Universität zu Köln

Stelzer, Dominikus ORCID: 0000-0001-7970-6388, Graf, Erika ORCID: 0000-0002-6831-0756, Koster, Ingrid, Ihle, Peter, Gunster, Christian ORCID: 0000-0003-3085-6259, Droge, Patrik, Kloss, Andreas, Mehl, Claudia, Farin-Glattacker, Erik, Geraedts, Max, Schubert, Ingrid, Siegel, Achim and Vach, Werner ORCID: 0000-0003-1865-8399 (2022). Assessing the effect of a regional integrated care model over ten years using quality indicators based on claims data - the basic statistical methodology of the INTEGRAL project. BMC Health Serv. Res., 22 (1). LONDON: BMC. ISSN 1472-6963

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Abstract

Background The regional integrated health care model Healthy Kinzigtal started in 2006 with the goal of optimizing health care and economic efficiency. The INTEGRAL project aimed at evaluating the effect of this model on the quality of care over the first 10 years. Methods This methodological protocol supplements the study protocol and the main publication of the project. Comparing quality indicators based on claims data between the intervention region and 13 structurally similar control regions constitutes the basic scientific approach. Methodological key issues in performing such a comparison are identified and solutions are presented. Results A key step in the analysis is the assessment of a potential trend in prevalence for a single quality indicator over time in the intervention region compared to the corresponding trends in the control regions. This step has to take into account that there may be a common - not necessarily linear - trend in the indicator over time and that trends can also appear by chance. Conceptual and statistical approaches were developed to handle this key step and to assess in addition the overall evidence for an intervention effect across all indicators. The methodology can be extended in several directions of interest. Conclusions We believe that our approach can handle the major statistical challenges: population differences are addressed by standardization; we offer transparency with respect to the derivation of the key figures; global time trends and structural changes do not invalidate the analyses; the regional variation in time trends is taken into account. Overall, the project demanded substantial efforts to ensure adequateness, validity and transparency.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Stelzer, Dominikus UNSPECIFIED orcid.org/0000-0001-7970-6388 UNSPECIFIED Graf, Erika UNSPECIFIED orcid.org/0000-0002-6831-0756 UNSPECIFIED Koster, Ingrid UNSPECIFIED UNSPECIFIED UNSPECIFIED Ihle, Peter UNSPECIFIED UNSPECIFIED UNSPECIFIED Gunster, Christian UNSPECIFIED orcid.org/0000-0003-3085-6259 UNSPECIFIED Droge, Patrik UNSPECIFIED UNSPECIFIED UNSPECIFIED Kloss, Andreas UNSPECIFIED UNSPECIFIED UNSPECIFIED Mehl, Claudia UNSPECIFIED UNSPECIFIED UNSPECIFIED Farin-Glattacker, Erik UNSPECIFIED UNSPECIFIED UNSPECIFIED Geraedts, Max UNSPECIFIED UNSPECIFIED UNSPECIFIED Schubert, Ingrid UNSPECIFIED UNSPECIFIED UNSPECIFIED Siegel, Achim UNSPECIFIED UNSPECIFIED UNSPECIFIED Vach, Werner UNSPECIFIED orcid.org/0000-0003-1865-8399 UNSPECIFIED
URN:	urn:nbn:de:hbz:38-682339
DOI:	10.1186/s12913-022-07573-7
Journal or Publication Title:	BMC Health Serv. Res.
Volume:	22
Number:	1
Date:	2022
Publisher:	BMC
Place of Publication:	LONDON
ISSN:	1472-6963
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language MEDICAL-PRACTICE VARIATION Multiple languages Health Care Sciences & Services Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/68233