Co- and multimorbidity patterns in primary care based on episodes of care: results from the German CONTENT project

Abstract

Background: Due to technological progress and improvements in medical care and health policy the average age of patients in primary care is continuously growing. In equal measure, an increasing proportion of mostly elderly primary care patients presents with multiple coexisting medical conditions. To properly assess the current situation of co-and multimorbidity, valid scientific data based on an appropriate data structure are indispensable. CONTENT (CONTinuous morbidity registration Epidemiologic NeTwork) is an ambitious project in Germany to establish a system for adequate record keeping and analysis in primary care based on episodes of care. An episode is defined as health problem from its first presentation by a patient to a doctor until the completion of the last encounter for it. The study aims to describe co-and multimorbidity as well as health care utilization based on episodes of care for the study population of the first participating general practices.

Quaternary prevention, an answer of family doctors to overmedicalization

“…Let's see how they can contribute to the understanding of the seminal act in healthcare; the meeting between a patient and a provider. We are not addressing here the innumerous contributions of family doctors to epidemiology of the first line (2)(3)(4)(5), nor their contribution to the health information process (6,7), but their relation to time, to knowledge, and to preventative attitude.…”

The content of general practice consultations: cross-sectional study based on video recordings

“…It can be impossible to adequately deal with all these problems within a short time-limited consultation, so prioritisation is sometimes necessary. 7 There is a long history of research to describe the clinical content of general practice, for example the national morbidity studies in the UK 8 , the BEACH study in Australia, 9 and the CONTENT project in Germany 10 . However, fewer studies have explored the number of different problems dealt with at each consultation.…”

Herausforderungen an die Gesundheitsforschung für eine alternde Gesellschaft am Beispiel „Multimorbidität“

“…Mit der Zahl der chronischen Erkrankungen steigen die Zahl der Arztkontakte [18,19], die Zahl beziehungsweise die Dauer der Krankenhausaufenthalte [20] und die Krankheitskosten [13]. Darüber hinaus sind chronische Gesundheitsprobleme ausschlaggebend für die Anzahl von ärztlichen Verordnungen, Überweisungen und Hausarztkonsultationen [21].…”