Luehmann Dagmar

Luehmann Dagmar
University Medical Center Hamburg - Eppendorf · Department of Primary Medical Care

MD

About

149
Publications
18,220
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1,160
Citations
Introduction
Luehmann Dagmar currently works at the Department of Primary Medical Care, University Medical Center Hamburg - Eppendorf. Luehmann does research in Public Health, Medical Technology Assessment and Health Services Research.
Additional affiliations
January 2013 - present
University Medical Center Hamburg - Eppendorf
Position
  • Project Manager
January 1996 - December 2012
University Medical Center Schleswig-Holstein
Position
  • Senior Researcher
June 1991 - December 1995
Universitätsklinikum Schleswig - Holstein
Position
  • Medical Doctor

Publications

Publications (149)
Article
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Background Patient numbers in emergency departments are on the rise. The DEMAND intervention aims to improve the efficacy of emergency services by computer-assisted structured initial assessment assigning patients to emergency departments or primary care practices. The aims of our study were to evaluate patient satisfaction with this intervention a...
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Objectives This study aimed to explore the association between patient activation and patients’ experience of care among an elderly multimorbid population in Germany. Design Cross-sectional study. Setting Primary care practices in two German settings. Participants 346 patients with 3 or more chronic conditions aged 65 years and over from 36 prim...
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Purpose Social isolation is considered a risk factor for dementia. However, less is known about social isolation and dementia with respect to competing risk of death, particularly in the oldest-old, who are at highest risk for social isolation, dementia and mortality. Therefore, we aimed to examine these associations in a sample of oldest-old indiv...
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Background Patients with multiple long-term conditions often face a variety of challenges arising from the requirements of their health care. Knowledge of perceived treatment burden is crucial for optimizing treatment. In this study, we aimed to create a German version of the Multimorbidity Treatment Burden Questionnaire (MTBQ) and to evaluate its...
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Purpose: Health literacy (HL) intervention could be a potential prevention strategy to reduce the risk of metabolic syndrome (MS), but the association between low HL and MS is controversial. Therefore, the aim of this study was to investigate whether low HL is associated with obesity, diabetes, and hypertension, considering them as one cluster. M...
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Background and Objectives Providing health care for older adults with multimorbidity is often complex, challenging, and prone to fragmentation. Although clinical decision-making should take into account treatment interactions, individual burden and resources, current approaches to assessing quality of care mostly rely on indicators for single condi...
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Background It is almost unknown whether the driving status is associated with HRQOL among individuals in highest age.AimsBased on a multicenter prospective cohort study, the objective of this study was to examine whether the driving status is associated with health-related quality of life (HRQOL) among the oldest old in Germany.Methods Cross-sectio...
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Objectives Aim of this study was to analyse if subjectively perceived treatment urgency of patients in emergency departments is associated with self-reported health literacy and the willingness to use the general practitioner (GP) as coordinator of treatment. Design A multicentre, cross-sectional, observational study. Setting Emergency department...
Article
Background Dementia is a major economic challenge for societies worldwide. One approach of cost-of-illness studies focuses on the excess costs of people with dementia compared to costs in people without dementia. Yet, excess costs of dementia have rarely been examined. Objective To contribute to the existing evidence on excess costs of dementia by...
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Objectives Autonomy (defined as self-governance; not equivalent to independence) is relevant to well-being and psychological functioning. However, there is a lack of research on individuals aged >85 years and their perception of autonomy when receiving informal care. This study aims to answer the question if and how the receipt of informal care is...
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Objectives: The aims of our study were to describe the effect of the COVID-19 pandemic and lockdown on primary care in Germany regarding the number of consultations, the prevalence of specific reasons for consultation presented by the patients, and the frequency of specific services performed by the GP. Methods: We conducted a longitudinal obser...
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Background Prevalence of people with multimorbidity rises. Multimorbidity constitutes a challenge to the healthcare system, and treatment of patients with multimorbidity is prone to high-quality variations. Currently, no set of quality indicators (QIs) exists to assess quality of care, let alone incorporating the patient perspective. We therefore a...
