Biopsychosocial health care needs and costs of elderly people: a comparison study between Germany and the Netherlands

老年人的生物心理社会保健需求和费用：德国和荷兰的比较研究

• 批准号: 321002415
• 负责人: Professorin Dr. Beate Wild
• 金额: --
• 依托单位: Klinik für Allgemeine Innere Medizin und Psychosomatik
• 依托单位国家: 德国
• 项目类别: Research Grants
• 财政年份: 2016
• 资助国家: 德国
• 起止时间: 2015-12-31 至 2018-12-31
• 项目状态: 已结题
• 来源: https://gepris.dfg.de/gepris/projekt/321002415?language=en
• 关键词: Biopsychosocial; health; care; needs; costs

Over the past years, the proportion of elderly people has increased dramatically in many countries. To date, the highly heterogeneous group of elderly people consumes a disproportionate share of services and costs in health care. International comparisons can help gain a better knowledge regarding the distribution of health care use and costs and their relationship to health care systems. This study aims to investigate and compare health care use and costs of elderly people in Germany and in the Netherlands. To this end, two large population-based data sets from both Germany and the Netherlands will be analysed by using a person-centered segmentation approach. Person-centered care emphasizes the limitations of a disease-centered approach and asks for the evaluation of needs, values, and preferences of the patients. In a person-centered care system, it is important to know how the experienced health care needs are related to health care costs. Knowledge about the association between needs and costs are the basis for a good (re-) allocation of resources in the health care system. In this study, we will describe, explain, and compare health care use and costs of elderly people in association with their subjective bio-psycho-social needs and functioning. Specifically, in both epidemiologic study samples a person-centered segmentation will be conducted according to the bio-psycho-social needs and functioning of the elderly people. The segmentation analysis will apply a factor mixture model (FMM) combining a confirmatory factor analysis and a latent class analysis. Using this approach, we will determine various subpopulations (profiles) of elderly people, each with their own unique characteristics regarding subjective needs and functioning. The distribution of elderly people across these profiles will be compared between Germany and the Netherlands. Health care use and costs related to each segment will be evaluated in both samples. Differences between German and Dutch profiles regarding health care use and costs will be described. Important inferences regarding the association between health care use, costs, and health systems will be drawn. We anticipate that results of our study could be groundbreaking for the ongoing discussion regarding the re-organization of health care in the elderly and the re-allocation of resources in the health care systems. As a result of the study we will obtain an algorithm which assigns elderly people to specific risk profiles. This algorithm could be implemented in general practices and treatment plans could be organized according to the needs in specific profiles.

在过去几年中，许多国家的老年人比例急剧增加。到目前为止，高度多样化的老年人群体在医疗保健服务和费用中所占的份额不成比例。国际比较有助于更好地了解卫生保健使用和费用的分布及其与卫生保健系统的关系。本研究旨在调查和比较德国和荷兰老年人的医疗保健使用和费用。为此，两个大的人口为基础的数据集，从德国和荷兰将使用以人为中心的分割方法进行分析。以人为本的护理强调以疾病为中心的方法的局限性，并要求对患者的需求，价值观和偏好进行评估。在以人为本的医疗体系中，了解经验性医疗需求与医疗费用的关系是很重要的。了解需求和成本之间的关系是医疗保健系统资源合理（重新）分配的基础。在这项研究中，我们将描述，解释和比较老年人的医疗保健使用和成本与他们的主观生物，心理，社会需求和功能。具体而言，在两个流行病学研究样本中，将根据老年人的生物-心理-社会需求和功能进行以人为中心的细分。细分分析将采用结合验证性因素分析和潜在类别分析的因素混合模型（FMM）。使用这种方法，我们将确定老年人的各种亚群（概况），每个亚群在主观需求和功能方面都有自己独特的特征。将比较德国和荷兰之间老年人在这些概况中的分布情况。将在两个样本中评估与每个部分相关的医疗保健使用和成本。德国和荷兰的配置文件之间的差异，关于医疗保健的使用和成本将被描述。重要的推论之间的关联，医疗保健的使用，成本和卫生系统将得出。我们预计，我们的研究结果可能是开创性的正在进行的讨论有关重组的医疗保健在老年人和医疗保健系统的资源重新分配。作为研究的结果，我们将获得一种算法，该算法将老年人分配到特定的风险状况。该算法可以在一般实践中实施，并且可以根据特定配置文件中的需要来组织治疗计划。