Strong primary care and patients’ survival

Michel Wensing; Joachim Szecsenyi; Petra Kaufmann-Kolle; Gunter Laux

doi:10.1038/s41598-019-47344-9

journal article Open Access Jul 26, 2019

Strong primary care and patients’ survival

Michel Wensing

Joachim Szecsenyi Petra Kaufmann-Kolle Gunter Laux

Scientific Reports Vol. 9 No. 1 · Springer Science and Business Media LLC

View at Publisher Save 10.1038/s41598-019-47344-9

Abstract

AbstractPrimary healthcare is the cornerstone of any healthcare system. A major health system reform to strengthen primary care has been implemented in Germany since 2008. Key components include: voluntary participation, intensive management of patients with chronic diseases, coordination of access to medical specialists, continuous quality improvement, and capitation-based reimbursement. The objective of this study was to assess the effect of this reform on survival of enrolled patients. We conducted a comparative cohorts study with 5-year follow-up, starting in the year 2012 in Baden-Wuerttemberg, Germany. Participants were 1,003,336 enrolled patients and 725,310 control patients. A Cox proportional hazards regression model was applied to compare survival of enrolled patients with a composed control cohort of non-enrolled patients, adjusted for a range of patient and physician characteristics. Average age of enrolled patients was 57.3 years and 56.1% were women. Compared to control patients, they had lower mortality (Hazard Ratio: 0.978; 95% CI: 0.968; 0.989). Participation in chronic disease management programs had independent impact on survival rate (Hazard Ratio 0.744, 95% CI: 0.734; 0.753). We concluded that strong primary care is safe and potentially beneficial in terms of patients’ survival.

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Details

Published: Jul 26, 2019
Vol/Issue: 9(1)
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Authors

Funding

AOK Baden-Wuerttemberg (health insurance organisation). There no specific grant number.

AOK Baden Wuerttemberg

Cite This Article

Michel Wensing, Joachim Szecsenyi, Petra Kaufmann-Kolle, et al. (2019). Strong primary care and patients’ survival. Scientific Reports, 9(1). https://doi.org/10.1038/s41598-019-47344-9

Strong primary care and patients’ survival

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