Details
| Original language | English |
|---|---|
| Article number | 29 |
| Journal | Health Economics Review |
| Volume | 5 |
| Publication status | Published - 16 Oct 2015 |
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.
Keywords
- Crohn, Guidelines, Inflammatory bowel disease, Quality, Regional differences, Ulcerative colitis
ASJC Scopus subject areas
- Medicine(all)
- Health Policy
Sustainable Development Goals
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In: Health Economics Review, Vol. 5, 29, 16.10.2015.
Research output: Contribution to journal › Article › Research › peer review
}
TY - JOUR
T1 - Regional differences in health care of patients with inflammatory bowel disease in Germany
AU - Lange, Ansgar
AU - Prenzler, Anne
AU - Bachmann, Oliver
AU - Linder, Roland
AU - Neubauer, Sarah
AU - Zeidler, Jan
AU - Manns, Michael P.
AU - von der Schulenburg, J. Matthias
N1 - Funding Information: This study was funded by the German Research Foundation (DFG).
PY - 2015/10/16
Y1 - 2015/10/16
N2 - 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.
AB - 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.
KW - Crohn
KW - Guidelines
KW - Inflammatory bowel disease
KW - Quality
KW - Regional differences
KW - Ulcerative colitis
UR - http://www.scopus.com/inward/record.url?scp=84971330601&partnerID=8YFLogxK
U2 - 10.1186/s13561-015-0067-1
DO - 10.1186/s13561-015-0067-1
M3 - Article
AN - SCOPUS:84971330601
VL - 5
JO - Health Economics Review
JF - Health Economics Review
SN - 2191-1991
M1 - 29
ER -