scholarly journals Study protocol for a quasi-experimental claims-based study evaluating 10-year results of the population-based integrated healthcare model ‘Gesundes Kinzigtal’ (Healthy Kinzigtal): the INTEGRAL study

BMJ Open ◽  
2019 ◽  
Vol 9 (1) ◽  
pp. e025945 ◽  
Author(s):  
Ingrid Schubert ◽  
Achim Siegel ◽  
Erika Graf ◽  
Erik Farin-Glattacker ◽  
Peter Ihle ◽  
...  
Keyword(s):  
Integrated Care ◽  
Temporal Trends ◽  
Healthcare Utilisation ◽  
Population Based ◽  
Unintended Consequences ◽  
Federal State ◽  
Full Spectrum ◽  
Integrated Healthcare ◽  
Intervention Region ◽  
Quasi Experimental

IntroductionPatients often experience interface problems when treated by different specialists and in different healthcare sectors. Integrated care concepts aim to reduce these problems. While most integrated healthcare models focus on individual diseases, the integrated care model ‘Gesundes Kinzigtal’ applies a population-based approach and addresses the full spectrum of morbidities for a population defined by area of residence—the Kinzigtal. A special feature of the model is the joint savings contract between the regional management company and the statutory health insurers. The INTEGRAL study aims at assessing the effectiveness of ‘Gesundes Kinzigtal’ under routine conditions in comparison to conventional care over a period of 10 years in order to understand the benefits but also the potential for (unintended) harms.Methods and analysisDatabaseClaims data from statutory health insurance funds 2005–2015. The evaluation consists of a quasi-experimental study, with Kinzigtal as intervention region, at least 10 further regions with a similar population and healthcare infrastructure as primary controls and an additional random sample of insurees from the federal state of Baden-Württemberg as secondary controls. Model-specific and ‘non-specific’ indicators adopted from the literature and enriched by focus group interviews will be used to evaluate the model’s effectiveness and potential unintended consequences by analysing healthcare utilisation in general. Temporal trends per indicator in the intervention region will be compared with those in each control region. The overall variation in trends for the indicators across all regions provides information about the potential to modify an indicator due to local differences in the healthcare system.Ethics and disseminationEthic Commission of the Faculty of Medicine, Philipps-University Marburg (ek_mr_geraedts_131117). Results will be discussed in workshops, submitted for publication in peer-review journals and presented at conferences.Trial registration numberDRKS00012804.

Interpersonal Communication in Response to an Intervention and Its Impact on Smoking Cessation Within a Low-Income Population

2017 ◽  
Vol 45 (4) ◽  
pp. 550-558 ◽  
Author(s):  
Michael J. Parks ◽  
Soyoon Kim
Keyword(s):  
Smoking Cessation ◽  
Interpersonal Communication ◽  
Low Income ◽  
Population Level ◽  
Population Based ◽  
Effect Sizes ◽  
Full Spectrum ◽  
Quit Attempt ◽  
Quasi Experimental

Background. It is a priority to develop population-based strategies for reducing barriers to smoking cessation among low-income populations. Harnessing secondary transmission such as interpersonal communication (IC) has helped to reduce tobacco use, but there is a dearth of quasi-experimental research that examines IC and the full spectrum of smoking cessation behaviors, particularly in the context of population-level programs. Aims. Using quasi-experimental methods, we examined IC in response to a population-level intervention and its impact on the full spectrum of smoking cessation outcomes among low-income smokers. Method. We used propensity score matching; three different propensity score matching procedures were used to estimate and approximate experimental effects. We assessed four cessation outcomes: utilization of a free tobacco quitline (QL), making a quit attempt, and being smoke-free for 7 and 30 days at follow-up. We also examined predictors of IC. Results. IC was significantly related to QL utilization (effect sizes ranging from 0.135 to 0.166), making a quit attempt (effect sizes ranging from 0.115 to 0.147), being smoke-free for 7 days (effect sizes ranging from 0.080 to 0.121), and being smoke-free for 30 days at follow-up (effect sizes ranging from 0.058 to 0.082). Program-related and participant characteristics predicted IC, such as receiving emotional direct mail materials and living with a fellow smoker. Discussion. IC in response to a population-based program affected the cessation process, and IC had a marked impact on sustained cessation. Conclusion. Population-based programs should aim to harness psychosocial dynamics such as IC to promote sustained cessation among low-income populations.

