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Regional differences in health care of patients with inflammatory bowel disease in Germany.

Lange A, Prenzler A, Bachmann O, Linder R, Neubauer S, Zeidler J, Manns MP, von der Schulenburg JM - Health Econ Rev (2015)

Bottom Line: No difference in the frequencies of TNF-alpha inhibitor therapies was found.The results revealed that some aspects had positive effects on the probability of implementing healthcare in accordance with pathways and guidelines.No clear evidence of a general healthcare undersupply in rural areas was found.

View Article: PubMed Central - PubMed

Affiliation: Leibniz University Hannover, Center for Health Economics Research Hannover (CHERH), Koenigsworther Platz 1, D-30167, Hannover, Germany. al@ivbl.uni-hannover.de.

ABSTRACT

Background: The regional availability of specialized physicians is an important aspect in healthcare of patients with IBD. The association between physician density and healthcare is not yet clear. Most studies did not consider district type, which reflects population density. Our research question was, "Do specialist density and district type influence the healthcare of IBD patients in Germany?"

Methods: We combined a claims dataset from a German health insurance fund with population and physician data. Four main aspects were investigated: regular specialist visits, drug therapies, surveillance colonoscopy, and IBD-related hospitalizations. Various regression analyses were performed.

Results: The study cohort was comprised of 21,771 individuals, including 9282 patients with Crohn disease and 12,489 patients with ulcerative colitis. Patients who were living in districts with higher specialist densities were more likely to attend specialist visits on a regular basis. No difference in the frequencies of TNF-alpha inhibitor therapies was found. However, individuals from urban areas were more likely to receive a permanent immunosuppressive therapy with continuous specialist support.

Conclusions: The results revealed that some aspects had positive effects on the probability of implementing healthcare in accordance with pathways and guidelines. No clear evidence of a general healthcare undersupply in rural areas was found.

No MeSH data available.


Related in: MedlinePlus

Patient selection flowchart
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Fig1: Patient selection flowchart

Mentions: A total of 30,180 individuals were selected for inclusion based on a relevant diagnosis in the inpatient or outpatient sector. The final study cohort was comprised of 21,771 individuals, including 9282 CD and 12,489 UC patients (Fig. 1). The mean age of the cohort was approximately 50 years and the sex distribution was nearly equal with females comprising 49 % of the cohort. Almost 80 % lived in urban areas or autonomous cities. Further details of the cohort are given in Additional file 1.Fig. 1


Regional differences in health care of patients with inflammatory bowel disease in Germany.

Lange A, Prenzler A, Bachmann O, Linder R, Neubauer S, Zeidler J, Manns MP, von der Schulenburg JM - Health Econ Rev (2015)

Patient selection flowchart
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4608952&req=5

Fig1: Patient selection flowchart
Mentions: A total of 30,180 individuals were selected for inclusion based on a relevant diagnosis in the inpatient or outpatient sector. The final study cohort was comprised of 21,771 individuals, including 9282 CD and 12,489 UC patients (Fig. 1). The mean age of the cohort was approximately 50 years and the sex distribution was nearly equal with females comprising 49 % of the cohort. Almost 80 % lived in urban areas or autonomous cities. Further details of the cohort are given in Additional file 1.Fig. 1

Bottom Line: No difference in the frequencies of TNF-alpha inhibitor therapies was found.The results revealed that some aspects had positive effects on the probability of implementing healthcare in accordance with pathways and guidelines.No clear evidence of a general healthcare undersupply in rural areas was found.

View Article: PubMed Central - PubMed

Affiliation: Leibniz University Hannover, Center for Health Economics Research Hannover (CHERH), Koenigsworther Platz 1, D-30167, Hannover, Germany. al@ivbl.uni-hannover.de.

ABSTRACT

Background: The regional availability of specialized physicians is an important aspect in healthcare of patients with IBD. The association between physician density and healthcare is not yet clear. Most studies did not consider district type, which reflects population density. Our research question was, "Do specialist density and district type influence the healthcare of IBD patients in Germany?"

Methods: We combined a claims dataset from a German health insurance fund with population and physician data. Four main aspects were investigated: regular specialist visits, drug therapies, surveillance colonoscopy, and IBD-related hospitalizations. Various regression analyses were performed.

Results: The study cohort was comprised of 21,771 individuals, including 9282 patients with Crohn disease and 12,489 patients with ulcerative colitis. Patients who were living in districts with higher specialist densities were more likely to attend specialist visits on a regular basis. No difference in the frequencies of TNF-alpha inhibitor therapies was found. However, individuals from urban areas were more likely to receive a permanent immunosuppressive therapy with continuous specialist support.

Conclusions: The results revealed that some aspects had positive effects on the probability of implementing healthcare in accordance with pathways and guidelines. No clear evidence of a general healthcare undersupply in rural areas was found.

No MeSH data available.


Related in: MedlinePlus