Evaluation of the German living guideline "Protection against the Overuse and Underuse of Health Care" - an online survey among German GPs.

IF 2 Q2 MEDICINE, GENERAL & INTERNAL
Lisette Warkentin, Martin Scherer, Thomas Kühlein, Felix Pausch, Dagmar Lühmann, Cathleen Muche-Borowski, Susann Hueber
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Abstract

Background: The aim of this study was to evaluate the awareness and use of the German guideline "Protection against the overuse and underuse of health care" from the general practitioners' (GPs') perspective. In addition, the study assessed how GPs perceive medical overuse and what solutions they have for reducing it.

Methods: We performed a cross-sectional online survey with recruitment from 15.06. to 31.07.2023. Participants were members of the German College of General Practitioners and Family Physicians (DEGAM). The main outcomes were the awareness and use of the guideline.

Results: The analysis included data from 626 physicians. 51% were female and the median age was 50 years. The guideline is known by 81% of the participants, 32% read it in more detail. The majority considered the guideline a helpful tool in reducing overuse (67%). Almost 90% wished to have more guidelines with clear do-not-do recommendations. Physicians indicated in mean (M) that 30.2% (SD = 19.3%) of patients ask them for medical services that they do not consider to be necessary and that M = 30.2% (SD = 18.1%) of all GP services can be attributed to medical overuse. About half of the participants thought that overuse is a moderate or major problem in their practice (52%) and in general practice overall (58%). More participants rated that it is especially a problem in specialist (87%) and inpatient care (82%). Changes in the reimbursement system, raising awareness for the problem and more evidence-based guidelines were considered helpful in mitigating overuse.

Conclusions: Although the guideline is seen as a useful tool in mitigating medical overuse, there is still further potential for its implementation and utilisation. GPs see more overuse in the inpatient and outpatient specialist areas than in their area of practice. Instead of self-critically approaching the problem, the proposed strategies are aimed at the healthcare system itself.

对德国生活指南“防止医疗保健过度使用和使用不足”的评估——一项对德国全科医生的在线调查。
背景:本研究的目的是从全科医生的角度评估德国指南“防止医疗保健的过度使用和使用不足”的认识和使用情况。此外,该研究还评估了全科医生如何看待医疗过度使用,以及他们有哪些减少医疗过度使用的解决方案。方法:从2006年15月15日开始,我们进行了一项横断面在线调查。31.07.2023。参与者是德国全科医生和家庭医生学院(DEGAM)的成员。主要结果是对指南的认识和使用。结果:分析包括626名医生的数据。51%为女性,中位年龄为50岁。81%的参与者知道该指南,32%的人阅读了更详细的内容。大多数人认为该指南是减少过度使用的有用工具(67%)。几乎90%的人希望有更多的指导方针,明确建议不要做。医生在平均值(M)中指出,30.2% (SD = 19.3%)的患者要求他们提供他们认为没有必要的医疗服务,而所有全科医生服务的M = 30.2% (SD = 18.1%)可归因于医疗过度使用。大约一半的参与者认为,在他们的实践中(52%)和一般实践中(58%),过度使用是一个中度或严重的问题。更多的参与者认为这在专科医生(87%)和住院治疗(82%)中尤其是个问题。人们认为,改变报销制度、提高对这一问题的认识以及提供更多循证指南有助于减少过度使用。结论:尽管该指南被视为减轻医疗过度使用的有用工具,但其实施和利用仍有进一步的潜力。全科医生在住院和门诊专科领域看到的滥用情况比在他们的实践领域看到的更多。而不是自我批判地接近问题,提出的战略是针对医疗保健系统本身。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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CiteScore
4.40
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