Observational studyBMC family practice2020
Regional differences in reasons for consultation and general practitioners' spectrum of services in northern Germany - results of a cross-sectional observational study.
Observational study in BMC family practice, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02558322 (Regional Variation of Patient Population and Reasons for Consultation in the Primary Medical Care of Northern Germany), which is not on this map. Cited by 9 papers.
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.
Regional Variation of Patient Population and Reasons for Consultation in the Primary Medical Care of Northern Germany
Who cites it
9 citing papers in PubMed.
- Regional differences in the patient population of general practices in northern Germany: results of a mixed-methods study.BMJ open · 2020Trial
- Factors associated with potentially inappropriate medication use, medication underuse and overuse in older adults in the German National Cohort.Journal of internal medicine · 2026Article
- Developing and testing a framework for coding general practitioners' free-text diagnoses in electronic medical records - a reliability study for generating training data in natural language processing.BMC primary care · 2024Article
- Development and feasibility of a function-based preventive intervention for lifestyle-related disorders.BMC public health · 2024Article
- Sex differences in patterns of referral and resource utilization in the cardiology clinic: an outpatient analysis.Frontiers in cardiovascular medicine · 2023Article
- Frequency and management of emergencies in primary care offices: A cross-sectional study in northwestern Germany.The European journal of general practice · 2022Article
- The effect of COVID-19 pandemic and lockdown on consultation numbers, consultation reasons and performed services in primary care: results of a longitudinal observational study.BMC family practice · 2021Observational
- The primary care workforce in Europe: a cross-sectional international comparison of rural and urban areas and changes between 1993 and 2011.European journal of public health · 2020Article
- Regional and patient-related factors influencing the willingness to use general practitioners as coordinators of the treatment in northern Germany - results of a cross-sectional observational study.BMC family practice · 2020Observational
Corrections and comments
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Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAmong other factors, the patients' consultation reasons and GPs' spectrum of services determine the process and outcome of the medical treatment. So far, however, there has been little information on differences in reasons for consultation and GPs' services between urban and rural areas. Our study's goal was thus to investigate these factors in relation to the regional location of GPs' practices.
methodsWe conducted a cross-sectional observational study based on standardised GP interviews in a quota sampling design. All counties and independent cities within a radius of 120 km around Hamburg were divided into three regional categories (urban area, environs, rural area) and stratified proportionally to the population size. Differences in the number of reasons for consultation and services were analysed by multivariate linear regressions in mixed models adjusted for random effects on the levels of the German federal states and administrative districts. Differences in individual consultation reasons and services were identified by logistic regression via stepwise forward and backward selection.
resultsPrimary care practices in 34 of the 37 selected administrative districts (91.9%) were represented in the dataset. In total, 211 GPs were personally interviewed. On average, GPs saw 344 patients per month with a slightly higher number of patients in rural areas. They reported 59.1 ± 15.4 different reasons for consultation and 30.3 ± 3.9 different services. There was no statistically significant regional variation in the number of different consultation reasons, but there was a broader service spectrum by rural GPs (ß = - 1.42; 95% confidence interval - 2.75/- 0.08; p = 0.038) which was statistically explained by a higher level of medical training. Additionally, there were differences in the frequency of individual consultation reasons and services between rural and urban areas.
conclusionGPs in rural areas performed more frequently services usually provided by medical specialists in urban areas. This might be caused by a low availability of specialists in rural areas. The association between medical training and service spectrum might imply that GPs compensate the specific needs of their patients by completing advanced medical training before or after setting up a medical practice.
trial registrationThe study was registered in ClinicalTrials.gov (NCT02558322).
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