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Zink group

Health services research helps to improve outcomes of rheumatic diseases

Introduction
Members
Cooperation partners
Selected Publications

Health Services Research

Research in our group focuses on the systematic and long-term evaluation of the quality and outcomes of health care of people with rheumatic and musculoskeletal diseases in Germany. Using large primary and secondary data bases, developments and deficits in specialized as well as non-specialized health care are investigated. Findings are fed back to the treating physicians and inform clinical and political decision making.

An important instrument of research is the National Database of the German Collaborative Arthritis Centres. Since 1993 it has enabled our group to monitor trends in treatments and outcomes of inflammatory rheumatic diseases in more than 15,000 patients per year. Over the years, these data have substantiated how new therapeutic options and earlier access to rheumatologic care are reflected in continuously improving clinical outcomes of patients. The ability to work has increased significantly, the disease activity and the burden of illness due to pain or functional limitations have decreased.

Our group has been involved in two national research networks funded by the Federal Ministry of Education and Research (BMBF). Taking advantage of routine data from BARMER health insurance, claims data were analysed in the PROCLAIR project in combination with patient-reported outcomes from questionnaire surveys including a total of 20,000 of BARMER health insurance members. Diverging treatment concepts between rheumatologists and non-specialised physicians, as well as regional differences in health care, were detected. In addition, there were substantial differences in the provision of care depending on age and social status. Depression turned out to be an important predictor of poor clinical and socioeconomic outcomes. A collaborative work from the PROCLAIR and METARTHROS projects revealed a high burden of diabetes and other chronic comorbidities in patients with rheumatoid arthritis as well as deficits in specialized care.

All treatment guidelines in RA include recommendations for therapeutic strategies in case of unfavourable prognostic factors. Data from the early arthritis cohort CAPEA showed that autoantibodies and early erosions did not predict achievement of low disease activity or remission whereas baseline disease activity, functional limitation and obesity were predictive.

Keywords
Health care research, claims data, inflammatory rheumatic diseases

Programme area Epidemiology and Health Services Research, and Deputy Scientific Director Prof. Dr. Angela Zink Phone +49 (0)30 28460-622 zink@drfz.de more
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Group leader
Prof. Dr. Angela Zink

Deputy Group Leader
Dr. Katinka Albrecht

Scientists
Dr. Johanna Callhoff, Dr. Dörte Huscher

Medical documentalists
Katja Thiele, Sascha Bischoff, Gregor Förster

Research Assistant
Sabine Achtelstetter

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

Continue to Selected Publications

(1)          Albrecht K, Huscher D, Eidner T, Kleinert S, Spathling-Mestekemper S, Bischoff S, Zink A. Medical treatment of rheumatoid arthritis in 2014 : Current data from the German Collaborative Arthritis Centers. Z Rheumatol 2017;76:50-57

(2)          Albrecht K, Luque Ramos A, Callhoff J, Hoffmann F, Minden K, Zink A.Outpatient care and disease burden of rheumatoid arthritis : Results of a linkage of claims data and a survey of insured persons. Z Rheumatol 2018;77:102-112

(3)          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;44:766-772

(4)          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;57:329-336

(5)          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; J  Jan 15. pii: jrheum.180668. doi: 10.3899/jrheum.180668. [Epub ahead of print]

(6)          Baganz L, Richter A, Albrecht K, Schneider M, Burmester GR, Zink A, Strangfeld A. Are prognostic factors adequately selected to guide treatment decisions in patients with rheumatoid arthritis? A collaborative analysis from three observational cohorts. Semin Arthritis Rheum. 2018 Sep 17. pii: S0049-0172(18)30331-7. doi:10.1016/j.semarthrit.2018.09.003.[Epub ahead of print]

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