Hildebrandt Helmut, Pimperl Alexander, Schulte Timo, Hermann Christopher, Riedel Harald, Schubert Ingrid, Köster Ingrid, Siegel Achim, Wetzel Martin
Gesundes Kinzigtal, Haslach, Deutschland,
Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz. 2015 Apr;58(4-5):383-92. doi: 10.1007/s00103-015-2120-y.
The integrated care system Gesundes Kinzigtal (ICSGK), one of the most comprehensive population-based ICS in Germany, started its work nearly 9 years ago. The ICSGK is pursuing the Triple Aim: improving the health of the population, improving the individual's experience of care, and at the same time reducing the per capita costs of care.
To evaluate the impact of the ICSGK on the Triple Aim.
The ICSGK is being evaluated externally and internally via a mix of diverse quantitative and qualitative methods. This paper presents selected results for each Triple Aim dimension.
Regarding population health, most of the quality indicators examined by the external scientific evaluation show positive development. For example, the prevalence of patients with fractures among all insurants with osteoporosis is presented. In 2011, this prevalence was approximately 26 % in the "Kinzigtal" population (aged ≥ 20 years old) in comparison to 33 % in the control group. As far as patient experience is concerned, to the question "Would you recommend becoming a member of Gesundes Kinzigtal to your friends or relatives?" 92.1 % of those questioned answered "Yes, for sure" or "Yes, probably." Twenty-four percent of those questioned further stated that they would now live "more healthy" than before enrolment in the ICSGK. In the subgroup of questioned insurants who had objective agreements with their doctors 45.4 % answered in this way. On the subject of cost-effectiveness, for both participating socil health insurance schemes, cost savings relative to the costs normally expected for the ICSGK population concerned are observed every year. In the seventh intervention year (2012) the total is 4.56 million Euros for the AOK Baden-Württemberg (BW), which is a contribution margin of 146 Euros per insurant for the 31.156 insurants concerned (LKK BW = 322 Euros per insurant relative to cost savings). The results presented in this paper indicate positive effects in all three Triple Aim dimensions. Further longitudinal studies are recommended to validate those first results together with a detailed analysis to obtain in-depth insights into the specific influence of subcomponents of the total intervention.
健康金齐格塔尔综合医疗系统（ICSGK）是德国最全面的基于人群的综合医疗系统之一，于近9年前开始运作。ICSGK追求三重目标：改善人群健康、提升个人就医体验，同时降低人均医疗成本。
评估ICSGK对三重目标的影响。
通过多种定量和定性方法对ICSGK进行外部和内部评估。本文展示了三重目标各维度的部分选定结果。
在人群健康方面，外部科学评估所考察的大多数质量指标呈积极发展态势。例如，呈现了所有骨质疏松症参保患者中骨折患者的患病率。2011年，“金齐格塔尔”人群（年龄≥20岁）中该患病率约为26%，而对照组为33%。就患者体验而言，对于“你会向你的朋友或亲戚推荐成为健康金齐格塔尔的成员吗？”这一问题，92.1%的受访者回答“肯定会”或“很可能会”。24%的受访者进一步表示，他们现在的生活比加入ICSGK之前“更健康”。在与医生有客观协议的受访参保人群子组中，45.4%的人这样回答。在成本效益方面，对于两个参与的社会医疗保险计划，每年都观察到相对于ICSGK相关人群正常预期成本的成本节约。在第七个干预年（2012年），巴登-符腾堡州AOK的节约总额为456万欧元，对于31156名相关参保人而言，人均节约贡献为14
