Zink group

Improving health care provision by continuous outcome monitoring

Introduction
Members
Cooperation partners
Selected Publications

Health Services Research

Our group has the mission to provide the rheumatology community with information concerning the development of health care of patients with rheumatic and musculoskeletal diseases (RMDs) in Germany.

We observe treatment and outcomes in specialized rheumatological care, as well as on the population level. This research has implications for health care planning – in particular rheumatologic work force planning – and identifies gaps in health care, as well as problems that persons with RMDs face in daily life. The results are fed into the work of the German Society for Rheumatology (DGRh), the Arthritis Centres, the German League against Rheumatism as well as individual rheumatologic sites who use the data for quality assessment.

With the National database of the German Collaborative Arthritis Centres, we have observed treatment and outcomes of inflammatory rheumatic diseases since 1993. Every year, physician- and patient-reported data of around 17,000 persons treated by rheumatologists have been systematically collected and analysed.

Over the years, we have substantiated how new therapeutic options and closer cooperation between medical disciplines are reflected in a better clinical outcome of patients. Many patients are now in in a satisfactory condition; the ability to work has significantly increased and the burden of illness due to pain or functional limitations has decreased. This applies not only to rheumatoid arthritis, but also to other systemic inflammatory rheumatic diseases such as spondyloarthritis or vasculitides. These changes can be attributed to the combination of better cooperation among the medical disciplines with earlier start of therapy, and to novel therapeutic options.

We have also broadened the scope of our research to include evaluation of health care provision outside of rheumatology. Taking advantage of routine data from the second largest health insurance in Germany, the BARMER, claims data were analysed in combination with patient-reported outcomes. Large surveys including a total of 20,000 members of the insurance with diagnoses of rheumatoid arthritis, spondyloarthritis, or osteoarthritis of hip and knee were performed. Large differences in treatment concepts between rheumatologists and non-specialised physicians were found, and deficits in health care, particularly in rural areas, were detected. In addition, there were substantial differences in the provision of care depending on age, social status and the health care provider.

Group Leader
    Prof. Dr. Angela Zink

Prof. Dr. Angela Zink

German Rheumatism Research Centre
Health Services Research
Charitéplatz 1
10117 Berlin

Tel. +49 (0)30 28460-622
Fax +49 (0)30 28460-626
zink@drfz.de

Keywords
Health services research
Trends in treatment
Long-term observation
Cost of illness
Predictors of outcome

Continue to Members

Group leader
Prof. Dr. Angela Zink

Deputy group leader
Dr. med. Katinka Albrecht

Scientist
Dr. rer. medic. Johanna Callhoff

Medical documentalists
Sascha Bischoff, B.A.
Dipl.-Soz. tech. Gregor Förster
Dipl.-Soz. tech. Katja Thiele

Research assistance
Sabine Achtelstetter

Group Leader
    Prof. Dr. Angela Zink

Prof. Dr. Angela Zink

German Rheumatism Research Centre
Health Services Research
Charitéplatz 1
10117 Berlin

Tel. +49 (0)30 28460-622
Fax +49 (0)30 28460-626
zink@drfz.de

Keywords
Health services research
Trends in treatment
Long-term observation
Cost of illness
Predictors of outcome

Continue to Cooperation partners

German Society for Rheumatology (DGRh)

German League against Rheumatism (DRL)

Dr. Tobias Alexander, Charité – Universitätsmedizin Berlin

Dr. Rieke H. E. Alten, Schlosspark-Klinik, Berlin

Prof. Dr. Martin Aringer, Universitätsklinikum Carl Gustav Carus Dresden

Dr. Frank Behrens, Centrum für innovative Diagnostik und Therapie, Frankfurt

Prof. Dr. Frank Buttgereit, Charité – Universitätsmedizin Berlin

Prof. Dr. Dr. Thomas Dietrich, University of Birmingham

Dr. Edmund Edelmann, Rheumazentrum Bad Aibling

Dr. Thorsten Eidner, Universitätsklinikum Jena

Prof. Dr. Erika Gromnica-Ihle, Berlin

Prof. Dr. Klaus-Peter Günther, Medizinische Fakultät Carl Gustav Carus, Technische Universität Dresden