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Background Low health literacy is believed to be associated with behaviours that increase the risk of type 2 diabetes. But there is limited knowledge on the relation between health literacy (HL) and diabetes risk, and whether improving HL could be a potential prevention strategy. Therefore, the main purpose of this study was to examine the link bet...
Article
Purpose : To investigate the association between health-related quality of life and ego integrity among the oldest old. Materials and methods : Cross-sectional data were taken from follow-up wave 9 of the multicenter prospective cohort study “Needs, health service use, costs and health-related quality of life in a large sample of oldest-old primar...
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Zusammenfassung Hintergrund Empfehlungen aus S3-Leitlinien (S3-LL) stellen eine wichtige Grundlage für die Entwicklung von Qualitätsindikatoren (QI) dar. Ein einheitliches methodisches Vorgehen zur Entwicklung von QI im Kontext von S3-LL existiert in Deutschland bisher nicht. Aus diesem Grund wurde ein methodischer Standard für die leitlinienbasie...
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PurposeTo describe health status and health state utilities measured by the EQ-5D-3L in a population-based sample of individuals aged 85 + in Germany, and to analyze associations with basic socio-demographic variables.Methods Cross-sectional data from follow-up wave 7 (n = 761) of the German AgeCoDe Study were used. The EQ-5D-3L questionnaire was u...
Article
Objective: There is a lack of studies disentangling whether changes in frailty are associated with subsequent changes in depressive symptoms or vice versa among the oldest old. Consequently, we aimed to disentangle this link. Design: Three waves [follow-up (FU) wave 7 to FU wave 9; n = 423 individuals in the analytical sample] were used from the m...
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Objectives The aim of our study was to explore patient types in general practitioner (GP) practices and to quantify the regional differences of the frequencies of these patient types in northern Germany. Design and setting We conducted a mixed-methods study based on focus groups and standardised interviews with GPs. All counties and independent ci...
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Objectives The aims of our study were to describe the disease spectrum of refugees, to analyse to what extent their healthcare needs could be met in an outpatient primary care walk-in clinic and which cases required additional services from secondary care (ie, outpatient specialists or hospitals). Design Retrospective longitudinal observational st...
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Background From 2015 to 2016 Germany faced an influx of 1.16 million asylum seekers. In the state of Hamburg Primary Care walk-in clinics (PCWC) were commissioned at refugee camps because the high number of residents (57,000 individuals) could not be provided with access to regular healthcare services. Our study aims were (1) to describe the utiliz...
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Objectives Previous studies have observed protective effects of high mental demands at work on cognitive functioning and dementia risk. However, it is unclear what types of demands drive this effect and whether this effect is subject to a person's genetic risk. We investigated to what extent eight different types of mental demands at work together...
Article
Introduction: There is a lack of studies investigating the link between time-varying factors associated with changes in frailty scores in very old age longitudinally. This is important because the level of frailty is associated with subsequent morbidity and mortality. Objective: To examine time-dependent predictors of frailty among the oldest ol...
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Background: In most countries, the general practitioner (GP) is the first point of contact in the healthcare system and coordinator of healthcare. However, in Germany it is possible to consult an outpatient specialist even without referral. Coordination by a GP might thus reduce health expenditures and inequalities in the healthcare system. The st...
Article
Purpose To determine the prevalence of overweight and obesity, and to identify factors associated with obesity, among the oldest old. Methods For this study, data from follow-up (FU) wave 7 and FU wave 8 of the “Study on Needs, Health Service Use, Costs and Health-Related Quality of Life in a Large Sample of Oldest-Old Primary Care Patients (85+)”...
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Background: Among other factors, the patients' consultation reasons and GPs' spectrum of services determine the process and outcome of the medical treatment. So far, however, there has been little information on differences in reasons for consultation and GPs' services between urban and rural areas. Our study's goal was thus to investigate these f...
Article
Zusammenfassung Ziel der Studie Analyse der Beziehung zwischen depressiven Symptomen und funktionellen Beeinträchtigungen bei Hochaltrigen (85+) im Längsschnitt. Methodik Drei Wellen der multizentrischen prospektiven Kohortenstudie AgeQualiDe wurden genutzt (n = 1272 Beobachtungen). Die Geriatrische Depressionsskala wurde zur Erfassung depressiver...
