Strong primary care and patients’ survival

• Verfasst von: Wensing, Michel [VerfasserIn]
• Verfasst von: Szecsenyi, Joachim [VerfasserIn]
• Verfasst von: Kaufmann-Kolle, Petra [VerfasserIn]
• Verfasst von: Laux, Gunter [VerfasserIn]
• Titel: Strong primary care and patients’ survival
• Verf.angabe: Michel Wensing, Joachim Szecsenyi, Petra Kaufmann-Kolle, Gunter Laux
• E-Jahr: 2019
• Jahr: 26 July 2019
• Umfang: 5 S.
• Fussnoten: Gesehen am 30.10.2019
• Titel Quelle: Enthalten in: Scientific reports
• Ort Quelle: [London] : Macmillan Publishers Limited, part of Springer Nature, 2011
• Jahr Quelle: 2019
• Band/Heft Quelle: 9(2019) Artikel-Nummer 10859, 5 Seiten
• ISSN Quelle: 2045-2322
• DOI: doi:10.1038/s41598-019-47344-9
• Datenträger: Online-Ressource
• Sprache: eng
• K10plus-PPN: 1680705369

Abstract

Primary healthcare is the cornerstone of any healthcare system. A major health system reform to strengthen primary care has been implemented in Germany since 2008. Key components include: voluntary participation, intensive management of patients with chronic diseases, coordination of access to medical specialists, continuous quality improvement, and capitation-based reimbursement. The objective of this study was to assess the effect of this reform on survival of enrolled patients. We conducted a comparative cohorts study with 5-year follow-up, starting in the year 2012 in Baden-Wuerttemberg, Germany. Participants were 1,003,336 enrolled patients and 725,310 control patients. A Cox proportional hazards regression model was applied to compare survival of enrolled patients with a composed control cohort of non-enrolled patients, adjusted for a range of patient and physician characteristics. Average age of enrolled patients was 57.3 years and 56.1% were women. Compared to control patients, they had lower mortality (Hazard Ratio: 0.978; 95% CI: 0.968; 0.989). Participation in chronic disease management programs had independent impact on survival rate (Hazard Ratio 0.744, 95% CI: 0.734; 0.753). We concluded that strong primary care is safe and potentially beneficial in terms of patients’ survival.