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Workshop Abstracts

Integration and quality of care – 10 year evaluation of the “Gesundes Kinzigtal” integrated care scheme in Germany: a workshop on background, methods and results.


Helmut Hildebrandt

OptiMedis AG, DE
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The “Gesundes Kinzigtal” integrated care scheme exists since 2006. First evaluations looked at cost and quality outcomes for its start-up phase until 2011. Now, another project (INTEGRAL) evaluates the 10-year effects of the scheme. The workshop explores the Gesundes Kinzigtal approach, the INTEGRAL protocol and the evaluation results. A focus will be on lessons learned in the implementation of the evaluation.


”Gesundes Kinzigtal” – located in Baden-Wurttemberg – has been discussed internationally as one of the few examples of integrating and reorienting healthcare within a public health oriented regional intervention using a combination of activation, empowerment, health promotion and shared-decision-making. One cornerstone is the scheme’s financing model: A for-profit company of health researchers and local physicians economically co-responsible for a population of about 33,000 insured people and their health status improvement via a shared-savings contract with the statutory health insurance of this region, AOK Baden-Wurttemberg. Internal evaluations showed cost reduction effects.

Aims and Objectives

INTEGRAL analyses whether Gesundes Kinzigtal was able to maintain or improve quality of care compared to usual care in other regions. A set of 126 quality indicators was developed in a mixed-methods approach consisting of literature research, indicator database research and a Delphi process (involving representatives of patients, providers, insurances, and indicator experts). The indicators cover process- and outcome-quality and were operationalized using claims data of the AOK. A control design was applied including ~32,000 members (citizens) of Gesundes Kinzigtal as intervention group, insurees from 13 regions with similar population and healthcare infrastructure as primary control group and a random sample of AOK insurees in Baden-Wurttemberg as secondary control group (about 300,000). Statistical analysis included descriptive analysis and logistic regression models.



Target audience

The workshop is addressed to two target groups:

1)            Population health planners, policy makers and service providers implementing or running an integrated care scheme

2)            Researchers (epidemiologists, health services researchers, health economists etc.) looking to evaluate a complex integrated care intervention

Learnings/Take away

•              What are the main differences in terms of outcomes between the start-up and the consolidation phase of Gesundes Kinzigtal? What types of effects and what effect strengths can be expected from such a scheme in the long run?

•              How can these effects be measured and what are the efforts involved in the evaluation?

•              What indicators and data sources were used to capture the complexity of the Gesundes Kinzigtal intervention?

•              How was the regional comparison design set up to control for various population-related confounders?


5’ Welcome and introduction (Dr. h.c. Helmut Hildebrandt, OptiMedis)

15’ A primer on Gesundes Kinzigtal, its approach and objectives (Christoph Löschmann, Gesundes Kinzigtal (tbc))

10’ Group work: Methodological and practical requirements for a 10-year evaluation to determine the effectiveness of the scheme in its consolidation phase? (Ingo Meyer, PMV research group)

20’ The INTEGRAL indicator set (Prof. Dr. Max Geraedts, Marburg University)

20’ The INTEGRAL evaluation control design (Dr. Achim Siegel, Tübingen University)

20’ Key results of the 10-year evaluation (Dr. Ingrid Schubert, PMV research group (tbc))

Preferred length


How to Cite: Hildebrandt H. Integration and quality of care – 10 year evaluation of the “Gesundes Kinzigtal” integrated care scheme in Germany: a workshop on background, methods and results.. International Journal of Integrated Care. 2021;21(S1). DOI:
Published on 01 Sep 2021.
Peer Reviewed


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