Deutschlandweite, regionalisierte Prognose der bevölkerungsbezogenen Morbidität für häufige Krebserkrankungen – Auswirkungen auf die Versorgung

Bahr, Jeanette; Berg, Neeltje van den; Kraywinkel, Klaus; Stentzel, Ulrike; Radicke, Franziska; Baumann, Walter; Hoffmann, Wolfgang

doi:10.1055/s-0041-101356

Cited by 6 publications

(4 citation statements)

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“…Therefore, this bias could artificially increase correlations. However, our approach is widely used in health care research and represents a reasonable proxy for the need for health care [ 9 , 12 , 13 ]. Regarding our approach to measure accuracy in % of allowed error, it has to be noted that this approach focuses on areas with least error and ignores those with most errors, which limits its implications.…”

Section: Discussionmentioning

confidence: 99%

“…Following this, a proper utilization of medical care is depending on the definition applied. In Germany as well as in other countries, the realistic theory is commonly used for the definition of the need for health care [ 9 , 12 , 13 ]. Consequently, the treatable morbidity—determined by current evidence-based knowledge—can be used as a surrogate marker for this need.…”

Section: Introductionmentioning

confidence: 99%

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Prediction of hospital visits for the general inpatient care using floating catchment area methods: a reconceptualization of spatial accessibility

et al. 2020

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Background: The adequate allocation of inpatient care resources requires assumptions about the need for health care and how this need will be met. However, in current practice, these assumptions are often based on outdated methods (e.g. Hill-Burton Formula). This study evaluated floating catchment area (FCA) methods, which have been applied as measures of spatial accessibility, focusing on their ability to predict the need for health care in the inpatient sector in Germany. Methods: We tested three FCA methods (enhanced (E2SFCA), modified (M2SFCA) and integrated (iFCA)) for their accuracy in predicting hospital visits regarding six medical diagnoses (atrial flutter/fibrillation, heart failure, femoral fracture, gonarthrosis, stroke, and epilepsy) on national level in Germany. We further used the closest provider approach for benchmark purposes. The predicted visits were compared with the actual visits for all six diagnoses using a correlation analysis and a maximum error from the actual visits of ± 5%, ± 10% and ± 15%. Results: The analysis of 229 million distances between hospitals and population locations revealed a high and significant correlation of predicted with actual visits for all three FCA methods across all six diagnoses up to ρ = 0.79 (p < 0.001). Overall, all FCA methods showed a substantially higher correlation with actual hospital visits compared to the closest provider approach (up to ρ = 0.51; p < 0.001). Allowing a 5% error of the absolute values, the analysis revealed up to 13.4% correctly predicted hospital visits using the FCA methods (15% error: up to 32.5% correctly predicted hospital). Finally, the potential of the FCA methods could be revealed by using the actual hospital visits as the measure of hospital attractiveness, which returned very strong correlations with the actual hospital visits up to ρ = 0.99 (p < 0.001). Conclusion: We were able to demonstrate the impact of FCA measures regarding the prediction of hospital visits in non-emergency settings, and their superiority over commonly used methods (i.e. closest provider). However, hospital beds were inadequate as the measure of hospital attractiveness resulting in low accuracy of predicted hospital visits. More reliable measures must be integrated within the proposed methods. Still, this study strengthens the possibilities of FCA methods in health care planning beyond their original application in measuring spatial accessibility.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Prediction of hospital visits for the general inpatient care using floating catchment area methods: a reconceptualization of spatial accessibility

et al. 2020

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“…Therefore, empirical investigations with full coverage of the target population have a high degree of external validity. Other studies that are based on samples of the population, for example from cancer registries [ 47 ] or surveys of self-reported health status [ 48 ], should clearly state how far and with respect to which characteristics they are representative of the target population.…”

Section: Criteria For Estimating Needs-based Supplymentioning

confidence: 99%

Assessing needs-based supply of physicians: a criteria-led methodological review of international studies in high-resource settings