Dr. Jörg Henes, Universitätsklinikum Tübingen

Dr. Ulrich von Hinüber, Dr. Winfried Demary und Dr. Bettina Linhart, Rheumatologie und Osteologie, Hildesheim

Dr. Guido Hoese, Rheumapraxis, Stadthagen

Prof. Dr. Falk Hoffmann, Carl von Ossietzky Universität Oldenburg

Dr. Kirsten Karberg, Praxis für Rheumatogolgie und Innere Medizin, Berlin

Dr. Stefan Kleinert und Dr. Florian Schuch, Praxisgemeinschaft Rheumatologie Nephrologie Erlangen

Prof. Dr. Ina Kötter, Asklepios Klinik Altona, Hamburg

Prof. Dr. Andreas Krause, Immanuel Krankenhaus Berlin

Dr. Wolfgang Ochs, Internistisch-rheumatologische Praxisgemeinschaft, Bayreuth

Prof. Dr. Jutta Richter, Prof. Dr. Matthias Schneider, Universitätsklinikum Düsseldorf

Prof. Dr. Georg Schett, Universitätsklinikum Erlangen

Prof. Dr. Jochen Schmitt, Medizinische Fakultät Carl Gustav Carus, Technische Universität Dresden

Dr. Susanna Späthling-Mestekemper, Rheumapraxis München-Pasing

Dr. Siegfried Wassenberg, Dr. Ralf Weier und Dr. Benjamin Köhler, Rheumazentrum Ratingen

Group Leader
    Prof. Dr. Angela Zink

Prof. Dr. Angela Zink

German Rheumatism Research Centre
Health Services Research
Charitéplatz 1
10117 Berlin

Tel. +49 (0)30 28460-622
Fax +49 (0)30 28460-626
zink@drfz.de

Keywords
Health services research
Trends in treatment
Long-term observation
Cost of illness
Predictors of outcome

Continue to Selected Publications

2019

Albrecht K, Callhoff J, Zink A. Long-term trends in rheumatology care. Achievements and deficits in 25 years of the German national rheumatology database. German version. Z Rheumatol. 2019 Jul 11. https://link.springer.com/article/10.1007/s00393-019-0660-5

Callhoff J, Albrecht K, Hoffmann F, Poddubnyy D, Günther KP, Zink A. Reality of care for musculoskeletal diseases at the population level : Results of the PROCLAIR collaborative project. German version. Z Rheumatol. 2019 Jul 4.
http://link.springer.com/article/10.1007/s00393-019-0664-1

Jacobs H, Hoffmann F, Callhoff J, Postler A, Saam J, Zink A, et al. Utilization of individual out-of-pocket health services (IGeL) in persons with osteoarthritis in Germany : Results of a survey from the PROCLAIR study. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz. 2019 Jul 4.
https://link.springer.com/article/10.1007%2Fs00103-019-02986-y

J. Callhoff, K. Thiele, T. Dörner, A. Zink, J.G. Richter, J. Henes, K. Albrecht, Trends in employment and hospitalisation in patients with Sjögren’s syndrome 1996-2016: results from the German National database, Clin Exp Rheumatol 2019; 37 (Suppl. 118): S00-S00.
https://www.clinexprheumatol.org/article.asp?a=13940

Vordenbäumen S, Brinks R, Richter JG, Albrecht K, Schneider M. Clinical characteristics of patients with alpha-galactosidase A gene variants in a German multicentre cohort of early undifferentiated arthritis. Ann Rheum Dis. 2019 Mar 22. pii: annrheumdis-2019-215223. doi: 10.1136/annrheumdis-2019-215223. [Epub ahead of print] No abstract available.

