実際)
試験登録日
最初に提出
QC基準を満たした最初の提出物
最初の投稿 (見積もり)
学習記録の更新
投稿された最後の更新 (実際)
QC基準を満たした最後の更新が送信されました
最終確認日
詳しくは
本研究に関する用語
その他の研究ID番号
- KVHH-KVSH-2015/1
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