Utilization and Trans-sectoral Patterns of Care for Patients Admitted to Emergency Departments in Germany
试验速览
- 阶段
- 不适用
- 入组人数
- 680,000
- 试验地点
- 1
- 主要终点
- Prevalence of adequate, inadequate and avoidable ED-visits
研究概览
简要总结
The overall aim of INDEED is to facilitate trans-sectoral and interdisciplinary health services research of emergency care in Germany.
Clinical hospital data from 15 to 20 emergency departments in Germany will be linked to routine ambulatory health care data provided by the Association of Statutory Health Insurance Physicians (Kassenärztliche Vereinigung, KV). INDEED will identify health care gaps and inadequate resource allocation as well as develop strategies for adaptations of the health care system to existing demands.
详细描述
B a c k g r o u n d:
Emergency departments nationally and internationally are challenged by a continuously increasing number and complexity of patients and consequent crowding. International studies showed that crowding is associated with unfavourable outcomes. Emergency departments are an important interface between the outpatient and inpatient health care sectors. Health care sectors in Germany are not organisationally cross-linked and data linkage for analysis of the health care system is not generally performed. Hence, there is a lack of data to trans-sectorally describe and monitor patients' pathways and patterns of care in the health care system.
RESEARCH AIMS:
The overall aim of INDEED is to facilitate trans-sectoral and interdisciplinary health services research of emergency care in Germany.
The primary objective of the project is to assess the trans-sectoral utilization of health care services of patients 2 years prior and 1 year after treatment in an emergency department. Patterns of adequate, inadequate and potentially avoidable care will be examined.
研究设计
- 研究类型
- Observational
- 观察模型
- Other
- 时间视角
- Prospective
入排标准
- 年龄范围
- 18 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •adult ED patients who attended one of the participating EDs in 2016
- •patients with public health insurance
排除标准
- •no exclusion criteria are applied
结局指标
主要结局
Prevalence of adequate, inadequate and avoidable ED-visits
时间窗: Baseline
Prevalence of adequate, inadequate and avoidable ED-visits will be operationalized by a) patients with low utilization of primary health care, b) low urgency, c) preventable conditions, d) chronic diseases that could have been adequately controlled, e) frequent-users, f) patients without contact to a physician in the ED ("left without being seen").
次要结局
- Characterization of health care resource utilization before and after an ED-visit(from 2 years before until 1 year after ED-visit (2014-2017))
- influencing factors on avoidable ED-visits(from 2 years before until 1 year after ED-visit (2014-2017))
- influencing factors on adequate ED-visits(from 2 years before until 1 year after ED-visit (2014-2017))
- Exploratory analysis of influencing factors on patient-related mortality(from 2 years before until 1 year after ED-visit (2014-2017))
- Exploratory analysis of influencing factors on morbidity(from 2 years before until 1 year after ED-visit (2014-2017))
- influencing factors on inadequate ED-visits(from 2 years before until 1 year after ED-visit (2014-2017))
- Exploratory analysis of influencing factors on increased health care costs.(from 2 years before until 1 year after ED-visit (2014-2017))
研究者
Martin Moeckel
Prof. Dr.
Charite University, Berlin, Germany