Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Observational Study
. 2016 Jun 29;6(6):e010738.
doi: 10.1136/bmjopen-2015-010738.

Regional variation of patient behaviour and reasons for consultation in the general practice of Northern Germany: protocol for an observational study

Ingmar Schäfer  1 , Heike Hansen  1 , Nadine Pohontsch  1 , Laura Bole  1 , Hans-Otto Wagner  1 , Miriam Führ  1 , Dagmar Lühmann  1 , Martin Scherer  1
Affiliations
Observational Study

Regional variation of patient behaviour and reasons for consultation in the general practice of Northern Germany: protocol for an observational study

Ingmar Schäfer et al. BMJ Open. .

Abstract

Introduction: Inappropriate supply and an increasing demand on the healthcare system have been of concern for health policy in Germany for at least 15 years. In the primary care setting, this especially relates to an undersupply of general practitioners (GPs) in the countryside. In addition, there seem to be other regional differences, for example, a difference in accessing primary and secondary care between rural and urban areas. Despite these findings, regional differences in health services have not been studied extensively in Germany. Therefore, this study aims to explore regional variations of patient populations and reasons for accessing primary medical care.

Methods and analysis: We will conduct a cross-sectional observational study based on standardised interviews with 240 GPs and ∼1200 patients. Data collection started on 10 June 2015 and will probably be completed by 31 October 2016. We will include all districts and cities within 100 km from Hamburg and assign them according to the type of regions: rural, urban and environs. All eligible GPs will be invited to participate. Each practice will recruit up to 15 patients, aged 18 years or older. Questionnaires are based on a preliminary qualitative study and were pretested. Data will be analysed with descriptive statistics and regression modelling strategies adjusted for confounders and the GP-induced cluster structure.

Ethics and dissemination: Our study was approved by the Ethics Committee of the Medical Association of Hamburg and is conducted in accordance with the Declaration of Helsinki. Study participants give written informed consent before data collection and data is pseudonymised. Survey data and person identifiers are stored separately in locked cabinets and have restricted availability. The results of our study will be presented at conferences and published in peer-reviewed journals.

Trial registration number: NCT02558322; Pre-results.

Keywords: PRIMARY CARE; patient types; reasons for consultation; regional variation; rural area; urban area.

PubMed Disclaimer

References

    1. Advisory Council for the Concerted Action in Health Care. Appropriateness and efficiency. Volume III Overuse, underuse and misuse. Report 2000/2001. http://www.svr-gesundheit.de/fileadmin/user_upload/Gutachten/2000-2001/K... (accessed 19 Aug 2015).
    1. Van den Berg N, Fiss T, Meinke C et al. . GP-support by means of AGnES-practice assistants and the use of telecare devices in a sparsely populated region in Northern Germany—proof of concept. BMC Fam Pract 2009;10:44 10.1186/1471-2296-10-44 - DOI - PMC - PubMed
    1. Roos M, Hartleb L, Langbein SH. Der Hausarztmangel auf dem Land ist angekommen. Z Allgemeinmedizin 2015;91:131–6.
    1. Kopetsch T. Dem Deutschen Gesundheitswesen gehen die Ärzte aus! Studie zur Altersstruktur- und Arztzahlenentwicklung. 5th edn Berlin: Bundesärztekammer, Kassenärztliche Bundesvereinigung, 2010.
    1. Voigt K, Liebnitzky J, Riemenschneider H et al. . Beratungsanlässe bei allgemeinärztlichen Hausbesuchen. Erste Ergebnisse der SESAM-3-Studie. Z Allgemeinmedizin 2011;87:65–71.

Publication types

Associated data