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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

Probability of undergoing regular surveillance colonoscopies
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Fig4: Probability of undergoing regular surveillance colonoscopies

Mentions: The group of UC patients, who were 50 years and older, comprised of 6664 individuals. Of the patients, 9 % (587) had regular surveillance colonoscopies during the study period (Table 1). Figure 4 shows that the probability of undergoing regular colonoscopy was mainly independent of the specialist density in the rural areas, whereas in the urban areas, the probability of undergoing regular colonoscopy clearly increased with specialist density. The variation is particularly obvious in autonomous cities, where the probability of undergoing regular colonoscopy increased from 10 % for a specialist density of 0.4 per 10,000 inhabitants to 40 % for a specialist density of 1.4 per 10,000 inhabitants.Fig. 4


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)

Probability of undergoing regular surveillance colonoscopies
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

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

Fig4: Probability of undergoing regular surveillance colonoscopies
Mentions: The group of UC patients, who were 50 years and older, comprised of 6664 individuals. Of the patients, 9 % (587) had regular surveillance colonoscopies during the study period (Table 1). Figure 4 shows that the probability of undergoing regular colonoscopy was mainly independent of the specialist density in the rural areas, whereas in the urban areas, the probability of undergoing regular colonoscopy clearly increased with specialist density. The variation is particularly obvious in autonomous cities, where the probability of undergoing regular colonoscopy increased from 10 % for a specialist density of 0.4 per 10,000 inhabitants to 40 % for a specialist density of 1.4 per 10,000 inhabitants.Fig. 4

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