Regional Variation in the Primary Medical Care of Northern Germany

NCT ID: NCT02558322

Last Updated: 2017-08-03

Basic Information

• Recruitment Status: COMPLETED
• Total Enrollment: 1022 participants
• Study Classification: OBSERVATIONAL
• Study Start Date: 2015-05-31
• Study Completion Date: 2017-07-31

Brief Summary

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.

Detailed Description

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.

Conditions

Any Condition Treated in Primary Care

Study Design

• Observational Model Type: OTHER
• Study Time Perspective: CROSS_SECTIONAL

Study Groups

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.

Primary medical care

Intervention Type: OTHER

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.

Primary medical care

Intervention Type: OTHER

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.

Primary medical care

Intervention Type: OTHER

All study participants receive primary care as usual in the respective region

Interventions

Primary medical care

All study participants receive primary care as usual in the respective region

Intervention Type: OTHER

Eligibility Criteria

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)

• Minimum Eligible Age: 18 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: Yes

Sponsors

Universitätsklinikum Hamburg-Eppendorf

OTHER

Sponsor Role: lead

Responsible Party

Responsibility Role: SPONSOR

Principal Investigators

Martin Scherer, Prof. Dr.

Role: PRINCIPAL_INVESTIGATOR

Department of Primary Medical Care, University Medical Center Hamburg-Eppendorf

Locations

Department of Primary Medical Care, University Medical Center Hamburg-Eppendorf

Hamburg, , Germany

Countries

Germany

References

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.

Reference Type: DERIVED

PMID: 33247029 (View on PubMed)

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.

Reference Type: DERIVED

PMID: 32552721 (View on PubMed)

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.

Reference Type: DERIVED

PMID: 32005159 (View on PubMed)

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.

Reference Type: DERIVED

PMID: 27357194 (View on PubMed)

Other Identifiers

KVHH-KVSH-2015/1

Identifier Type: -

Identifier Source: org_study_id