A5101506627- Health Systems, Economic Evaluations, Quality of Life
- Global Health Care Issues
- Chronic Disease Management Strategies
- Health and Medical Studies
- Healthcare Policy and Management
- Pharmaceutical Practices and Patient Outcomes
- Mental Health Treatment and Access
- Mental Health and Psychiatry
- Health disparities and outcomes
- Psychiatric care and mental health services
- Health, psychology, and well-being
- Schizophrenia research and treatment
- Medication Adherence and Compliance
- Frailty in Older Adults
- Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Peripheral Artery Disease Management
- Digital Mental Health Interventions
- Healthcare cost, quality, practices
- Employment and Welfare Studies
- Health Promotion and Cardiovascular Prevention
- Social and Demographic Issues in Germany
- Pharmaceutical studies and practices
- Spondyloarthritis Studies and Treatments
- Stroke Rehabilitation and Recovery
- Media Influence and Health
University Medical Center Hamburg-Eppendorf
2013-2024
Universität Hamburg
2013-2024
Weihenstephan-Triesdorf University of Applied Sciences
2015
University of Duisburg-Essen
2012-2013
Aarhus University Hospital
2013
Leipzig University
2007-2012
Klinik und Poliklinik für Psychiatrie und Psychotherapie
2010
The concept of frailty is rapidly gaining attention as an independent syndrome with high prevalence in older adults. Thereby, often related to certain adverse outcomes like mortality or disability. Another outcome discussed increased health care utilization. However, only few studies examined the impact on utilization and corresponding costs. aim this study was therefore investigate comprehensively relationship between frailty, Cross sectional data from 2598 participants (57–84 years)...
to investigate how frailty and symptoms affect healthcare costs in older age longitudinally. data were gathered from a prospective cohort study Saarland, Germany (two waves with 3-year interval, n = 1,636 aged 57–84 years at baseline). Frailty was assessed by the five Fried criteria. defined as having least three criteria, presence of 1–2 criteria 'pre-frail'. Healthcare quantified based on self-reported use sectors inpatient treatment, outpatient professional nursing care informal well...
Leicht H, Heinrich S, Heider D, Bachmann C, Bickel van den Bussche Fuchs A, Luppa M, Maier W, Mösch E, Pentzek Rieder-Heller SG, Tebarth F, Werle J, Weyerer Wiese B, Zimmermann T, König H-H, for the AgeCoDe study group. Net costs of dementia by disease stage. Objective: To estimate net degree severity from a societal perspective, including detailed assessment formal and informal nursing care. Method: In cross-sectional study, illness were analysed in 176 patients 173 matched non-demented...
To analyze the association of health care costs with predisposing, enabling, and need factors, as defined by Andersen's behavioral model utilization, in German elderly population.Using a cross-sectional design, cost data 3,124 participants aged 57-84 years 8-year-follow-up ESTHER cohort study were analyzed. Health utilization 3-month period was assessed retrospectively through an interview conducted trained physicians at respondents' homes. Unit applied to calculate from societal...
Background Chronic diseases, like diabetes mellitus, heart disease and cancer are leading causes of death disability. These conditions at least partially preventable or modifiable, e.g. by enhancing patients' self-management. We aimed to examine the effectiveness telephone-based health coaching (TBHC) in chronically ill patients. Methods Findings This prospective, pragmatic randomized controlled trial compares an intervention group (IG) participants TBHC a control (CG) without TBHC....
Article Abstract Objective: To compare the 1-year cost-effectiveness of therapeutic assertive community treatment (ACT) with standard care in schizophrenia. ACT was specifically developed for patients schizophrenia, delivered by psychosis experts highly trained respective psychotherapies, and embedded into an integrated system. Method: Two catchment areas Hamburg, Germany, similar population size health structures were assigned to offer 12-month (n = 64) or 56) 120 first- multiple-episode...
In order to limit rising publicly-financed health expenditure, out-of-pocket payments for care services (OOPP) have been raised in many industrialized countries. However, higher health-related OOPP may burden social subgroups unequally. Germany, inequalities rarely analyzed. The aim of this study was examine the German elderly population different sectors system. Socio-economic and morbidity-related determinants were analyzed.This cross-sectional analysis used data N = 3,124 subjects aged 57...
Abstract Background Loneliness in older adults is common, particularly women. In this article, gender differences the association of loneliness and health care use are investigated a large sample community-dwelling adults. Methods Data 2525 persons (ages 55–85 years)—participants fourth follow- up (2011–2014) ESTHER study- were analyzed. assessed by study doctors course home visit. Gender-specific regression models with Gamma-distribution performed using as independent variable to predict...
