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
Studie Overzicht
Toestand
Interventie / Behandeling
Gedetailleerde beschrijving
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.
Studietype
Inschrijving (Werkelijk)
Contacten en locaties
Studie Locaties
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Hamburg, Duitsland, 20246
- Department of Primary Medical Care, University Medical Center Hamburg-Eppendorf
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Deelname Criteria
Geschiktheidscriteria
Leeftijden die in aanmerking komen voor studie
Accepteert gezonde vrijwilligers
Geslachten die in aanmerking komen voor studie
Bemonsteringsmethode
Studie Bevolking
Beschrijving
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)
Studie plan
Hoe is de studie opgezet?
Ontwerpdetails
Cohorten en interventies
Groep / Cohort |
Interventie / Behandeling |
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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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Wat meet het onderzoek?
Primaire uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
|---|---|---|
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Reasons for consultation and utilized services in the GP practice
Tijdsspanne: 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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Secundaire uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
|---|---|---|
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Patient population in the GP practice
Tijdsspanne: 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
Tijdsspanne: 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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Medewerkers en onderzoekers
Onderzoekers
- Hoofdonderzoeker: Martin Scherer, Prof. Dr., Department of Primary Medical Care, University Medical Center Hamburg-Eppendorf
Publicaties en nuttige links
Algemene publicaties
- 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.
Studie record data
Bestudeer belangrijke data
Studie start (Werkelijk)
Primaire voltooiing (Werkelijk)
Studie voltooiing (Werkelijk)
Studieregistratiedata
Eerst ingediend
Eerst ingediend dat voldeed aan de QC-criteria
Eerst geplaatst (Schatting)
Updates van studierecords
Laatste update geplaatst (Werkelijk)
Laatste update ingediend die voldeed aan QC-criteria
Laatst geverifieerd
Meer informatie
Termen gerelateerd aan deze studie
Andere studie-ID-nummers
- KVHH-KVSH-2015/1
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