Methodological Flaw in the Study Design
I noticed in the article that a doctor-patient contact (DPC) on a specific date was considered to have occurred when at least one billing item was found that required personal contact between doctor and patient. The basis for this was the Uniform Value Scale (Einheitlicher Bewertungsmaßstab, EBM) EBM 2000plus, which was introduced on 1 April 2005.
However, this merely reflects the initial contact for chronically ill patients. For such patients, a further billing item is available. At the very latest, however, it is the third contact that will not be reflected, except for the very few cases where a billing position for the healthcare service delivered even exists. No billing item exists, for example, for conducting an ECG. Furthermore, EBM 2000plus does not include any billing items for a second instance of wound care, a second consultation without a psychosomatic background, a follow-up with a clinical examination alone, without “hi-tech medicine.” A comparison with 1996 data, when every contact was included, is therefore not possible.
Because of this serious methodological flaw the study’s meaningfulness seems questionable.
Dr. med. Kirsten Bogusch, Urbach, email@example.com
|1.||Hauswaldt J, Hummers-Pradier E, Junius-Walker U: Health service use among patients with chronic or multiple illnesses, and frequent attenders—secondary analysis of routine primary care data from 1996 to 2006. Dtsch Arztebl Int 2012; 109(47): 814–20 VOLLTEXT|