Correspondence
In Reply
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We would like to thank Dr. Hector for his analysis of the results of the evaluation study (1) and would like to provide the following answers to the questions he poses. The increased number of GP consultations in the group of participants in the GP-centered health care (HzV) of the AOK PLUS in Thuringia (Germany), as compared to the control group, is attributable to a more intensive monitoring of patients, who were predominantly older, multimorbid, and chronically ill. We especially interpret the decrease in the specialist consultations without referral, as a higher degree of GP care coordination. We consider the idea that specialist physician referrals are more frequent in the HzV group than in the control group „on a patient's request without compelling reason“ unfounded; however, this cannot be checked based on these data.
Furthermore, we think that our article, and particularly the section on limitations, has already addressed the critical comments of Dr. Hector, namely, those concerning the propensity score matching and the morbidity index. We would like to point out once again that this evaluation compared GP-centered health care to usual care. Indeed, our study results may even suggest that the GP-centered health care is better than usual care at allowing the GP practices to provide patients in need with the necessary time and care, as mentioned by Dr. Hector.
DOI: 10.3238/arztebl.2017.0254b
On behalf of the authors:
Dr. rer. pol. Antje Freytag
Institut für Allgemeinmedizin, Universitätsklinikum Jena, Germany
Dr. rer. medic. Janine Biermann
Lehrstuhl für Medizinmanagment, Universität Duisburg-Essen, Germany
Prof. Dr. med. Dipl.-Päd. MPH Jochen Gensichen
Institut für Allgemeinmedizin Universitätsklinikum Jena, Germany
jochen.gensichen@med.uni-jena.de
Conflict of interest statement
Prof. Gensichen has received study support (third-party funds) from AOK PLUS.
Dr. Freytag and Dr. Biermann declare that no conflict of interest exists.
a case-control study based on insurance claims data. Dtsch Arztebl Int 2016; 113: 791–8 VOLLTEXT
| 1. | Freytag A, Biermann J, Ochs A, Lux G, Lehmann T, Ziegler J, Schulz S, Wensing M, Wasem J, Gensichen J: The Impact of GP-centered healthcare— a case-control study based on insurance claims data. Dtsch Arztebl Int 2016; 113: 791–8 VOLLTEXT |
