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

2 augusti 2017 uppdaterad 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.

Studieöversikt

Status

Avslutad

Betingelser

Intervention / Behandling

Detaljerad beskrivning

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.

Studietyp

Observationell

Inskrivning (Faktisk)

1022

Kontakter och platser

Det här avsnittet innehåller kontaktuppgifter för dem som genomför studien och information om var denna studie genomförs.

Studieorter

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

Deltagandekriterier

Forskare letar efter personer som passar en viss beskrivning, så kallade behörighetskriterier. Några exempel på dessa kriterier är en persons allmänna hälsotillstånd eller tidigare behandlingar.

Urvalskriterier

Åldrar som är berättigade till studier

18 år och äldre (Vuxen, Äldre vuxen)

Tar emot friska volontärer

Ja

Kön som är behöriga för studier

Allt

Testmetod

Sannolikhetsprov

Studera befolkning

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%.

Beskrivning

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

Det här avsnittet ger detaljer om studieplanen, inklusive hur studien är utformad och vad studien mäter.

Hur är studien utformad?

Designdetaljer

Kohorter och interventioner

Grupp / Kohort
Intervention / 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.
Övrig: 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.
Övrig: 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.
Övrig: Primary medical care
All study participants receive primary care as usual in the respective region

Vad mäter studien?

Primära resultatmått

Resultatmått
Åtgärdsbeskrivning
Tidsram
Reasons for consultation and utilized services in the GP practice
Tidsram: 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

Sekundära resultatmått

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

Samarbetspartners och utredare

Det är här du hittar personer och organisationer som är involverade i denna studie.

Sponsor

Universitätsklinikum Hamburg-Eppendorf

Utredare

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

Publikationer och användbara länkar

Den som ansvarar för att lägga in information om studien tillhandahåller frivilligt dessa publikationer. Dessa kan handla om allt som har med studien att göra.

Allmänna publikationer

Studieavstämningsdatum

Dessa datum spårar framstegen för inlämningar av studieposter och sammanfattande resultat till ClinicalTrials.gov. Studieposter och rapporterade resultat granskas av National Library of Medicine (NLM) för att säkerställa att de uppfyller specifika kvalitetskontrollstandarder innan de publiceras på den offentliga webbplatsen.

Studera stora datum

Studiestart (Faktisk)

1 maj 2015

Primärt slutförande (Faktisk)

1 maj 2017

Avslutad studie (Faktisk)

1 juli 2017

Studieregistreringsdatum

Först inskickad

2 september 2015

Först inskickad som uppfyllde QC-kriterierna

21 september 2015

Första postat (Uppskatta)

24 september 2015

Uppdateringar av studier

Senaste uppdatering publicerad (Faktisk)

3 augusti 2017

Senaste inskickade uppdateringen som uppfyllde QC-kriterierna

2 augusti 2017

Senast verifierad

1 augusti 2017

Mer information

Termer relaterade till denna studie

Andra studie-ID-nummer

  • KVHH-KVSH-2015/1

Denna information hämtades direkt från webbplatsen clinicaltrials.gov utan några ändringar. Om du har några önskemål om att ändra, ta bort eller uppdatera dina studieuppgifter, vänligen kontakta register@clinicaltrials.gov. Så snart en ändring har implementerats på clinicaltrials.gov, kommer denna att uppdateras automatiskt även på vår webbplats .

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