Abstract Introduction The gene MICA encodes the protein major histocompatibility complex class I polypeptide-related sequence A. It is expressed in synovium of patients with rheumatoid arthritis (RA) and its implication autoimmunity discussed. We analyzed association genetic variants susceptibility to RA. Methods Initially, 300 French Caucasian individuals belonging 100 RA trio families were studied. An additional independent a German case-control cohort (90/182 individuals) available for...
ABSTRACT Background: Depression in old age is common. Only few studies examined the association of depressive symptoms and direct costs elderly a cross-sectional way. This study aims to investigate prospectively health service use over course 4.5 years considering also different courses symptomatology. Methods: 305 primary care patients aged 75+ were assessed face-to-face regarding (Geriatric Scale), at baseline later. Resource utilization was monetarily valued using 2004/2005 prices. The...
Objective To improve health care for the elderly, a consideration of biopsychosocial needs may be particular importance—especially because prevalence multiple conditions, mental disorders, and social challenges facing elderly people. The aim study was to investigate significance costs in Methods Data were derived from 8-year follow-up ESTHER study—a German epidemiological population. A total 3124 participants aged 57 84 years visited at home by trained medical doctors. Biopsychosocial...
Background Cardiovascular disease is a leading cause of death in older people, and the impact being exposed or not to preventive cardiovascular medicines accordingly high. Underutilization beneficial drugs common, but prevalence estimates differ across settings, knowledge on predictors limited, clinical consequences are rarely investigated. Methods Using data from prospective population-based cohort study, we assessed prevalence, determinants, outcomes medication underuse based criteria...
Due to a multitude of reasons Randomized Control Trials on the basis so-called "routine data" provided by insurance companies cannot be conducted. Therefore estimation "causal effects" for any kind treatment is hampered since systematic bias due specific selection processes must suspected. The basic problem counterfactual, which evaluate difference between two potential outcomes same unit, discussed. focus lies comparison performance different approaches control differences and group. These...
Previous studies have demonstrated the efficacy of rehabilitation after a cardiovascular procedure. Especially older and multimorbid patients benefit from cardiac Prehabilitation prior to procedures may also positive effects on patients' pre- postoperative outcomes. Results current meta-analysis show that prehabilitation can improve perioperative outcomes alleviate adverse effects. Germany currently lacks structured program for patients, which is coordinated across healthcare sectors.In...
Although the estimated need for primary health care is covered to 108% in Germany, a physician shortage emerging some regions. Moreover, number of young physicians completing specialist medical training general medicine decreasing. Therefore present study aimed investigate factors influencing aspire such as well aspects considered important practice establishment by these physicians.14 939 aged under 40 years without completed were contacted mail using databases five state chambers (Lower...
Background In the growing population of elderly, drug-related problems are considered an important health care safety issue. One aspect this is prescription potentially inappropriate medication (PIM) which to increase costs. Objective Using data from Health Economics Potentially Inappropriate Medication (HEPIME) study, we aimed analyze how number prescribed substances moderates association PIM use as defined by German PRISCUS list and costs applying a longitudinal perspective. Methods An...
Abstract Background Schizophrenia is among the most burdensome and costly illnesses worldwide. To estimate cost of schizophrenia in France, a longitudinal study was carried out between 1998 2002. The main objective this to describe update longitudinal, representative sample French patients. second identify drivers treatment schizophrenia. Methods Based on cohort 288 schizophrenic patients during 2 years prospective follow-up, collected clinical, patient reported outcomes, quality life,...
Background: excess weight is a risk factor for numerous co-morbidities that predominantly occur in later life. This study's purpose was to analyse the association between and health service use/costs older population Germany. Methods: this cross-sectional analysis used data of n = 3,108 individuals aged 58–82 from population-based prospective cohort study. Body mass index (BMI) waist-to-height ratio (WHtR) were calculated based on clinical examinations. Health use measured by questionnaire...
Background Case management undertaken by healthcare assistants in small primary care practices is effective improving depression symptoms and adherence patients with major depression. Aims To evaluate the cost-effectiveness of case practices. Method Cost-effectiveness analysis on basis a pragmatic randomised controlled trial (2005-2008): practice-based 74 provided to 562 over 1 year. Our outcome was incremental costeffectiveness ratio (ICER) calculated as differences mean costs number...