ArticleBMJ open2019
Effect of involving certified healthcare assistants in primary care in Germany: a cross-sectional study.
Article in BMJ open, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
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, 1 synthesis or guideline pooled it.
- The impact of Medical Associate Professions (MAPs) on the productivity, quality of care, patient and healthcare workforce satisfaction, and budget implications in various healthcare settings: a systematic review.BMC health services research · 2025Pooled it
- The effects of perceived chronic stress and work-related factors on the risk of incident depression among German general practice personnel: a causal pathway approach using IMPROVEjob study data.BMC public health · 2026Article
- Developing an Evidence-Based and Patient-Centred Care Concept to Address Deficits in German Primary Care of Venous Leg Ulcers: Results of an Expert Survey Within the ULCUS CRURIS CARE Project.International wound journal · 2026Article
- Core values and best practice criteria for interprofessional teams in primary care: a qualitative interview study with general practitioners and other health professionals from Bavaria, Germany.BMC primary care · 2025Article
- Continuity of care in a pandemic: an observational study in GP-centred healthcare in Germany.BMJ open quality · 2025Observational
- Physician assistants in outpatient medical practice in Germany - opportunities and challenges.German medical science : GMS e-journal · 2025Review
- Task shifting to improve practice efficiency: A survey among general practitioners in non-urban Baden-Wuerttemberg, Germany.The European journal of general practice · 2024Article
- [Attitudes of general practitioners and medical practice assistants towards the delegation of medical services: Results of a survey in Berlin, Brandenburg and Thuringia].Gesundheitswesen (Bundesverband der Arzte des Offentlichen Gesundheitsdienstes (Germany)) · 2023Article
- Information exchange networks for chronic diseases in primary care practices in Germany: a cross-sectional study.BMC primary care · 2022Article
- Work-Related Intervention Needs of Medical Assistants and How to Potentially Address Them according to Supervising General Practitioners: A Qualitative Study.International journal of environmental research and public health · 2022Article
- Primary care practice-based care management for chronically ill patients (PraCMan) in German healthcare: Outcome of a propensity-score matched cohort study.The European journal of general practice · 2021Article
- Continuity in general practice and hospitalization patterns: an observational study.BMC family practice · 2021Observational
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
objectivesGrowing prevalence of chronic diseases and limited resources are the key challenges for future healthcare. As a promising approach to maintain high-quality primary care, non-physician healthcare professionals have been trained to broaden qualifications and responsibilities. This study aimed to assess the influence of involving certified healthcare assistants (HCAs, German: Versorgungsassistent/in in der Hausarztpraxis) on quality and efficacy of primary care in Germany.
designCross-sectional study.
settingPrimary care.
participantsPatients insured by the Allgemeine Ortskrankenkasse (AOK) statutory health insurer (AOK, Baden-Wuerttemberg, Germany).
interventionsSince 2008 practice assistants in Germany can enhance their professional education to become certified HCAs. PRIMARY AND SECONDARY OUTCOME MEASURES: Claims data related to patients treated in practices employing at least one HCA were compared with data from practices not employing HCAs to determine frequency of consultations, hospital admissions and readmissions. Economic analysis comprised hospitalisation costs, prescriptions of follow-on drugs and outpatient medication costs.
resultsA total of 397 493 patients were treated in HCA practices, 463 730 patients attended to non-HCA practices. Patients in HCA practices had an 8.2% lower rate of specialist consultations (p<0.0001), a 4.0% lower rate of hospitalisations (p<0.0001), a 3.5% lower rate of readmissions (p=0.0463), a 14.2% lower rate of follow-on drug prescriptions (p<0.0001) and 4.7% lower costs of total medication (p<0.0001). No difference was found regarding the consultation rate of general practitioners and hospital costs.
conclusionsFor the first time, this high-volume claims data analysis showed that involving HCAs in primary care in Germany is associated with a reduction in hospital admissions, specialist consultations and medication costs. Consequently, broadening qualifications may be a successful strategy not only to share physicians' work load but to improve quality and efficacy in primary care to meet future challenges. Future studies may explore specific tasks to be shared with non-physician workforces and standardisation of the professional role.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.