The use of routine data from primary care practices in Germany to analyze the impact of the outbreak of SARS-CoV-2 on the utilization of primary care services for patients with type 2 diabetes mellitus

Strumann, Christoph; Blickle, Paul-Georg; Meißner, Wolfgang von; Steinhäuser, Jost

doi:10.1186/s12875-022-01945-y

Cited by 9 publications

(4 citation statements)

References 27 publications

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“…In addition to sociodemographic information, data about the practice visits (diagnoses, prescriptions) and laboratory test results, as well as permanent diagnoses the patients have received prior to the sample period, were considered in the analysis. Details about the data processing can be found in Strumann et al [ 19 ].…”

Section: Methodsmentioning

confidence: 99%

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Quality of care in patients with hypertension: a retrospective cohort study of primary care routine data in Germany

Strumann,

Engler,

von Meissner

et al. 2024

BMC Prim. Care

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Background Hypertension is a leading cause of morbidity and mortality if not properly managed. Primary care has a major impact on these outcomes if its strengths, such as continuity of care, are deployed wisely. The analysis aimed to evaluate the quality of care for newly diagnosed hypertension in routine primary care data. Methods In the retrospective cohort study, routine data (from 2016 to 2022) from eight primary care practices in Germany were exported in anonymized form directly from the electronic health record (EHR) systems and processed for this analysis. The analysis focused on five established quality indicators for the care of patients who have been recently diagnosed with hypertension. Results A total of 30,691 patients were treated in the participating practices, 2,507 of whom have recently been diagnosed with hypertension. Prior to the pandemic outbreak, 19% of hypertensive patients had blood pressure above 140/90 mmHg and 68% received drug therapy (n = 1,372). After the pandemic outbreak, the proportion of patients with measured blood pressure increased from 63 to 87%, while the other four indicators remained relatively stable. Up to 80% of the total variation of the quality indicators could be explained by individual practices. Conclusion For the majority of patients, diagnostic procedures are not used to the extent recommended by guidelines. The analysis showed that quality indicators for outpatient care could be mapped onto the basis of routine data. The results could easily be reported to the practices in order to optimize the quality of care.

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Section: Methodsmentioning

confidence: 99%

“…Therefore, a wide range of electronic health record (EHR) systems are used which are largely inadequate for data extraction [ 18 ]. The Supraregional Health Service Research Network (SHRN) was established to enable the analysis of anonymized routine data from GP practices in Germany [ 19 ].…”

Section: Introductionmentioning

confidence: 99%

Quality of care in patients with hypertension: a retrospective cohort study of primary care routine data in Germany

Strumann,

Engler,

von Meissner

et al. 2024

BMC Prim. Care

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“…Auch gibt es andere PVS als das unsere, die die Aufgabe der Erstellung von Patient*innenlisten sehr viel besser zu ermöglichen scheinen als unser PVS MediStar. Als Beispiel sei hier das PVS EVA (abasoft) genannt, dessen Möglichkeiten in Kombination mit einem eigens entwickelten Datenimport- und Exportmodul kürzlich im Rahmen einer Forschungsarbeit zur Coronapandemie genutzt wurden [ 16 ].…”

Section: Diskussionunclassified

Klinische Qualitätssteuerung – ein praktischer Versuch in der Hausarztpraxis am Beispiel der Influenzaimpfung