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Background The number of patients in emergency rooms without a medical emergency is increasing. Outpatient services for mutual support and relief between the in-patient and out-patient sector are not yet fully established. Aim of the work The aim was to determine the extent to which patients in emergency rooms have real medical emergencies by comp...
Article
Aim: The purpose of this study was to investigate whether transpersonal trust (TPT) moderates the relationship between chronic conditions and general practitioner (GP) visits among the oldest old in Germany. Methods: The multicenter prospective cohort Study on Needs, health service use, costs and health-related quality of life in a large sample...
Article
Gemäß David Sackett ist unter evidenzbasierter Medizin (EbM) oder evidenzbasierter Praxis im engeren Sinne „eine Vorgehensweise des medizinischen Handelns, individuelle Patienten auf der Basis der besten zur Verfügung stehenden Daten zu versorgen“ zu verstehen. Diese Definition zeigt, dass klinische Leitlinien ein geeignetes Instrument zur Implemen...
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Background: Initiatives such as "Choosing Wisely" in the USA and "Smarter Medicine" in Switzerland have published lists of widely overused health care services. The German initiative "Choosing Wisely Together (Gemeinsam Klug Entscheiden)" follows this example. The goal of our study was to prioritize important recommendations against the overuse an...
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Background Traumatic events like critical illness and intensive care are threats to life and bodily integrity and pose a risk factor for posttraumatic stress disorder (PTSD). PTSD affects the quality of life and morbidity and may increase health-care costs. Limited access to specialist care results in PTSD patients being treated in primary care set...
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Objective The purpose of this study was to examine the impact of falls on depressive symptoms among the oldest old in Germany longitudinally. Methods Data were used from 2 waves of the multicenter prospective cohort “Study on needs, health service use, costs and health‐related quality of life in a large sample of oldest‐old primary care patients (...
Article
This is a structured guideline mandated by the German College of General Practitioners and Family Physicians which was accepted by The Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaften (The Association of the Scientific Medical Societies).
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Background: The number of patients in emergency departments has risen steadily in recent years, with a particular increase in patients not requiring urgent treatment. The aim of this study is to characterize this group of patients with respect to their sociodemographic features, health status, and reasons for attending an emergency department. Me...
Article
Background: In the future, an increase in health care needs in the elderly is expected. Reports on unmet care needs of the oldest old with cognitive disorders are pending. This study aims at exploring unmet needs in the oldest old primary care patients with mild cognitive impairment (MCI) and dementia. Furthermore, the association between sociodem...
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Background Subjective cognitive decline (SCD), the potentially earliest notable manifestation of preclinical Alzheimer's disease and other dementias, was consistently associated with lower quality of life in cross-sectional studies. The aim of this study was to investigate whether such an association persists longitudinally – particularly with heal...
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Objective The study aimed to develop a comprehensive algorithm (meta-algorithm) for primary care encounters of patients with multimorbidity. We used a novel, case-based and evidence-based procedure to overcome methodological difficulties in guideline development for patients with complex care needs. Study design Systematic guideline development me...
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Background:Most of the previous studies attempted to disentangle the relationship between disability and depressive symptoms were limited to observation periods of only few years. Moreover, evidence is missing regarding the complex co-occurrence of disability and depressive symptoms in old age in Germany. In order to close the research gap, we aime...
Article
Objective: We aimed at identifying differences regarding cognition, depressive symptoms and health-related quality of life between members of private and statutory health insurance (SHI) in very old age in Germany. Methods: Cross-sectional data were gathered from the multicenter prospective "Study on Needs, health service use, costs and health-rela...
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Background: Arteriosclerotic disorders increase the risk of dementia. As they have common causes and risk factors, coronary heart disease (CHD) could influence the course of dementia. Aim: To determine whether CHD increases the speed of cognitive decline in Alzheimer's disease, and to discuss the potential for secondary cardiovascular prevention...
