Background: Type 2 Diabetes mellitus (T2DM) and periodontitis share common risk factors and influence one another. However, primary care and oral health care continue to operate separate from each other and fail to synchronize care for patients with T2DM and periodontitis. The purpose of this practice-based trial is to evaluate the implementation of a new integrated care pathway for patients with T2DM and periodontitis.
View Article and Find Full Text PDFIntroduction: A wide range of factors influence coordination and continuity of care. The aim of this study was to explore how management continuity of cardiovascular-related ambulatory care is influenced by the following network characteristics: presence of a case coordinator, network reciprocity, network composition and team climate.
Methods: This cross-sectional observational study included three written surveys.
Background: Due to the nature of their work, general practitioners (GPs) need to be up to date with evidence in various medical domains. While much synthesised research evidence is easily accessible nowadays, in practice, the time to search for and review this evidence proposes a challenge. In German primary care, the knowledge infrastructure is rather fragmented, leaving GPs with relatively few primary care specific resources of information and many resources from other medical fields.
View Article and Find Full Text PDFBackground: Healthcare providers' inclination to seek or lead other providers' opinions on clinical topics may influence healthcare practices, particularly regarding their alignment across different providers in controversial domains. This study aimed to explore opinion-seeking behaviours of general practitioners and their impacts on clinical opinions in ambulatory cardiovascular care in Germany.
Methods: Between 2019 and 2021, we performed a written survey in two samples of general practitioners and one sample of self-employed cardiologists in three German states.
Background: Chronic cardiovascular diseases demand continuous care from general practitioners and medical specialists. Especially in fragmented healthcare systems, such as in Germany, a large body of research is devoted to the improvement of care continuity. Meanwhile, measuring continuity of care itself has been a challenge due to the absence of validated instruments.
View Article and Find Full Text PDFThis thesis analysed the implementation of the German medical specialists' contract in cardiology, a managed care programme within the state of Baden-Wuerttemberg. Research focused on exploring differences between participating and non-participating physicians, their motivation to participate, actual implementation of the programme and its perceived effects. Mixed methods consisting of questionnaires and qualitative telephone interviews with cardiologists and general practitioners showed that participants were older than non-participants, participation was mainly financially driven and implementation was successful regarding medical aspects, but less so regarding patient services and communication between providers.
View Article and Find Full Text PDFBackground: Cardiovascular diseases are often accompanied by comorbidities, which require good coordination of care. Especially in fragmented healthcare systems, it is important to apply strategies such as case management to achieve high continuity of care. The aim of this study was to document continuity of care from the patients' perspective in ambulatory cardiovascular care in Germany and to explore the associations with patient-reported experience of cardiovascular prevention.
View Article and Find Full Text PDFBackground: Coordination of care requires information exchange between health workers. The structure of their information exchange networks may influence the quality and efficiency of healthcare delivery. The aim of this study was to explore and classify information exchange networks in primary care for patients with chronic diseases in Germany.
View Article and Find Full Text PDFBackground: Participation of general practitioners is crucial for health care studies. However, recruiting them is an ongoing challenge and participation rates of general practitioners around the globe are often low. One feasible and cost-efficient approach to potentially enhance participation rates among general practitioners are personalized invitation letters, since they may increase one's attention to and appreciation of a study.
View Article and Find Full Text PDFIntroduction: In 2009 a managed care programme for coordinated ambulatory cardiology care was established in Southern Germany. Designed as a voluntary contract between health insurers and ambulatory medical specialists, it aims for a guideline-oriented, efficient health care by general practitioners and medical specialists. In this study, we aimed to identify factors associated with physicians' participation and their relation to the aims of the programme.
View Article and Find Full Text PDFBackground: As the number of elderly and multimorbid patients increases, healthcare has become more complex. This requires good coordination of treatment and care given the various health care professionals involved (e.g.
View Article and Find Full Text PDFBMC Health Serv Res
December 2019
Background: In 2009 health insurers AOK and Bosch BKK introduced the "FacharztProgramm Kardiologie" - a program for coordinated ambulatory cardiology care in the German state of Baden-Württemberg. It aims for efficient, medical guideline-oriented cardiology care to reduce avoidable hospitalizations as well as costs of care. A high number of cardiologists participate and the program has served as blueprint for programs in other medical fields.
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