Regional differences in health care of patients with inflammatory bowel disease in Germany

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dc.identifier.uri http://dx.doi.org/10.15488/649
dc.identifier.uri http://www.repo.uni-hannover.de/handle/123456789/673
dc.contributor.author Lange, Ansgar
dc.contributor.author Prenzler, Anne
dc.contributor.author Bachmann, Oliver
dc.contributor.author Linder, Roland
dc.contributor.author Neubauer, Sarah
dc.contributor.author Zeidler, Jan
dc.contributor.author Manns, Michael P.
dc.contributor.author Schulenburg, Johann-Matthias Graf von der
dc.date.accessioned 2016-11-03T12:40:19Z
dc.date.available 2016-11-03T12:40:19Z
dc.date.issued 2015
dc.identifier.citation Lange, Ansgar; Prenzler, Anne; Bachmann, O.; Linder, R.; Neubauer, Sarah et al.: Regional differences in health care of patients with inflammatory bowel disease in Germany. In: Health Economics Review 5 (2015), Nr. 1, 29. DOI: http://dx.doi.org/10.1186/s13561-015-0067-1
dc.description.abstract Background: The regional availability of specialized physicians is an important aspect in healthcare of patients with IBD. The association between physician density and healthcare is not yet clear. Most studies did not consider district type, which reflects population density. Our research question was, “Do specialist density and district type influence the healthcare of IBD patients in Germany?” Methods: We combined a claims dataset from a German health insurance fund with population and physician data. Four main aspects were investigated: regular specialist visits, drug therapies, surveillance colonoscopy, and IBD-related hospitalizations. Various regression analyses were performed. Results: The study cohort was comprised of 21,771 individuals, including 9282 patients with Crohn disease and 12,489 patients with ulcerative colitis. Patients who were living in districts with higher specialist densities were more likely to attend specialist visits on a regular basis. No difference in the frequencies of TNF-alpha inhibitor therapies was found. However, individuals from urban areas were more likely to receive a permanent immunosuppressive therapy with continuous specialist support. Conclusions: The results revealed that some aspects had positive effects on the probability of implementing healthcare in accordance with pathways and guidelines. No clear evidence of a general healthcare undersupply in rural areas was found. eng
dc.description.sponsorship DFG
dc.language.iso eng
dc.publisher Heidelberg : Springer Verlag
dc.relation.ispartofseries Health Economics Review 5 (2015), Nr. 1
dc.rights CC BY 4.0
dc.rights.uri http://creativecommons.org/licenses/by/4.0/
dc.subject Crohn eng
dc.subject Guidelines eng
dc.subject Inflammatory bowel disease eng
dc.subject Quality eng
dc.subject Regional differences eng
dc.subject Ulcerative colitis eng
dc.subject adalimumab eng
dc.subject afelimomab eng
dc.subject azathioprine eng
dc.subject budesonide eng
dc.subject certolizumab pegol eng
dc.subject etanercept eng
dc.subject golimumab eng
dc.subject infliximab eng
dc.subject mercaptopurine eng
dc.subject methotrexate eng
dc.subject prednisolone eng
dc.subject prednisone eng
dc.subject adult eng
dc.subject Article eng
dc.subject colonoscopy eng
dc.subject Crohn disease eng
dc.subject female eng
dc.subject geography eng
dc.subject Germany eng
dc.subject health care eng
dc.subject health care planning eng
dc.subject health care quality eng
dc.subject health insurance eng
dc.subject hospitalization eng
dc.subject human eng
dc.subject immunosuppressive treatment eng
dc.subject inflammatory bowel disease eng
dc.subject major clinical study eng
dc.subject male eng
dc.subject medical specialist eng
dc.subject physician eng
dc.subject population density eng
dc.subject practice guideline eng
dc.subject priority journal eng
dc.subject rural area eng
dc.subject ulcerative colitis eng
dc.subject urban area eng
dc.subject.ddc 330 | Wirtschaft ger
dc.subject.ddc 610 | Medizin, Gesundheit ger
dc.title Regional differences in health care of patients with inflammatory bowel disease in Germany
dc.type article
dc.type Text
dc.relation.issn 2191-1991
dc.relation.doi http://dx.doi.org/10.1186/s13561-015-0067-1
dc.bibliographicCitation.issue 1
dc.bibliographicCitation.volume 5
dc.bibliographicCitation.firstPage 29
dc.description.version publishedVersion
tib.accessRights frei zug�nglich


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