ArticleSSM - population health2023
Improving the evaluation of an integrated healthcare system using entropy balancing: Population health improvements in Gesundes Kinzigtal.
Article in SSM - population health, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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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.
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Who cites it
6 citing papers in PubMed.
- Locoregional Control from Complete Peritoneal Cytoreduction in Patients with Extraperitoneal Colorectal Cancer Metastases: An Entropy Balanced Analysis.Annals of surgical oncology · 2026Article
- Towards an integrated care. A position paper by the Association of the Scientific Medical Societies in Germany (AWMF).German medical science : GMS e-journal · 2026Article
- Using Propensity Score Subclassification to Estimate the Population-Average Causal Effect of Temporomandibular Dysfunction Experience on Oral Health-Related Quality of Life Among Australian Adults.Community dentistry and oral epidemiology · 2025Article
- Association of Hospital Market Competition with Outcomes of Complex Cancer Surgery.Annals of surgical oncology · 2024Article
- Mortality for Time-Sensitive Conditions at Urban vs Rural Hospitals During the COVID-19 Pandemic.JAMA network open · 2024Article
- Comparing Machine Learning and Advanced Methods with Traditional Methods to Generate Weights in Inverse Probability of Treatment Weighting: The INFORM Study.Pragmatic and observational research · 2024Article
Corrections and comments
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Authors and funding
2 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: Evidence of integrated healthcare networks' effect on population health is scarce. Moreover, current designs for evaluating such networks have shortcomings that can result in misleading conclusions. Our paper evaluates Gesundes Kinzigtal, a best-practice integrated healthcare network, using an innovative design that enlightens the discussion about health gains produced by integrated healthcare. Research question: What is the effect of Gesundes Kinzigtal on population health? Methods: We evaluated the effect of the integrated healthcare initiative by performing a quasi-experimental evaluation based on entropy balancing. Integrated network participants were compared to a control group and followed for five years. Claims data from 2004 to 2018 was used. Population health outcomes correspond to survival (Cox hazard ratio, Kaplan-Meier curve), mortality ratio, mean age at the time of death, and years of life lost or gained. Design validity was evaluated by assessing group balance at baseline. Finally, we compared our results to those obtained using a previously published design for evaluating integrated networks. Results: The treatment group was composed of 9083 network participants, compared to an equivalent control group, showing, respectively, a mortality ratio of 5.4% vs 7.5% (p < 0.05), mean age at the time of death of 80.1 vs 80.3 (p > 0.05) and a gain of 0.2 years of life per person for the treatment group (p > 0.05). The Cox hazard ratio (0.72; p < 0.05) and mean survival time (1784 vs 1768 days; p < 0.05) showed better survival for treated participants. Results using the previously published design were more favorable for the treatment group; however, the design excluded participants significantly associated with greater healthcare needs. Discussion: The integrated network had a favorable effect on participants' mortality and survival risk. Previous evaluations based on propensity score matching might overestimate the network's impact on population health by excluding participants with greater healthcare needs.
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