Richter JG, Chehab G, Kiltz U, Callhoff J, Voormann A, Lorenz HM, Schneider M, Specker C. [Digital Health in Rheumatology – Status 2018/19]. Dtsch Med Wochenschr. 2019 Apr;144(7):464-469. German

Oude Voshaar MAH, Vonkeman HE, Courvoisier D, Finckh A, Gossec L, Leung YY, Michaud K, Pinheiro G, Soriano E, Wulfraat N, Zink A, van de Laar MAFJ. Towards standardized patient reported physical function outcome reporting: linking ten commonly used questionnaires to a common metric. Qual Life Res. 2019 Jan;28(1):187-197.

Luque Ramos A, Redeker I, Hoffmann F, Callhoff J, Zink A, Albrecht K. Comorbidities in Patients with Rheumatoid Arthritis and Their Association with Patient-reported Outcomes: Results of Claims Data Linked to Questionnaire Survey. J Rheumatol. 2019 Jan 15. pii: jrheum.180668. doi: 10.3899/jrheum.180668. [Epub ahead of print]

Jacobs H, Callhoff J, Hoffmann F, Zink A, Albrecht K. Non-drug treatment of rheumatoid arthritis : An analysis of claims data and a survey of insured persons (Project PROCLAIR)]. Z Rheumatol 2019 Mar;78(2):119-126. German https://link.springer.com/article/10.1007%2Fs00393-018-0567-6

2018

Albrecht K, Huscher D, Buttgereit F, Aringer M, Hoese G, Ochs W, Thiele K, Zink A. Long-term glucocorticoid treatment in patients with polymyalgia rheumatica, giant cell arteritis, or both diseases: results from a national rheumatology database. Rheumatol Int. 2018 Apr;38(4):569-577.

Albrecht K, Luque Ramos A, Hoffmann F, Redeker I, Zink A. High prevalence of diabetes in patients with rheumatoid arthritis: results from a questionnaire survey linked to claims data. Rheumatology (Oxford). 2018;57(2):329-336.

Redeker I, Hoffmann F, Callhoff J, Haibel H, Sieper J, Zink A, Poddubnyy D. Determinants of psychological well-being in axial spondyloarthritis: an analysis based on linked claims and patient-reported survey data. Ann Rheum Dis. 2018 Jul;77(7):1017-1024.

2017

Albrecht K, Zink A. Poor prognostic factors guiding treatment decisions in rheumatoid arthritis patients: a review of data from randomized clinical trials and cohort studies. Arthritis Res Ther. 2017;19(1):68.

Callhoff J, Luque Ramos A, Zink A, Hoffmann F, Albrecht K. The Association of Low Income with Functional Status and Disease Burden in German Patients with Rheumatoid Arthritis: Results of a Cross-sectional Questionnaire Survey Based on Claims Data. J Rheumatol. 2017;44(6):766-772.

Van der Helm-van Mil AH, Zink A. What is rheumatoid arthritis? Considering consequences of changed classification criteria. Ann Rheum Dis. 2017;76(2):315-317.

Jobski K, Luque Ramos A, Albrecht K, Hoffmann F. Pain, depressive symptoms and medication in German patients with rheumatoid arthritis-results from the linking patient-reported outcomes with claims data for health services research in rheumatology (PROCLAIR) study. Pharmacoepidemiol Drug Saf. 2017;26(7):766-774.

Luque Ramos A, Albrecht K, Zink A, Hoffmann F. Rheumatologic care of nursing home residents with rheumatoid arthritis: a comparison of the year before and after nursing home admission. Rheumatol Int. 2017;37(12):2059-2064.

Zink A, Albrecht K. Rheumatoid arthritis: The benefits of early treatment after decades. Nat Rev Rheumatol. 2017;13(8):458-459.

Group Leader
    Prof. Dr. Angela Zink

Prof. Dr. Angela Zink

German Rheumatism Research Centre
Health Services Research
Charitéplatz 1
10117 Berlin

Tel. +49 (0)30 28460-622
Fax +49 (0)30 28460-626
zink@drfz.de

Keywords
Health services research
Trends in treatment
Long-term observation
Cost of illness
Predictors of outcome

Continue to Introduction