Tobias Freund1, Joachim Szecsenyi, Dominik Ose. 1. Abteilung Allgemeinmedizin und Versorgungsforschung, Universitätsklinikum Heidelberg, Heidelberg, Germany. tobias.freund@med.uni-heidelberg.de
Abstract
BACKGROUND AND PURPOSE: Since 2004, primary care in Germany has increasingly been provided in special general practitioner (GP)-centred health care contracts (HZV). To date there is limited evidence about the characteristics of their beneficiaries regarding morbidity burden and health care utilization. METHODS: We analysed insurance claims data from all beneficiaries of the "Allgemeine Ortskrankenkasse (AOK) Baden-Württemberg" listed in 10 general practices that contracted in a special GP-centred health care contract (HZV). We compared beneficiaries enrolled in the HZV with those who were not enrolled in the contract. Comparisons included the number of hospital admissions in 2007-2008 and the Charlson comorbidity index. RESULTS: Insurance claims data of 6,026 beneficiaries were available for analysis. In the third quarter of 2009, 51% (3,066) of the beneficiaries were enrolled in the HZV. They were significantly older (mean 61 years [SD 18 years] vs. 49 years [SD 22 years]; p < 0,001) and had a higher number of hospital admissions in 2007 and 2008 (mean 0.64 [SD 1.20] vs. 0.57 [SD 1.21]; p < 0.05) compared with beneficiaries who were not enrolled in the HZV. Charlson comorbidity index was significantly higher for beneficiaries of the HZV (mean 1,55 [SD 1,92] vs. 1,12 [SD 1,86]; p < 0,001). CONCLUSION: Beneficiaries of a GP-centred health care contract tended to be older and suffered from a higher morbidity burden when compared with beneficiaries of the same health care fund who were not enrolled in the contract. Besides, beneficiaries of the contract had higher numbers of hospital admissions during the two year period before enrolment. These findings have substantial implications for individualized care management approaches that may be offered to beneficiaries of GP-centred health care contracts.
BACKGROUND AND PURPOSE: Since 2004, primary care in Germany has increasingly been provided in special general practitioner (GP)-centred health care contracts (HZV). To date there is limited evidence about the characteristics of their beneficiaries regarding morbidity burden and health care utilization. METHODS: We analysed insurance claims data from all beneficiaries of the "Allgemeine Ortskrankenkasse (AOK) Baden-Württemberg" listed in 10 general practices that contracted in a special GP-centred health care contract (HZV). We compared beneficiaries enrolled in the HZV with those who were not enrolled in the contract. Comparisons included the number of hospital admissions in 2007-2008 and the Charlson comorbidity index. RESULTS: Insurance claims data of 6,026 beneficiaries were available for analysis. In the third quarter of 2009, 51% (3,066) of the beneficiaries were enrolled in the HZV. They were significantly older (mean 61 years [SD 18 years] vs. 49 years [SD 22 years]; p < 0,001) and had a higher number of hospital admissions in 2007 and 2008 (mean 0.64 [SD 1.20] vs. 0.57 [SD 1.21]; p < 0.05) compared with beneficiaries who were not enrolled in the HZV. Charlson comorbidity index was significantly higher for beneficiaries of the HZV (mean 1,55 [SD 1,92] vs. 1,12 [SD 1,86]; p < 0,001). CONCLUSION: Beneficiaries of a GP-centred health care contract tended to be older and suffered from a higher morbidity burden when compared with beneficiaries of the same health care fund who were not enrolled in the contract. Besides, beneficiaries of the contract had higher numbers of hospital admissions during the two year period before enrolment. These findings have substantial implications for individualized care management approaches that may be offered to beneficiaries of GP-centred health care contracts.
Authors: Barbara Starfield; Klaus W Lemke; Terence Bernhardt; Steven S Foldes; Christopher B Forrest; Jonathan P Weiner Journal: Ann Fam Med Date: 2003 May-Jun Impact factor: 5.166
Authors: Cornelia Jäger; Tobias Freund; Jost Steinhäuser; Christian Stock; Johannes Krisam; Petra Kaufmann-Kolle; Michel Wensing; Joachim Szecsenyi Journal: Implement Sci Date: 2017-01-13 Impact factor: 7.327