Temporal Trends in Undervaccination: A Population-Based Cohort Study

2021 ◽  
Author(s):  
Matthew F. Daley ◽  
Liza M. Reifler ◽  
Jo Ann Shoup ◽  
Komal J. Narwaney ◽  
Elyse O. Kharbanda ◽  
...  
Keyword(s):  
Cohort Study ◽  
Temporal Trends ◽  
Population Based

A population-based analysis in 375,233 cases of heart failure stages A, B and C. Real world epidemiology of prevalence and temporal trends in South-European populations

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
S Jimenez ◽  
M Cainzos-Achirica ◽  
D Monterde ◽  
L Garcia-Eroles ◽  
C Enjuanes ◽  
...  
Keyword(s):  
Heart Failure ◽  
Chronic Conditions ◽  
Temporal Trends ◽  
Population Level ◽  
Population Based ◽  
Relative Increase ◽  
Funding Source ◽  
Private Company ◽  
Healthcare Database ◽  
Evolutionary Changes

Abstract Background Prevalence of congestive heart failure (CHF) and predisposing conditions has described previously. Most of these studies evaluated centre-European or north-American populations. However, the prevalence and evolutionary changes of Heart Failure stages A, B and C has not been fully elucidated in Mediterranean cohorts. Purpose To estimate the prevalence of CHF (HF Stage C) and four additional key chronic cardiovascular, metabolic and renal conditions predisposing to the development of CHF (HF Stages A and B) at a population level in a south-European healthcare area. We analysed the evolutionary changes in the prevalence in these five conditions. Methods In a healthcare area of 1,3Millions inhabitants, we extracted health related information of all individuals ≥55 years old. We analysed data of 375,233 individuals included in the population-based healthcare database of a public Institute of Health between 2015 and 2017. The conditions of interest were CHF, chronic kidney disease (CKD), diabetes mellitus (DM), ischemic heart disease (IHD) and hypertension (HTN). Results The prevalence of chronic conditions was high, particularly of HTN (48.2–48.9%) and DM individuals (14.6–14.8%). The other conditions were less frequent, with prevalence around 2–4% for IHD, 5–9% for CKD and 2–4% for CHF (Table). However, the less frequent conditions had a striking upward trend with over 1,500 new prevalent cases per year between 2015 and 2017 for CHF (45% relative increase), more than 2,500 new prevalent cases for IHD (67% relative increase) and more than 4,000 new prevalent cases per year for CKD (44% relative increase). Conclusion In this south European cohort, there were a high prevalence of HTN and DM as risk factors and a significant trend of increasing prevalence in high cost chronic conditions such as CHF, IHD and CKD. Funding Acknowledgement Type of funding source: Private company. Main funding source(s): The present study was funded by an unrestricted research grant from Vifor Pharma.

scholarly journals Disparities in the Use of Intravenous t-PA among Ischemic Stroke Patients: Population-based Recent Temporal Trends

2019 ◽  
Vol 28 (5) ◽  
pp. 1243-1251 ◽  
Author(s):  
Mohammad A. Faysel ◽  
Jonathan Singer ◽  
Caroline Cummings ◽  
Dimitre G. Stefanov ◽  
Steven R. Levine
Keyword(s):  
Ischemic Stroke ◽  
Temporal Trends ◽  
Population Based ◽  
Stroke Patients

scholarly journals The association of smoking status with healthcare utilisation, productivity loss and resulting costs: results from the population-based KORA F4 study

2013 ◽  
Vol 13 (1) ◽  
Author(s):  
Margarethe Wacker ◽  
Rolf Holle ◽  
Joachim Heinrich ◽  
Karl-Heinz Ladwig ◽  
Annette Peters ◽  
...  
Keyword(s):  
Smoking Status ◽  
Productivity Loss ◽  
Healthcare Utilisation ◽  
Population Based

Effect of Pokémon GO on incidence of fatal traffic injuries: a population-based quasi-experimental study using the national traffic collisions database in Japan

