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Articles by H. H Konig
Total Records ( 2 ) for H. H Konig
  M Luppa , T Luck , S Weyerer , H. H Konig , E Brahler and S. G. Riedel Heller
 

Objective: in the past decades, many studies have examined predictors of nursing home placement (NHP) in the elderly. This study provides a systematic review of predictors of NHP in the general population of developed countries.

Design: relevant articles were identified by searching the databases MEDLINE, Web of Science, Cochrane Library and PSYNDEXplus. Studies based on population-based samples with prospective study design and identification of predictors by multivariate analyses were included. Quality of studies and evidence of predictors were determined.

Results: thirty-six studies were identified; one-third of the studies were of high quality. Predictors with strong evidence were increased age, low self-rated health status, functional and cognitive impairment, dementia, prior NHP and a high number of prescriptions. Predictors with inconsistent results were male gender, low education status, low income, stroke, hypertension, incontinence, depression and prior hospital use.

Conclusions: findings suggested that predictors of NHP are mainly based on underlying cognitive and/or functional impairment, and associated lack of support and assistance in daily living. However, the methodical quality of studies needs improvement. More theoretical embedding of risk models of NHP would help to establish more clarity in complex relationships in using nursing homes.

  H. H Konig , A Born , D Heider , H Matschinger , S Heinrich , S. G Riedel Heller , D Surall , M. C Angermeyer and C. Roick
 

Background

Individuals with anxiety disorders often do not receive an accurate diagnosis or adequate treatment in primary care.

Aims

To analyse the cost-effectiveness of an optimised care model for people with anxiety disorders in primary care.

Method

In a cluster randomised controlled trial, 46 primary care practices with 389 individuals positively screened with anxiety were randomised to intervention (23 practices, 201 participants) or usual care (23 practices, 188 participants). Physicians in the intervention group received training on diagnosis and treatment of anxiety disorders combined with the offer of a psychiatric consultation–liaison service for 6 months. Anxiety, depression, quality of life, service utilisation and costs were assessed at baseline, 6-month and 9-month follow-up.

Results

No significant differences were observed between intervention and control group on the Beck Anxiety Inventory, Beck Depression Inventory and EQ–5D during follow-up. Total costs were higher in the intervention group (4911 v. 3453, P = 0.09). The probability of an incremental cost-effectiveness ratio <50 000 per quality-adjusted life year was below 10%.

Conclusions

The optimised care model did not prove to be cost-effective.

 
 
 
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