Routine Data Analysis
To support the project, we analyze BARMER claims data with the following objectives:

• Identifying frequently performed outpatient surgical procedures to facilitate an evidence-based selection of relevant procedures for PROM (Patient-Reported Outcome Measures) assessment.
• Mapping postoperative complications of the selected procedures via routine administrative data using:
  
  • ICD-10 codes for complications (e.g., hemorrhages, postoperative infections)
  • ATC codes for analgesic prescriptions (e.g., opioids, anti-inflammatory drugs)
  • Hospital readmissions within 30 to 90 days
  • Secondary surgical interventions indicative of a complication
• Identifying patient-specific risk factors associated with an increased likelihood of complications.
• Analyzing regional variations in UFO rates to detect potential differences in healthcare quality and geographic patterns.

Patient Involvement
The perspectives and firsthand experiences of patients undergoing surgical procedures play a central role in the project. Therefore, the initiative is continuously supported by a Patient Advisory Board. During advisory board meetings, researchers and patients collaboratively deliberate on project content, methodological approaches, and findings. For instance, patients provide insight into experienced symptoms of impending complications or share their experiences regarding inpatient and outpatient postoperative care. These insights directly inform the development of the survey instrument.
Patient involvement within the UFO project is integrated into the initiative "Joint Research with Citizens" of the Institute of General Practice and the "Patient Involvement" Working Group of the Center for Health Services Research. Furthermore, in collaboration with general practitioners through the RESPoNsE Teaching and Research Practice Network of the Institute of General Practice, we are exploring how the developed survey instrument can be integrated into postoperative follow-up care.
Would you like to participate in the project as a patient or general practitioner, or do you have feedback for us? Please let us know. Contact:

• Prof. Dr. Verena Vogt
• Meik Hildebrand, M.Sc.
• Anni Matthes, M.Sc.
• Richard Schmidt
• Josephine Storch, M.Sc.
• Prof. Dr. med. J. Bleidorn

• Klinik für Anästhesiologie und Intensivmedizin (KAI), Universitätsklinikum Jena: apl. Prof. Dr. Winfried Meißner (Projektleitung, Konsortialführung)
• Bundesverband für Ambulantes Operieren e.V. (BAO)
• BARMER
• Deutsche Gesellschaft für Anäesthesiologie und Intensivmedizin (DGAI)
• Deutsche Gesellschaft für Allgemein- und Viszeralchirurgie (DGAV)

• Aktionsbündnis für Patientensicherheit (APS)

Feasibility study

• Piloting a randomized study at the level of medical practices

Evaluation

• Exploratory analysis of efficacy based on the pilot study
  • Can the intervention lead to a reduction in the utilization of diagnostic tests?
  • How can this be measured reliably?
• Piloting the health economic evaluation

Development of implementation strategies

• Presentation of the healthcare situation of patients with thyroid diseases using statutory health insurance (SHI) routine data
  • Presentation of care pathways using sequence analysis
  • Analysis of patient groups with similar care needs and patterns using sequence analysis
• Modeling and analysis of the transferability of the diagnostic box into standard care

• Prof. Dr. Verena Vogt
• Meik Hildebrandt, M.Sc.
• Kristina Söhl, MPH

• Institute of General Practice, University Hospital Erlangen: Dr. phil. Susann Hueber, Dr. med. Lisette Warkentin, and Prof. Dr. Thomas Kuehlein (Consortium Lead)
• Faculty of Medicine Carl Gustav Carus, Department of General Practice, Technische Universitaet Dresden: Dr. Dipl.-Soz. Karen Voigt
•  MPH, Dr. Jeannine Schuebel
• GWQ ServicePlus AG, Duesseldorf
• Association of Statutory Health Insurance Physicians of Thuringia (KVT), Weimar

[1] Schübel J, Voigt K, Uebel T. Erhöhter TSH-Wert in der Hausarztpraxis: S2k-Leitlinie: Deutsche Gesellschaft für Allgemeinmedizin und Familienmedizin e.V; 2023. https://www.degam.de/leitlinie-s2k-053-046.

[2] Hueber S, Biermann V, Tomandl J, Warkentin L, Schedlbauer A, Tauchmann H, Klemperer D, Lehmann M, Donnachie E, Kühlein T. Consequences of early thyroid ultrasound on subsequent tests, morbidity and costs: an explorative analysis of routine health data from German ambulatory care. BMJ Open. 2023;13(3):e059016. DOI:10.1136/bmjopen-2021-059016

[3] Hildebrandt M, Pioch C, Dammertz L, Ihle P, Nothacker M, Schneider U, Swart E, Busse R, Vogt V. Quantifying Low-Value Care in Germany: An Observational Study Using Statutory Health Insurance Data From 2018 to 2021. Value in Health. 2024. https://doi.org/10.1016/j.jval.2024.10.3852 .

The introduction of the new form of care (NVF) is being evaluated within the framework of an accompanying scientific study by the Quantitative Health Services Research working group of the Institute of General Practice. The evaluation covers the following key areas:

• Screening rates: Does the introduction of the NVF lead to a higher rate of fundus screening examinations among statutorily insured individuals with diabetes mellitus in underserved regions of Thuringia?
• Impact on ophthalmological capacities: Does the NVF relieve ophthalmic practices and create capacity for other necessary treatments?
• Implementation in practice: How effectively can the NVF be integrated into existing healthcare structures?
• Participant satisfaction: How do patients and healthcare professionals rate the new form of care?
• Cost-effectiveness: Is the NVF economically viable compared to conventional ophthalmic care?

• Prof. Dr. Verena Vogt
• Richard Schmidt
• Dr. rer. nat. Robby Markwart
• Dr. rer. medic. Sarah Salomo

Association of Statutory Health Insurance Physicians of Thuringia (KV Thuringia)

• Universitätsklinikum Jena, Institut für Allgemeinmedizin
• BARMER
• DAK-Gesundheit
• Techniker Krankenkasse

• AOK PLUS
• KKH
• BKK Landesverband Mitte