Souhrada,

Zrenner,

Schaubroeck

et al. 2023

Z Allg Med

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ZusammenfassungKlinische Qualitätssteuerung (KQS) meint ein Qualitätsmanagement im klinischen Bereich. Vermutlich aufgrund der Coronapandemie meldeten sich im Jahr 2020 deutlich mehr influenzaimpfwillige Patient*innen als in den Vorjahren, sodass sich abzeichnete, dass für Hochrisikopatient*innen nicht ausreichend Impfdosen zur Verfügung stehen würden. Um dem Problem zu begegnen, setzten wir einen KQS-Zyklus in Gang. Bei diesem Artikel handelt es sich explizit nicht um eine wissenschaftliche Arbeit, sondern um die exemplarische Beschreibung einer Priorisierung und einer KQS als Beispiel, zur Anregung und zur Diskussion. Wir erstellten folgenden Prozess: 1. Evaluation des Ist-Zustands; 2. Priorisierung der Patient*innen, die sich als impfwillig gemeldet hatten, und Impfung der Hochrisikogruppe zuerst; 3. Identifikation, telefonische Kontaktierung und Impfung der Hochrisikopatient*innen, die sich nicht selbstständig als impfwillig gemeldet hatten. Patient*innen über 60-Jahre mit chronisch obstruktiver Lungenerkrankung (COPD) wurden als Indikatorgruppe gewählt. Zunächst waren nur 3 (8 %) unserer 38 COPD-Patient*innen gegen Influenza geimpft. Nach Priorisierung und Impfung der Hochrisikogruppe in der Liste der Impfwilligen waren 25 (66 %) der insgesamt 38 COPD-Patient*innen geimpft. Nach telefonischer Einladung und Aufforderung waren zuletzt 28 (74 %) der 38 Patient*innen geimpft. Dies entspricht einer Steigerung der Impfquote der über 60-jährigen COPD-Patient*innen von 8 % auf 74 % und damit nahezu dem Zielwert der Weltgesundheitsorganisation (WHO). Hausärzt*innen müssen sich gelegentlich mit Ressourcenknappheit auseinandersetzen und sich mit Strategien beschäftigen, ihr zu begegnen. Unter anderem in diesem Zusammenhang bietet sich eine KQS in der Hausarztpraxis an. Die Praxisverwaltungssysteme (PVS) sollten für diesen Zweck von Seiten der Hersteller benutzerfreundlicher gestaltet werden.

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“…However, to meet the demands in mental health care, a profound knowledge about prevalences is necessary. Apart from specific research projects, routine care data to analyze the prevalences of diseases are still in their infancy in Germany [27][28][29].…”

Section: Introductionmentioning

confidence: 99%

Motives and modifying factors for giving or rejecting psychiatric diagnoses in general medicine and psychiatry – a qualitative interview study

Tebartz van Elst,

Niehoff,

Steinhäuser

2024

BMC Psychiatry

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Background There is a discussion among general practitioners and psychiatrists regarding over-diagnosing versus under-reporting of psychiatric diagnoses. A deeper understanding of this topic is relevant for providing reasonable health care and for planning future studies. A crucial factor to understanding this discussion is the difference in the prevalence of a disease in each sector. One way to attain knowledge about such prevalences is the analysis of routine care data of the sector in question. However, diagnosis-related data might be modified by several additional influencing factors. Aims This study aims to explore what kind of motives and modifying factors play a role for or against giving psychiatric diagnoses in psychiatric and general medical settings. Methods Twenty-six semi-structured interviews were conducted with German physicians in the fields of general medicine and psychiatry. Interviews were analysed using content analysis. Results The analysis revealed three major motivational categories for finding a diagnosis: (1) “objective matters” such as “categorisation for research”; (2) “functional and performance-related factors” such as “requirement for medication”, “billing aspects” that go with certain diagnoses or “access to adequate care” and (3) “Individual factors” such as the “personality of a physician”. Similarly, factors emerged that lead to not making psychiatric diagnoses like “fear of stigmatization among patients” or “detrimental insurance status with psychiatric diagnosis”. Additionally participants mentioned other reasons for “not diagnosing a psychiatric diagnosis“, such as “coding of other clinical pictures”. Conclusion The diagnostic process is a complex phenomenon that goes far beyond the identification of medical findings. This insight should be considered when processing and interpreting secondary data for designing health care systems or designing a study.

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The use of routine data from primary care practices in Germany to analyze the impact of the outbreak of SARS-CoV-2 on the utilization of primary care services for patients with type 2 diabetes mellitus

Cited by 9 publications

References 27 publications

Quality of care in patients with hypertension: a retrospective cohort study of primary care routine data in Germany

Quality of care in patients with hypertension: a retrospective cohort study of primary care routine data in Germany

Klinische Qualitätssteuerung – ein praktischer Versuch in der Hausarztpraxis am Beispiel der Influenzaimpfung

Motives and modifying factors for giving or rejecting psychiatric diagnoses in general medicine and psychiatry – a qualitative interview study

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