Background Primary care is a central element of healthcare and addresses the main health problems of the population. While primary care gains in importance due to an aging population, there is an ongoing debate on physician shortages in German rural regions. The study aims on analyzing the population’s preferences on primary healthcare and, therefore, on helping policy makers to make care delivery more responsive to patients’ needs when planning political reforms of primary care. Methods A paper-based discrete choice experiment (DCE) was used to assess preferences of the population of eight rural regions in Germany. Based on literature search and qualitative research, six attributes were selected and included in the choice experiment. The survey presented participants with eight choice sets in which they had to choose between two possible scenarios of care. A conditional logistic regression as well as a latent class model (LCM) were used to analyze preferences for primary healthcare. Results Nine hundred four participants completed the survey (response rate 46.1%). The conditional logistic regression showed significant impact of the attributes “home visits”, “distance to practice”, “number of healthcare providers”, “opening hours of the practice”, and “diagnostic facilities” on the respondents’ choices of primary healthcare alternatives. Moreover, the LCM identified four classes that can be characterized by preference homogeneity within and heterogeneity between the classes. Conclusion Although the study revealed heterogeneous preferences among the latent classes, several similarities in preferences for primary care could be detected. The knowledge on these public preferences may help policy makers when implementing new models of primary care and, thus, raise the populations’ acceptance of future primary care provision and innovative care models. Electronic supplementary material The online version of this article (10.1186/s12875-019-0967-y) contains supplementary material, which is available to authorized users.

Background: Hyperkalemia (HK) can affect health outcomes and quality of life, as it is referred to as a potentially life-threatening condition caused by an increased serum potassium concentration in the blood. Patients suffering from heart failure or chronic kidney diseases are at a higher risk of HK, which can further be amplified by the treatment received. To date, data on HK prevalence is lacking for Germany and the aims of this study were to assess HK and compare health-relevant outcomes and healthcare costs between HK patients and non-HK patients. Methods: The InGef research database containing healthcare claims of over 4 million individuals in Germany was utilized for this retrospective, matched cohort analysis. Patients with non-acute outpatient treated and a subgroup of patients with chronic HK, were identified in 2015 with an individual 1 year pre-and post-index period, taking the first observable HK diagnosis/treatment in 2015 into account as the index event. To identify non-acute outpatient treated HK patients, at least two ICD-10-GM diagnosis codes E87.5 "Hyperkalemia" and/or prescriptions of polystyrene sulfonate were required. Chronic HK patients had additional diagnoses and/or prescriptions in all quarters following the first observable HK diagnosis. Patients without HK were matched 1:1 to the respective HK cohorts. Results: In the year 2015, 3333 patients with non-acute outpatient treated HK were identified of which 1693 were patients with chronic HK. After matching, 3191 and 1664 HK patients and controls were available for analysis. A significantly higher number of hospitalizations was observed for both HK cohorts in comparison to their matched controls. Dialysis initiation as well as the healthcare costs were higher for both HK cohorts when compared to their matched counterparts.

were used to estimate the age-adjusted national prevalence of diagnosed HCU and PKU patients. RESULTS: Among 97.3 million patients in the MSN, 6,613 (0.068 per 1,000) had a diagnosis of HCU between 1/1/2010 and 12/31/2016, compared to 5,120 (0.053 per 1,000) with a PKU diagnosis. Of the HCU cases, 0.51% were ages 0e11 years and 80% were 45 years or older at the time of the first recorded diagnosis during the study period. For PKU cases, 53% were ages 0e11 years and 13% were 45 years or older. The estimated age-adjusted prevalence of diagnosed HCU in the US for 2017 was~0.01% (31,162 cases) vs. 0.005% (16,615 cases) for PKU. CONCLUSIONS: As expected, the highest proportion of diagnosed PKU was observed in the youngest age group (ages 0e11 years), likely due to infants being diagnosed through mandatory newborn screening. Conversely, the proportion of diagnosed HCU cases in the younger age group was approximately ten times smaller, implying that HCU patients are not diagnosed primarily at birth or during early childhood. This suggests that current newborn screening tests fail to capture the vast majority of HCU cases, with patients diagnosed at later ages, even into adulthood, when they present with symptoms or comorbid conditions indicative of HCU.

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management of the disease. Therapies that reduce significantly this clinical indicator eABRare key for increasing the efficiency in the healthcare spend and improve the clinical outcome of patients.OBJECTIVES: Management of hemophilia B requires factor IX (FIX) infusions to replenish missing coagulation factor. Newer extended half-life (EHL) replacement products with longer half-lives compared to standard half-life (SHL) products are available in the US. In this exploratory analysis of US claims data, we compared the expenditures and dispensation of two EHL products versus an SHL product for hemophilia B treatment. METHODS: De-identified claims from a large national specialty pharmacy dispensation claims database were used to identify male patients with severe hemophilia B who received FIX replacement from May 2016 (first month of albutrepenonacog alfa dispensation) to September 2017 and had 1 month of dispensation data. Two patient groups (SHL vs. EHL) were compared. Key outcome measures were direct expenditures and factor IUs dispensed, measured over monthly increments. Descriptive statistics were used to analyze results. Medians for expenditures and IUs were used to accommodate data distribution skewing. RESULTS: 213 Hem B patients met the inclusion criteria and were included in the analysis, including patients who were dispensed >1 FIX product. The SHL (nonacog alfa) group comprised 133 patients; the EHL group included 72 patients in the eftrenonacog alfa group and 39 patients in the albutrepenonacog alfa group. The median per-patient-per-calendar-month FIX product dispensation was 20,456 IU (interquartile range [IQR], 28,896 IU; nonacog) versus 17,438 IU (IQR, 16,483 IU; eftrenonacog) and 10,453 IU (IQR, 8377 IU; albutrepenonacog). Median per-patient-per-calendar-month expenditures were higher for EHLs