Geiger

Schang²,

Sundmacher

2023

BMC Health Serv Res

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Background Many health systems embrace the normative principle that the supply of health services ought to be based on the need for healthcare. However, a theoretically grounded framework to operationalize needs-based supply of healthcare remains elusive. The aim of this paper is to critically assess current methodologies that quantify needs-based supply of physicians and identify potential gaps in approaches for physician planning. To this end, we propose a set of criteria for consideration when estimating needs-based supply. Methods We conducted searches in three electronic bibliographic databases until March 2020 supplemented by targeted manual searches on national and international websites to identify studies in high-resource settings that quantify needs-based supply of physicians. Studies that exclusively focused on forecasting methods of physician supply, on inpatient care or on healthcare professionals other than physicians were excluded. Additionally, records that were not available in English or German were excluded to avoid translation errors. The results were synthesized using a framework of study characteristics in addition to the proposed criteria for estimating needs-based physician supply. Results 18 quantitative studies estimating population need for physicians were assessed against our criteria. No study met all criteria. Only six studies sought to examine the conceptual dependency between need, utilization and supply. Apart from extrapolations, simulation models were applied most frequently to estimate needs-based supply. 12 studies referred to the translation of need for services with respect to a physician’s productivity, while the rest adapted existing population-provider-ratios. Prospective models for estimating future care needs were largely based on demographic predictions rather than estimated trends in morbidity and new forms of care delivery. Conclusions The methodological review shows distinct heterogeneity in the conceptual frameworks, validity of data basis and modeling approaches of current studies in high-resource settings on needs-based supply of physicians. To support future estimates of needs-based supply, this review provides a workable framework for policymakers in charge of health workforce capacity planning.

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“…German healthcare planners with responsibility for healthcare service provision are challenged by changing environmental factors such as increasing numbers of people living with chronic disease driven by the ageing of the population [1,2] and shifts in morbidity [3]. This is further exacerbated by workforce shortages across the health professions which poses challenges for German health care planners in rural regions [4,5].…”

Section: Introductionmentioning

confidence: 99%

Healthcare planning across healthcare sectors in Baden-Wuerttemberg, Germany: a stakeholder online survey to identify indicators

Wronski

Koetsenruijter

Ose

et al. 2021

BMC Health Serv Res

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Background Stakeholders in the German state of Baden-Wuerttemberg agreed upon the central aims for healthcare planning. These include a focus on geographical districts; a comprehensive, cross-sectoral perspective on healthcare needs and services; and use of regional data for healthcare planning. Therefore, healthcare data at district level is needed. Nevertheless, decision makers face the challenge to make a selection from numerous indicators and frameworks, which all have limitations or do not well apply to the targeted setting. The aim of this study was to identify district level indicators to be used in Baden-Wuerttemberg for the purpose of cross-sectoral and needs-based healthcare planning involving stakeholders of the health system. Methods A conceptual framework for indicators was developed. A structured search for indicators identified 374 potential indicators in indicator sets of German and international institutions and agencies (n = 211), clinical practice guidelines (n = 50), data bases (n = 35), indicator databases (n = 25), published literature (n = 35), and other sources (n = 18). These indicators were categorised according to the developed framework dimensions. In an online survey, institutions of various stakeholders were invited to assess the relevance of these indicators from December 2016 until January 2017. Indicators were selected in terms of a median value of the assessed relevance. Results 22 institutions selected 212 indicators for the five dimensions non-medical determinants of health (20 indicators), health status (25), utilisation of the health system (34), health system performance (87), and healthcare provision (46). Conclusions Stakeholders assessed a large number of indicators as relevant for use in healthcare planning on district level. Trial registration Not applicable.

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Deutschlandweite, regionalisierte Prognose der bevölkerungsbezogenen Morbidität für häufige Krebserkrankungen – Auswirkungen auf die Versorgung

Abstract: Due to the increase of incident and prevalent cancer cases, the number of hospital days and sickness costs will increase. The results of the analyses show an increase of medical care services in the outpatient sector.

Cited by 6 publications

References 1 publication

Prediction of hospital visits for the general inpatient care using floating catchment area methods: a reconceptualization of spatial accessibility

Prediction of hospital visits for the general inpatient care using floating catchment area methods: a reconceptualization of spatial accessibility

Assessing needs-based supply of physicians: a criteria-led methodological review of international studies in high-resource settings

Healthcare planning across healthcare sectors in Baden-Wuerttemberg, Germany: a stakeholder online survey to identify indicators

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