Universität zu Köln

Schubert, Ingrid ORCID: 0000-0002-2191-1773, Stelzer, Dominikus ORCID: 0000-0001-7970-6388, Siegel, Achim, Koester, Ingrid, Mehl, Claudia, Ihle, Peter, Guenster, Christian, Droege, Patrik, Kloess, Andreas, Farin-Glattacker, Erik, Graf, Erika and Geraedts, Max (2021). Ten-Year Evaluation of the Population-Based Integrated Health Care System Gesundes Kinzigtal. Dtsch. Arztebl. Int., 118 (27-28). S. 465 - 495. COLOGNE: DEUTSCHER AERZTE-VERLAG GMBH. ISSN 1866-0452

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Abstract

Background: The population-based integrated health care system called Gesundes Kinzigtal (Integrierte Versorgung Gesundes Kinzigtal, IVGK) was initiated more than 10 years ago in the Kinzig River Valley region, which is located in the Black Forest in the German state of Baden-Wurttemberg. IVGK is intended to optimize health care while maximizing cost-effectiveness. It consists of programs for promoting health and for enabling cooperation among service providers, as well as of a shared-savings contract that has enabled resources to be saved every year. The goal of the present study was to investigate trends in the quality of care provided by IVGK over the past ten years in comparison to conventional care. Methods: This is a non-randomized observational study with a control-group design (Kinzig River Valley versus 13 structurally comparable control regions), employing data collected by AOK, a large statutory health-insurance provider in Germany, over the period 2006-2015. Quality assessment was conducted with the aid of a set of indicators, developed by the authors, that was based exclusively on claims data. The statistical analysis of the trends in these indicators over time was conducted with preset criteria for the relevance of any observed changes, as well as preset mechanisms of controlling for confounding factors. Results: For 88 of the 101 evaluable indicators, no relevant difference was seen between the trend over time in the region of the intervention and the average trend in the control regions. Relevant differences in favor of the IVGK were observed for six indicators, and negatively divergent trends compared to the controls were observed for seven indicators. In the main summarizing statistical analysis, no positive or negative difference was found between the Kinzig River Valley and the other regions with respect to trends in the health-care indicators over time. Conclusion: An evaluation based on 101 indicators derived from health-insurance data did not reveal any improvement of the quality of care by IVGK and the totality of the programs that were implemented under it. However, under the conditions of the shared-savings contract, no relevant diminution in the quality of care was observed over a period of 10 years either, compared with structurally similar control regions without an integrated care model.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Schubert, Ingrid UNSPECIFIED orcid.org/0000-0002-2191-1773 UNSPECIFIED Stelzer, Dominikus UNSPECIFIED orcid.org/0000-0001-7970-6388 UNSPECIFIED Siegel, Achim UNSPECIFIED UNSPECIFIED UNSPECIFIED Koester, Ingrid UNSPECIFIED UNSPECIFIED UNSPECIFIED Mehl, Claudia UNSPECIFIED UNSPECIFIED UNSPECIFIED Ihle, Peter UNSPECIFIED UNSPECIFIED UNSPECIFIED Guenster, Christian UNSPECIFIED UNSPECIFIED UNSPECIFIED Droege, Patrik UNSPECIFIED UNSPECIFIED UNSPECIFIED Kloess, Andreas UNSPECIFIED UNSPECIFIED UNSPECIFIED Farin-Glattacker, Erik UNSPECIFIED UNSPECIFIED UNSPECIFIED Graf, Erika UNSPECIFIED UNSPECIFIED UNSPECIFIED Geraedts, Max UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-589820
DOI:	10.3238/arztebl.m2021.0163
Journal or Publication Title:	Dtsch. Arztebl. Int.
Volume:	118
Number:	27-28
Page Range:	S. 465 - 495
Date:	2021
Publisher:	DEUTSCHER AERZTE-VERLAG GMBH
Place of Publication:	COLOGNE
ISSN:	1866-0452
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language HOSPITAL ADMISSIONS; QUALITY; GERMANY; IMPACT Multiple languages Medicine, General & Internal Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/58982