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
Visão geral do estudo
Status
Condições
Intervenção / Tratamento
Descrição detalhada
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.
Tipo de estudo
Inscrição (Real)
Contactos e Locais
Locais de estudo
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Hamburg, Alemanha, 20246
- Department of Primary Medical Care, University Medical Center Hamburg-Eppendorf
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Critérios de participação
Critérios de elegibilidade
Idades elegíveis para estudo
Aceita Voluntários Saudáveis
Gêneros Elegíveis para o Estudo
Método de amostragem
População do estudo
Descrição
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)
Plano de estudo
Como o estudo é projetado?
Detalhes do projeto
Coortes e Intervenções
Grupo / Coorte |
Intervenção / Tratamento |
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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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O que o estudo está medindo?
Medidas de resultados primários
Medida de resultado |
Descrição da medida |
Prazo |
|---|---|---|
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Reasons for consultation and utilized services in the GP practice
Prazo: 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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Medidas de resultados secundários
Medida de resultado |
Descrição da medida |
Prazo |
|---|---|---|
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Patient population in the GP practice
Prazo: 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
Prazo: 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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Colaboradores e Investigadores
Patrocinador
Investigadores
- Investigador principal: Martin Scherer, Prof. Dr., Department of Primary Medical Care, University Medical Center Hamburg-Eppendorf
Publicações e links úteis
Publicações Gerais
- 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.
Datas de registro do estudo
Datas Principais do Estudo
Início do estudo (Real)
Conclusão Primária (Real)
Conclusão do estudo (Real)
Datas de inscrição no estudo
Enviado pela primeira vez
Enviado pela primeira vez que atendeu aos critérios de CQ
Primeira postagem (Estimativa)
Atualizações de registro de estudo
Última Atualização Postada (Real)
Última atualização enviada que atendeu aos critérios de controle de qualidade
Última verificação
Mais Informações
Termos relacionados a este estudo
Outros números de identificação do estudo
- KVHH-KVSH-2015/1
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