Observational studyScandinavian journal of primary health care2018
Effects of a program to strengthen general practice care on hospitalisation rates: a comparative observational study.
Observational study in Scandinavian journal of primary health care, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
12 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Impact of relational continuity of primary care in aged care: a systematic review.BMC geriatrics · 2022Pooled it
- Interventions to Prevent Potentially Avoidable Hospitalizations: A Mixed Methods Systematic Review.Frontiers in public health · 2022Pooled it
- General-practitioner-centered health care: current results from the implementation of the German model.Scientific reports · 2026Article
- Continuity of care in a pandemic: an observational study in GP-centred healthcare in Germany.BMJ open quality · 2025Observational
- The underwhelming German life expectancy.European journal of epidemiology · 2023Article
- Continuity in general practice and hospitalization patterns: an observational study.BMC family practice · 2021Observational
- Intensified ambulatory cardiology care: effects on mortality and hospitalisation-a comparative observational study.Scientific reports · 2020Observational
- Relationship based care - how general practice developed and why it is undermined within contemporary healthcare systems.Scandinavian journal of primary health care · 2019Article
- Socioeconomic, Racial, and Ethnic Disparities in Postpartum Readmissions in Patients with Preeclampsia: a Multi-state Analysis, 2007-2014.Journal of racial and ethnic health disparities · 2019Article
- Strong primary care and patients' survival.Scientific reports · 2019Observational
- Improving continuity of patient care across sectors: study protocol of a quasi-experimental multi-centre study regarding an admission and discharge model in Germany (VESPEERA).BMC health services research · 2019Article
- Hospital Admission and Discharge: Lessons Learned from a Large Programme in Southwest Germany.International journal of integrated careArticle
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo determine the effect of a large-scale program to strengthen general practice on hospitalisation rates.
methodsThis observational study compared enrolled patients in the program and a sample of non-participating patients from non-participating GPs in the same geographic area in Germany. Key components of the program are: prompt access to care, comprehensiveness, continuity, empanelment, data-driven quality improvement, computerized decision support, and additional reimbursement of general practices. The outcomes in this study were hospitalisation, rehospitalisation, and avoidable hospital admission up to four years after patient inclusion. Poisson regression models and generalized estimating equations were used to estimate intervention effects.
resultsIn the baseline year, 19.1% were hospitalised and 13.6% had a potentially avoidable hospitalisation, 14.5% were rehospitalised within 4 weeks. Across the four observed years, yearly hospitalisations were 9.8 to 14.9% lower in enrolled patients, yearly re-hospitalisations were 5.3 to 11.5% lower, and yearly avoidable hospitalisations were 6.8 to 8.6% lower compared to the control cohort (all differences were statistically significant). The trend in the between-group difference for hospitalisations and re-hospitalisations increased, while it remained stable for avoidable hospitalisations.
conclusionThis study provides strong indications for the positive impact of strong general practice care on population outcomes. Key points A program to strengthen general practice in Germany comprised of prompt access to care, comprehensiveness, continuity, empanelment, data-driven quality improvement, computerized decision support, and additional reimbursement of general practices. Patients who remained in the program during 4 years had increasingly lowered rates of hospitalisation and rehospitalisation compared to a control group of patients. Avoidable hospitalisations were also lower, but no trend of further lowering was found. This might suggest a ceiling effect to impact of strong general practice on hospitalisations.
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