Abstract
BackgroundStakeholders in the German state of Baden-Wuerttemberg agreed upon the central aims for healthcare planning. These include a focus on geographical districts; a comprehensive, cross-sectoral perspective on healthcare needs and services; and use of regional data for healthcare planning. Therefore, healthcare data at district level is needed. Nevertheless, decision makers face the challenge to make a selection from numerous indicators and frameworks, which all have limitations or do not well apply to the targeted setting. The aim of this study was to identify district level indicators to be used in Baden-Wuerttemberg for the purpose of cross-sectoral and needs-based healthcare planning involving stakeholders of the health system.MethodsA conceptual framework for indicators was developed. A structured search for indicators identified 374 potential indicators in indicator sets of German and international institutions and agencies (n = 211), clinical practice guidelines (n = 50), data bases (n = 35), indicator databases (n = 25), published literature (n = 35), and other sources (n = 18). These indicators were categorised according to the developed framework dimensions. In an online survey, institutions of various stakeholders were invited to assess the relevance of these indicators from December 2016 until January 2017. Indicators were selected in terms of a median value of the assessed relevance.Results22 institutions selected 212 indicators for the five dimensions non-medical determinants of health (20 indicators), health status (25), utilisation of the health system (34), health system performance (87), and healthcare provision (46).ConclusionsStakeholders assessed a large number of indicators as relevant for use in healthcare planning on district level.Trial registrationNot applicable.
Highlights
Stakeholders in the German state of Baden-Wuerttemberg agreed upon the central aims for healthcare planning
Subproject 1 was part of a larger programme, the Model Project Cross-Sectoral Healthcare [13], which was initiated by the Ministry of Social Affairs and Integration of BW to explore how regional healthcare planning according the aims of the GLB could be conducted
Conceptual framework and its development process In order to guide the search and selection of indicators, we developed a conceptual framework together with a project group consisting of representatives from eight institutions, which were the Ministry of Social Affairs and Integration (MSAI), one population health organisation on state and three on district level, academic colleagues from two universities, and the authors
Summary
Stakeholders in the German state of Baden-Wuerttemberg agreed upon the central aims for healthcare planning. The aim of this study was to identify district level indicators to be used in Baden-Wuerttemberg for the purpose of cross-sectoral and needs-based healthcare planning involving stakeholders of the health system. German healthcare planners with responsibility for healthcare service provision are challenged by changing environmental factors such as increasing numbers of people living with chronic disease driven by the ageing of the population [1, 2] and shifts in morbidity [3]. This is further exacerbated by workforce shortages across the health professions which poses challenges for German health care planners in rural regions [4, 5].
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