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

Universitätsklinikum Hamburg-Eppendorf

Status: Completed

Conditions: Any Condition Treated in Primary Care

Treatments: Other: Primary medical care

Study type: Observational

Funder types: Other

Identifiers

NCT02558322

KVHH-KVSH-2015/1

Details and patient eligibility

About

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.

Full 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.

Enrollment: 1,022 patients

Sex: All

Ages: 18+ years old

Volunteers: Accepts Healthy Volunteers

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)

Trial design

1,022 participants in 3 patient groups

Primary medical care in rural areas

Description:

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.

Treatment:

Other: Primary medical care

Primary medical care in region environs

Description:

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.

Treatment:

Other: Primary medical care

Primary medical care in in urban areas

Description:

People living in cities with a population of at least 100,000 residents.

Treatment:

Other: Primary medical care