Linked survey and statutory health insurance data evaluating healthcare utilization patterns and associated factors of persons with diabetes in Germany – latent class analysis

Abstract Persons with diabetes mellitus have complex healthcare needs. Existing disease management programmes (DMPs) are based on a one-size-fits-all approach. However, individuals might require more individualised care. This study aims to identify groups with different patterns of healthcare utiliz...

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Main Authors: Ute Linnenkamp, Inga Deininghaus, Veronika Gontscharuk, Silke Andrich, Manuela Brüne, Nadezda Chernyak, Johannes Kruse, Mickaël Hiligsmann, Barbara Hoffmann, Andrea Icks
Format: Article
Language:English
Published: Nature Portfolio 2025-04-01
Series:Scientific Reports
Online Access:https://doi.org/10.1038/s41598-025-95514-9
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author Ute Linnenkamp
Inga Deininghaus
Veronika Gontscharuk
Silke Andrich
Manuela Brüne
Nadezda Chernyak
Johannes Kruse
Mickaël Hiligsmann
Barbara Hoffmann
Andrea Icks
author_facet Ute Linnenkamp
Inga Deininghaus
Veronika Gontscharuk
Silke Andrich
Manuela Brüne
Nadezda Chernyak
Johannes Kruse
Mickaël Hiligsmann
Barbara Hoffmann
Andrea Icks
author_sort Ute Linnenkamp
collection DOAJ
description Abstract Persons with diabetes mellitus have complex healthcare needs. Existing disease management programmes (DMPs) are based on a one-size-fits-all approach. However, individuals might require more individualised care. This study aims to identify groups with different patterns of healthcare utilization among people with diabetes in Germany and factors associated with these different patterns. A cross-sectional survey was conducted among a random sample from a statutory health insurance (SHI) with diabetes (n = 1332) and linked to longitudinal SHI data. Latent class analysis was used to identify subgroups with similar patterns of healthcare utilization and factors associated with different patterns. Four patterns of healthcare utilization were identified among people with diabetes: ‘low users’ (20.8% of the total sample); ‘low users with ophthalmologist visit’ (45.2%); ‘high users’ (26.5%); and ‘high users with mental health care’ (7.5%). The classes differed significantly in age, sex, type, duration and severity of diabetes, DMP membership, diabetes training, health-related quality of life, and prevalence of depression. The ‘high users with mental health care’ class was for example younger, more female, had a lower quality of life and the highest prevalence of depression. This study may provide a first basis for thinking about targeted care in Germany beyond DMPs.
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spelling doaj-art-3e596f703ab24b609ec6bb57fe1cee2f2025-08-20T02:08:08ZengNature PortfolioScientific Reports2045-23222025-04-0115111110.1038/s41598-025-95514-9Linked survey and statutory health insurance data evaluating healthcare utilization patterns and associated factors of persons with diabetes in Germany – latent class analysisUte Linnenkamp0Inga Deininghaus1Veronika Gontscharuk2Silke Andrich3Manuela Brüne4Nadezda Chernyak5Johannes Kruse6Mickaël Hiligsmann7Barbara Hoffmann8Andrea Icks9Institute for Health Services Research and Health Economics, Centre for Health and Society, Medical Faculty and University Hospital Düsseldorf, Heinrich Heine University DüssseldorfInstitute for Health Services Research and Health Economics, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University Düsseldorf, DüsseldorfInstitute for Health Services Research and Health Economics, Centre for Health and Society, Medical Faculty and University Hospital Düsseldorf, Heinrich Heine University DüssseldorfInstitute for Health Services Research and Health Economics, Centre for Health and Society, Medical Faculty and University Hospital Düsseldorf, Heinrich Heine University DüssseldorfInstitute for Health Services Research and Health Economics, Centre for Health and Society, Medical Faculty and University Hospital Düsseldorf, Heinrich Heine University DüssseldorfInstitute for Health Services Research and Health Economics, Centre for Health and Society, Medical Faculty and University Hospital Düsseldorf, Heinrich Heine University DüssseldorfClinic for Psychosomatic Medicine and Psychotherapy, University Clinics Gießen and MarburgDepartment of Health Services Research, CAPHRI Care and Public Health Research Institute, Maastricht UniversityInstitute for Occupational, Social and Environmental Medicine, Centre for Health and Society, Medical Faculty and University Hospital Düsseldorf, Heinrich Heine University DüsseldorfInstitute for Health Services Research and Health Economics, Centre for Health and Society, Medical Faculty and University Hospital Düsseldorf, Heinrich Heine University DüssseldorfAbstract Persons with diabetes mellitus have complex healthcare needs. Existing disease management programmes (DMPs) are based on a one-size-fits-all approach. However, individuals might require more individualised care. This study aims to identify groups with different patterns of healthcare utilization among people with diabetes in Germany and factors associated with these different patterns. A cross-sectional survey was conducted among a random sample from a statutory health insurance (SHI) with diabetes (n = 1332) and linked to longitudinal SHI data. Latent class analysis was used to identify subgroups with similar patterns of healthcare utilization and factors associated with different patterns. Four patterns of healthcare utilization were identified among people with diabetes: ‘low users’ (20.8% of the total sample); ‘low users with ophthalmologist visit’ (45.2%); ‘high users’ (26.5%); and ‘high users with mental health care’ (7.5%). The classes differed significantly in age, sex, type, duration and severity of diabetes, DMP membership, diabetes training, health-related quality of life, and prevalence of depression. The ‘high users with mental health care’ class was for example younger, more female, had a lower quality of life and the highest prevalence of depression. This study may provide a first basis for thinking about targeted care in Germany beyond DMPs.https://doi.org/10.1038/s41598-025-95514-9
spellingShingle Ute Linnenkamp
Inga Deininghaus
Veronika Gontscharuk
Silke Andrich
Manuela Brüne
Nadezda Chernyak
Johannes Kruse
Mickaël Hiligsmann
Barbara Hoffmann
Andrea Icks
Linked survey and statutory health insurance data evaluating healthcare utilization patterns and associated factors of persons with diabetes in Germany – latent class analysis
Scientific Reports
title Linked survey and statutory health insurance data evaluating healthcare utilization patterns and associated factors of persons with diabetes in Germany – latent class analysis
title_full Linked survey and statutory health insurance data evaluating healthcare utilization patterns and associated factors of persons with diabetes in Germany – latent class analysis
title_fullStr Linked survey and statutory health insurance data evaluating healthcare utilization patterns and associated factors of persons with diabetes in Germany – latent class analysis
title_full_unstemmed Linked survey and statutory health insurance data evaluating healthcare utilization patterns and associated factors of persons with diabetes in Germany – latent class analysis
title_short Linked survey and statutory health insurance data evaluating healthcare utilization patterns and associated factors of persons with diabetes in Germany – latent class analysis
title_sort linked survey and statutory health insurance data evaluating healthcare utilization patterns and associated factors of persons with diabetes in germany latent class analysis
url https://doi.org/10.1038/s41598-025-95514-9
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