Article
Objectives: To examine how visual impairment affects physical and cognitive function in old age. Design: A longitudinal population-based prospective cohort study. Setting General practitioner offices at six study centers in Germany. They were observed every 1.5 years over four waves. Participants: Individuals aged 77–101 at follow-up Wave 2 (N = 2...
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Background: It is unknown whether longitudinal stability versus instability in subjective cognitive decline (SCD) is a modifying factor of the association between SCD and risk of incident Alzheimer's disease (AD) dementia. Objective: We tested the modifying role of temporal stability of the SCD report on AD dementia risk in cognitively normal el...
Article
Background: Late-life depression is frequently accompanied by cognitive impairments. Objective: Whether these impairments indicate a prodromal state of dementia, or are a symptomatic expression of depression per se is not well-studied. Methods: In a cohort of very old initially non-demented primary care patients (n = 2,709, mean age = 81.1 y),...
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Objective: To investigate how visual impairment affects social ties in late life longitudinally. Design: Population-based prospective cohort study. Setting: Individuals in old age were recruited via general practitioners’ offices (at six study centers) in Germany. They were interviewed every 18 months. Participants: Individuals aged 75 years and...
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Introduction Inappropriate supply and an increasing demand on the healthcare system have been of concern for health policy in Germany for at least 15 years. In the primary care setting, this especially relates to an undersupply of general practitioners (GPs) in the countryside. In addition, there seem to be other regional differences, for example,...
Article
In einem 2011/12 durchgeführten Survey zur Aus-, Weiter- und Fortbildungssituation in Evidenzbasierter Medizin (EbM) in Deutschland, Österreich und der Schweiz wurde eine deutliche Zunahme an Aus-, Weiter-, und Fortbildungsveranstaltungen beschrieben, die für verschiedene Zielgruppen angeboten werden. Um Aussagen über einen möglichen berufsgruppens...
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A survey conducted in 2011/12 on evidence-based medicine teaching activities in Germany, Austria and Switzerland shows an apparent increase of undergraduate and postgraduate teaching activities addressing different target groups. The potential target-group specific or generalised nature of teaching activities in EbM were explored by comparing the c...
Article
Disease Management Programmes (DMPs) are structured treatment programmes for chronic diseases. The DMP requirements are primarily derived from evidence-based guidelines. DMPs are regularly revised to ensure that they reflect current best practice and medical knowledge. The aim of this study was to assess the need for updating the German DMP module...
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[english] The care in nursing homes was examined based on scientific studies. The analysis focuses on dementia and type II diabetes. There is evidence for deficits in the supply of medical specialist attendance to nursing home residents with these diseases in Germany. Compared with corresponding guidelines the medical care for nursing home resident...
Article
For decades various pressure ulcer risk assessment scales (PURAS) have been developed and implemented into nursing practice despite uncertainty whether use of these tools helps to prevent pressure ulcers. According to current methodological standards, randomised controlled trials (RCTs) are required to conclusively determine the clinical efficacy a...
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In the last 15 years Evidence-based Medicine (EbM) has gained much publicity in the German-speaking countries, but it is currently difficult to conclude how much the contents of EbM with its five steps according to Sackett have spread. Data from the year 2006 show that less than half of all medical faculties in Germany have introduced EbM into unde...
Book
Es wird die Versorgung in Pflegeheimen auf Basis wissenschaftlicher Studien untersucht. Schwerpunkte der Analyse sind Demenz und Diabetes. Es gibt Hinweise auf fachärztliche Versorgungsmängel bei Pflegeheimbewohnern mit diesen Krankheiten in Deutschland. Verglichen mit entsprechenden Leitlinien bestehen mögliche Unter- bzw. Fehlversorgungen.
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In December 2010, the Institutes for Social Medicine and Cancer Epidemiology of the University of Lübeck hosted the first Workshop for Early Career Investigators in the area of Health Services Research. This workshop was funded by the Deutsche Forschungsgemeinschaft (DFG, German Research Foundation) with the aim to promote young scientists and rese...
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An ageing population, a growing prevalence of chronic diseases and limited financial resources for health care underpin the importance of prevention of disabling health disorders and care dependency in the elderly. A wide variety of measures is generally available for the prevention of falls and fall-related injuries. The spectrum ranges from diagn...