title: Evaluation of a program to strengthen general practice care for patients with chronic disease in Germany
creator: Wensing, Michel
creator: Szecsenyi, Joachim
creator: Stock, Christian
creator: Kaufmann Kolle, Petra
creator: Laux, Gunter
subject: ddc-610
subject: 610 Medical sciences Medicine
description: Background: A program to strengthen general practice care for patients with chronic disease was offered in Germany. Enrollment was a free individual choice for both patients and physicians. This study aimed to examine the long-term impact of this program.   Methods: Two comparative evaluations were done, at 4 and 5 years (T1 and T2) after start of the program. In each year, patients in the program were compared with patients in usual care. Measures were based on routinely collected data and concerned 11 aspects of primary care and hospital care. Study groups were compared, using regression analysis adjusted for confounders and clustering.   Results: Data on 1.187.597 and 1.591.017 eligible patients were available for the analysis for T1 and T2, respectively. Compared to usual care, the program was associated with more visits to the GP per patient (adjusted difference at T2: +1.98), more drugs prescribed per patient (+0.071), lower percentage of drugs that should be avoided (−0.699), and lower yearly medication costs per patient (−85.39 euro). The number of referrals to ambulatory specialists, either with or without referral from GP, was reduced at T2. In hospital care, the program was associated with fewer hospital admissions per patient per year (−0.017) and fewer avoidable hospital admissions of all admissions (−1.165%). Total hospital costs were slightly higher in T1, but lower in T2. Days in hospital and number of readmissions were lower at T2 only.   Conclusion: The program has increased the role of general practice in healthcare for patients who chose to be included in the program of intensified general practice care.
publisher: BioMed Central
date: 2017
type: Article
type: info:eu-repo/semantics/article
type: NonPeerReviewed
format: application/pdf
identifier: https://archiv.ub.uni-heidelberg.de/volltextserverhttps://archiv.ub.uni-heidelberg.de/volltextserver/22550/1/12913_2017_Article_2000.pdf
identifier: DOI:
identifier: urn:nbn:de:bsz:16-heidok-225505
identifier:   Wensing, Michel ; Szecsenyi, Joachim ; Stock, Christian ; Kaufmann Kolle, Petra ; Laux, Gunter  (2017) Evaluation of a program to strengthen general practice care for patients with chronic disease in Germany.  BMC Health Services Research, 17 (62).  pp. 1-7.  ISSN 1472-6963     
relation: https://archiv.ub.uni-heidelberg.de/volltextserver/22550/
rights: info:eu-repo/semantics/openAccess
rights: Please see front page of the work (Sorry, Dublin Core plugin does not recognise license id)
language: eng