2017 ◽  
Vol 24 (6) ◽  
pp. 448-450 ◽  
Author(s):  
Sachiko Ono ◽  
Yosuke Ono ◽  
Nobuaki Michihata ◽  
Yusuke Sasabuchi ◽  
Hideo Yasunaga
Keyword(s):  
Experimental Study ◽  
Traffic Accident ◽  
Regression Discontinuity ◽  
Population Based ◽  
National Data ◽  
Difference In Differences ◽  
Quasi Experimental ◽  
Accident Research ◽  
Pokémon Go ◽  
Augmented Reality Game

Pokémon GO (Niantic Labs, released on 22 July 2016 in Japan) is an augmented reality game that gained huge popularity worldwide. Despite concern about Pokémon GO–related traffic collisions, the effect of playing Pokémon GO on the incidence of traffic injuries remains unknown. We performed a population-based quasi-experimental study using national data from the Institute for Traffic Accident Research and Data Analysis, Japan. The outcome was incidence of traffic injuries. Of 127 082 000 people in Japan, 886 fatal traffic injuries were observed between 1 June and 31 August in 2016. Regression discontinuity analysis showed a non-significant change in incidence of fatal traffic injuries after the Pokémon GO release (0.017 deaths per million, 95%CI −0.036 to 0.071). This finding was similar to that obtained from a difference-in-differences analysis. Effect of Pokémon GO on fatal traffic injuries may be negligible.

scholarly journals The effects of an integrated care intervention for the frail elderly on informal caregivers: a quasi-experimental study

2014 ◽  
Vol 14 (1) ◽  
Author(s):  
Benjamin Janse ◽  
Robbert Huijsman ◽  
Ruben Dennis Maurice de Kuyper ◽  
Isabelle Natalina Fabbricotti
Keyword(s):  
Experimental Study ◽  
Integrated Care ◽  
Frail Elderly ◽  
Informal Caregivers ◽  
Care Intervention ◽  
Quasi Experimental

Abstract 11133: The Incidence and Predicting Factors of Heart Failure After First Acute Myocardial Infarction: A Population[[Unable to Display Character: ‐]]Based Study in Taiwan

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Cheng-Han Lee ◽  
Yi-Heng Li ◽  
Ching-Lan Cheng ◽  
Jyh-Hong Chen ◽  
Yea-Huei Kao Yang
Keyword(s):  
Myocardial Infarction ◽  
Heart Failure ◽  
Acute Myocardial Infarction ◽  
Coronary Revascularization ◽  
Temporal Trends ◽  
Population Based ◽  
Research Database ◽  
Index Hospitalization ◽  
Predicting Factors ◽  
One Year

Background: Early coronary revascularization and medical therapy advancement improve the survival of patients (pts) with acute myocardial infarction (AMI). However, survivors of AMI are at heightened risk of developing heart failure (HF) and there is a paucity of information regarding this issue in Asian countries. This study described the temporal trends in the incidence of HF after the first AMI and the predicting factors of HF development in Taiwan. Methods: We conducted a nationwide population-based cohort study by using 1999 to 2009 National Health Insurance Research Database. Pts aged≧18 years, with no history of HF, who hospitalized with a first AMI between January 2002 and December 2008 were identified and followed up for one year. The primary outcome was HF. We evaluated the incidence of HF during the index hospitalization, 30 days, 6 months, and one year after the discharge. The predicting factors of HF were identified by Cox proportional hazard model. Results: Overall, 42,011 first AMI pts (mean age 64.4 ± 13.8 years; male 75.0%) from 2002 to 2008 were identified. The HF incidence during the index hospitalization was 14.8%. After exclusion of HF during the hospitalization, the overall HF prevalence at 30 days, 6 months, and 1 year was 9.6%, 14.2%, and 16.8%, respectively. The HF prevalence at 1 year declined from 17.9% to 14.9% (p<0.05) from 2002 to 2008. The independent predicting factors of HF after the first AMI were elder age (≧65 years) (adjusted HR 1.81, 95% CI 1.51-2.18), diabetes mellitus (adjusted HR 1.30, 95% CI 1.21-1.41), chronic kidney disease (adjusted HR 1.41, 95% CI 1.20-1.65), use of loop diuretics within 30 days after the discharge (adjusted HR 2.21, 95% CI 2.00-2.43), and recurrent AMI (adjusted HR 2.43, 2.16-2.74). Conclusions: Survivors of AMI without prior HF remain at risk of developing HF in Taiwan and most episodes occur within 6 months after AMI. Five important clinical factors of HF were identified that may help us for risk stratification.

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