Emergencies Clinical Trial
Official title:
Utilization and Trans-sectoral Patterns of Care for Patients Admitted to Emergency Departments in Germany
The overall aim of INDEED is to facilitate trans-sectoral and interdisciplinary health
services research of emergency care in Germany.
Clinical hospital data from 15 to 20 emergency departments in Germany will be linked to
routine ambulatory health care data provided by the Association of Statutory Health Insurance
Physicians (Kassenärztliche Vereinigung, KV). INDEED will identify health care gaps and
inadequate resource allocation as well as develop strategies for adaptations of the health
care system to existing demands.
B a c k g r o u n d:
Emergency departments nationally and internationally are challenged by a continuously
increasing number and complexity of patients and consequent crowding. International studies
showed that crowding is associated with unfavourable outcomes. Emergency departments are an
important interface between the outpatient and inpatient health care sectors. Health care
sectors in Germany are not organisationally cross-linked and data linkage for analysis of the
health care system is not generally performed. Hence, there is a lack of data to
trans-sectorally describe and monitor patients' pathways and patterns of care in the health
care system.
RESEARCH AIMS:
The overall aim of INDEED is to facilitate trans-sectoral and interdisciplinary health
services research of emergency care in Germany.
The primary objective of the project is to assess the trans-sectoral utilization of health
care services of patients 2 years prior and 1 year after treatment in an emergency
department. Patterns of adequate, inadequate and potentially avoidable care will be examined.
The secondary aim is to identify patient clusters with comparable needs of health care
provision. Within clusters and for all patients combined INDEED will examine health care
needs and gaps as well as factors that influence emergency department visits, disease
progression, comorbidities and mortality.
METHODS:
Clinical hospital data from 15 to 20 emergency departments in Germany will be linked to
routine ambulatory health care data provided by the Association of Statutory Health Insurance
Physicians (Kassenärztliche Vereinigung, KV).
A secondary data analysis of linked routinely collected hospital information system and
health insurance data of all adult patients that were treated with any condition in one of
the participating emergency departments in 2016 (n≈680.000 cases) will be performed. Data
analysis will cover the pattern of utilization of health care, identification of subgroups
with comparable need of health care provision, of factors that influence emergency department
visits and factors for ambulatory care sensitive conditions (ACSC) or inpatient treatment.
Study results will be evaluated considering age, multimorbidity and gender aspects as well as
the health system and health economic perspective. Thereby INDEED will identify health care
gaps and inadequate resource allocation as well as develop strategies for adaptations of the
health care system to existing demands.
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