[Evaluation of special GP-centered health care contracts in Germany by the participating GPs. present situation and future perspectives].
OBJECTIVE
In 2004, German statutory health care funds were given the possibility to offer their insured a special general practitioner-( GP-)centered health care contract (HZV), since 2007 they are obliged to do so. The aim of these contracts is to strengthen the role of the GP as a coordinator in the health care system. Until now, the evidence regarding the GPs' view on these contracts is poor. A written survey was conducted in Hesse in order to learn how the participating GPs evaluate the regional HZV.


METHODS
In Apri 2008, a questionnaire was developed, tested and mailed to 2,815 GPs who were participating in the GP-centered health care contract at that time. All analyses where conducted with SPSS (version 15.0).


RESULTS
A total of 686 questionnaires were returned (response rate 24.4%). Altogether, the GPs' feedback ranged from great approval to clear disapproval of the contract. However, 70.0% of the survey's participants evaluated the HZV in general to be positive, 60.1% felt it strengthens their role as a GP. Quality circles on good prescribing and GP-specific education, obligatory parts of the HZV, were evaluated to be especially positive (70.3% and 69.4%, respectively). Positive effects were also seen concerning coordination of care (53.3%) and cooperation with patients (36.3%). Improvements concerning cooperation with specialists and hospitals were reported less often (24.9% and 13.0%, respectively). Workload because of additional administration for the HZV was criticized.


CONCLUSIONS
In future, special GP-centered health care contracts should focus on improvement of cooperation between GPs and other caregivers. Workload for additional administration should be reduced.
Klingenberg
Anja
A
Institut für angewandte Qualitätsförderung und Forschung im Gesundheitswesen (AQUA-Institut) Göttingen, Göttingen, Germany. anja.klingenberg@aqua-institut.de
Broge
Björn
B
Herholz
Harald
H
Szecsenyi
Joachim
J
Ose
Dominik
D
D000328:Adult; D000368:Aged; D001291:Attitude of Health Personnel; D003284:Contract Services / Q000331:legislation & jurisprudence*; D003299:Cooperative Behavior; D003695:Delivery of Health Care / Q000331:legislation & jurisprudence*; D005194:Family Practice / Q000331:legislation & jurisprudence*; D005246:Feedback; D005260:Female; D005858:Germany; D018166:Health Care Reform / Q000331:legislation & jurisprudence*; D006801:Humans; D033183:Interdisciplinary Communication; D008297:Male; D008875:Middle Aged; D009313:National Health Programs / Q000331:legislation & jurisprudence*; D018802:Patient-Centered Care / Q000331:legislation & jurisprudence; D012017:Referral and Consultation / Q000331:legislation & jurisprudence*; D011795:Surveys and Questionnaires