Here we offer insights into selected scientific projects at the Institute.
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The Nordbaden Project:
Health Care Utilization Research in Germany
The Nordbaden Project was initiated in 2003 as a cross-sectional analysis of the real-world prevalence, resource use, and direct medical costs associated with attention-deficit/hyperactivity disorder (ADHD). Meanwhile, the project has evolved into a longitudinal patient-centered study, allowing to follow-up identified patients over prolonged periods of time and to study the impact of moderators (e.g., coexisting conditions) and mediators (e.g., specialist involvement) on the quality and cost of health care services provided. The database enables retrospective health care utilization studies based upon administrative claims data of the Kassenärztliche Vereinigung (KV) in Nordbaden (“Regierungsbezirk Karlsruhe”), an above-average affluent region in Southwestern Germany. It has been (and continues to be used) for a variety of studies into the administrative prevalence, the comorbidity, and the health care provision for mental health and other disorders, beyond ADHD.
The database covers the complete regional population enrolled in statutory health insurance (SHI; >2.2 million lives). Combination with sick funds data offers the possibility of prescription analyses for the subsample of patients insured by its member companies (850,000 lives in year 2009). The demographic structure (by age and gender) of the Nordbaden sample compares well to the national population. However, regional population density is much higher (396/sqkm versus 229/sqkm in 2009), and GDP per capita (34,800€ versus 29,300€) as well as the rate of persons insured by private sick funds (instead of statutory health insurance, SHI: 18.2% versus 14.6%) exceed the national average. There are also relatively more health care specialists in Nordbaden (for example, 11,400 persons per mental health care specialist and 3,200 per psychotherapist) compared to Germany (17,200 and 3,900, respectively), whereas the relative number of general practitioners is somewhat lower (with 1,500 persons per g.p. versus 1,400).
The Nordbaden sample thus constitutes a well-characterized study population. This project would not have been possible without the continuous generous support by the Kassenärztliche Vereinigung Baden-Württemberg and by the vdek association of sick funds in Baden Württemberg.