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Background <p>General practitioner-centered care (GPCC; German: <i>Hausarztzentrierte Versorgung</i>, HZV) is a&#xa0;structured primary&#xa0;care model within statutory health insurance in Germany in which the general practitioner acts as the first point of contact and coordinating instance, with guided utilization of specialist and inpatient services. The aim is to improve continuity and coordination of care to reduce unnecessary emergency contacts and avoidable hospitalizations. At the same time, the use of ambulance services is increasing, including among patients with low to moderate acuity. Against this background, this study examines whether participation in GPCC is associated with lower utilization of emergency medical services (EMS) use compared with usual care.</p> Methods <p>Retrospective cross-sectional analysis of statutory health insurance claims data from 2022. The primary outcome was the utilization of EMS: total (EMS1), with hospitalization (EMS2), and with potentially avoidable hospitalization (EMS3). Subgroup analyses were conducted for age groups &lt; 65 and ≥ 65&#xa0;years.</p> Results <p>Participation in GPCC was associated with lower EMS utilization (−8.2% EMS1; −9.8% EMS2; −8.6% EMS3), with stronger effects among individuals aged &lt; 65&#xa0;years. Higher age, male sex, morbidity, care dependency, nursing home residence, and urban residence were overall associated with higher utilization rates.</p> Conclusion <p>GPCC is associated with reduced EMS utilization and may contribute to relieving emergency medical services. The findings suggest that structured primary care improves the steering of patient flows and reduces misallocation, including through early detection and prevention of potentially avoidable hospitalizations.</p>

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Rettungseinsätze in der hausarztzentrierten Versorgung: Vergleich mit der Regelversorgung anhand von Routinedaten

  • 期刊论文

  • 发表日期：

    2026年7月27日

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  • Julia-Kristin Riedel,
  • Gunter Laux,
  • Attila Altiner,
  • Rüdiger Leutgeb

摘要

Background

General practitioner-centered care (GPCC; German: Hausarztzentrierte Versorgung, HZV) is a structured primary care model within statutory health insurance in Germany in which the general practitioner acts as the first point of contact and coordinating instance, with guided utilization of specialist and inpatient services. The aim is to improve continuity and coordination of care to reduce unnecessary emergency contacts and avoidable hospitalizations. At the same time, the use of ambulance services is increasing, including among patients with low to moderate acuity. Against this background, this study examines whether participation in GPCC is associated with lower utilization of emergency medical services (EMS) use compared with usual care.

Methods

Retrospective cross-sectional analysis of statutory health insurance claims data from 2022. The primary outcome was the utilization of EMS: total (EMS1), with hospitalization (EMS2), and with potentially avoidable hospitalization (EMS3). Subgroup analyses were conducted for age groups < 65 and ≥ 65 years.

Results

Participation in GPCC was associated with lower EMS utilization (−8.2% EMS1; −9.8% EMS2; −8.6% EMS3), with stronger effects among individuals aged < 65 years. Higher age, male sex, morbidity, care dependency, nursing home residence, and urban residence were overall associated with higher utilization rates.

Conclusion

GPCC is associated with reduced EMS utilization and may contribute to relieving emergency medical services. The findings suggest that structured primary care improves the steering of patient flows and reduces misallocation, including through early detection and prevention of potentially avoidable hospitalizations.