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Regional Variation in the Primary Medical Care of Northern Germany (AVFN)

2. august 2017 oppdatert av: Universitätsklinikum Hamburg-Eppendorf

Regional Variation of Patient Population and Reasons for Consultation in the Primary Medical Care of Northern Germany

The study explores the variation in the patient populations and describes regional differences regarding the reasons for consultations in the primary medical care in Germany. The data collection will be stratified by rural and urban areas as well as environs. The data set will include a large variety of data about physicians, patients and health care utilization.

Studieoversikt

Status

Fullført

Forhold

Intervensjon / Behandling

Detaljert beskrivelse

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

Observasjonsmessig

Registrering (Faktiske)

1022

Kontakter og plasseringer

Denne delen inneholder kontaktinformasjon for de som utfører studien, og informasjon om hvor denne studien blir utført.

Studiesteder

  • Tyskland
      • Hamburg, Tyskland, 20246
        • Department of Primary Medical Care, University Medical Center Hamburg-Eppendorf

Deltakelseskriterier

Forskere ser etter personer som passer til en bestemt beskrivelse, kalt kvalifikasjonskriterier. Noen eksempler på disse kriteriene er en persons generelle helsetilstand eller tidligere behandlinger.

Kvalifikasjonskriterier

Alder som er kvalifisert for studier

18 år og eldre (Voksen, Eldre voksen)

Tar imot friske frivillige

Ja

Kjønn som er kvalifisert for studier

Alle

Prøvetakingsmetode

Sannsynlighetsprøve

Studiepopulasjon

The study is located in Northern Germany. We included all districts and cities ("Landkreise" and "Kreisfreie Städte") which have at least 20% of their area within a maximum linear distance of 100kms from our study centre in Hamburg. We assigned all districts and cities to three region types: "urban area", "environs" and "rural area". In each region type 80 GPs will be recruited and stratified by district. The prospected sample size in each district unit corresponds to its population size in relation to the total population in the respective region type. In each GP practice 15 patients will be selected at random (using random number tables) and invited to participate in the study. From our experience with similar studies we anticipate a response rate of 33%.

Beskrivelse

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)

Studieplan

Denne delen gir detaljer om studieplanen, inkludert hvordan studien er utformet og hva studien måler.

Hvordan er studiet utformet?

Designdetaljer

Kohorter og intervensjoner

Gruppe / Kohort
Intervensjon / Behandling
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.
Annen: Primary medical care
All study participants receive primary care as usual in the respective region
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.
Annen: Primary medical care
All study participants receive primary care as usual in the respective region
Primary medical care in in urban areas
People living in cities with a population of at least 100,000 residents.
Annen: Primary medical care
All study participants receive primary care as usual in the respective region

Hva måler studien?

Primære resultatmål

Resultatmål
Tiltaksbeskrivelse
Tidsramme
Reasons for consultation and utilized services in the GP practice
Tidsramme: 3 months
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).
3 months

Sekundære resultatmål

Resultatmål
Tiltaksbeskrivelse
Tidsramme
Patient population in the GP practice
Tidsramme: 3 months
List of 27 patient types regarding their health care utilization behaviour
3 months
Health care utilization
Tidsramme: 3 months
Frequency of accessing GPs, specialists, general hospitals and rehab hospitals
3 months

Samarbeidspartnere og etterforskere

Det er her du vil finne personer og organisasjoner som er involvert i denne studien.

Sponsor

Universitätsklinikum Hamburg-Eppendorf

Etterforskere

  • Hovedetterforsker: Martin Scherer, Prof. Dr., Department of Primary Medical Care, University Medical Center Hamburg-Eppendorf

Publikasjoner og nyttige lenker

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Generelle publikasjoner

Studierekorddatoer

Disse datoene sporer fremdriften for innsending av studieposter og sammendragsresultater til ClinicalTrials.gov. Studieposter og rapporterte resultater gjennomgås av National Library of Medicine (NLM) for å sikre at de oppfyller spesifikke kvalitetskontrollstandarder før de legges ut på det offentlige nettstedet.

Studer hoveddatoer

Studiestart (Faktiske)

1. mai 2015

Primær fullføring (Faktiske)

1. mai 2017

Studiet fullført (Faktiske)

1. juli 2017

Datoer for studieregistrering

Først innsendt

2. september 2015

Først innsendt som oppfylte QC-kriteriene

21. september 2015

Først lagt ut (Anslag)

24. september 2015

Oppdateringer av studieposter

Sist oppdatering lagt ut (Faktiske)

3. august 2017

Siste oppdatering sendt inn som oppfylte QC-kriteriene

2. august 2017

Sist bekreftet

1. august 2017

Mer informasjon

Begreper knyttet til denne studien

Andre studie-ID-numre

  • KVHH-KVSH-2015/1

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