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The Development of Diabetes Complications in GP-Centered Healthcare

Kateryna Karimova, MSc; Lorenz Uhlmann, MSc; Marc Hammer, MPH; Corina Guethlin, PhD; Ferdinand M. Gerlach, MD, MPH; and Martin Beyer, MSc
This study compared general practitioner–centered healthcare (Hausarztzentrierte Versorgung [HZV]) with non-HZV healthcare in Germany regarding the development of diabetes complications. HZV is associated with reduced risk of diabetes complications.
ABSTRACT

Objectives: To compare the development of diabetes complications, measured in terms of clinical end points, of patients enrolled in general practitioner (GP)-centered healthcare (Hausarztzentrierte Versorgung [HZV]) and patients in usual GP care (non-HZV) over 4 years. 

Study Design: Retrospective closed cohort study based on German claims data.

Methods: The main end points in our evaluation were dialysis, blindness, amputation, stroke, myocardial infarction, cardiovascular disease, hypoglycemia, and mortality. We used Cox proportional hazards regression models for multivariable analysis. 

Results: We included 217,964 patients in our study: 119,355 were enrolled in HZV and 98,609 were in non-HZV. Compared with non-HZV, the HZV group had a 15.6% lower risk of requiring dialysis during the 4 years of observation. Risks were also lower in the HZV group for all other end points except mortality. 

Conclusions: The results of the present study indicate that GP-centered healthcare is associated with a delay in the occurrence of serious diabetes complications and reduces the risk of diabetes complications. This may be because GP-centered care is associated with improved coordination of care. 

Am J Manag Care. 2018;24(7):322-327

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