Substituting hospital-based outpatient cardiology care:The impact on quality, health and costs
Background: Many Western countries face the challenge of providing high-quality care while keeping the healthcare system accessible and affordable. In an attempt to deal with this challenge a new healthcare delivery model called primary care plus (PC+) was introduced in the Netherlands. Within the PC+ model, medical specialists perform consultations in a primary care setting. PC+ aims to support the general practitioners in gatekeeping and prevent unnecessary referrals to hospital care. The aim of this study was to examine the effects of a cardiology PC+ intervention on the Triple Aim outcomes... Mehr ...
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Dokumenttyp: | Artikel |
Erscheinungsdatum: | 2019 |
Reihe/Periodikum: | Quanjel , T C C , Spreeuwenberg , M D , Struijs , J N , Baan , C A & Ruwaard , D 2019 , ' Substituting hospital-based outpatient cardiology care : The impact on quality, health and costs ' , PLOS ONE , vol. 14 , no. 5 , 217923 . https://doi.org/10.1371/journal.pone.0217923 |
Schlagwörter: | Adult / Ambulatory Care/economics / Cardiology Service / Hospital/economics / Cardiology/trends / Female / Health Care Costs / Heart Diseases/economics / Humans / Male / Middle Aged / Netherlands/epidemiology / Outpatients / Primary Health Care / Surveys and Questionnaires |
Sprache: | Englisch |
Permalink: | https://search.fid-benelux.de/Record/base-28780885 |
Datenquelle: | BASE; Originalkatalog |
Powered By: | BASE |
Link(s) : | https://research.tilburguniversity.edu/en/publications/2731af0a-be7e-4e99-bb56-6fca7c8a5f83 |
Background: Many Western countries face the challenge of providing high-quality care while keeping the healthcare system accessible and affordable. In an attempt to deal with this challenge a new healthcare delivery model called primary care plus (PC+) was introduced in the Netherlands. Within the PC+ model, medical specialists perform consultations in a primary care setting. PC+ aims to support the general practitioners in gatekeeping and prevent unnecessary referrals to hospital care. The aim of this study was to examine the effects of a cardiology PC+ intervention on the Triple Aim outcomes, which were operationalized by patient-perceived quality of care, health-related quality of life (HRQoL) outcomes, and healthcare costs per patient. Methods: This is a quantitative study with a longitudinal observational design. The study population consisted of patients, with non-acute and low-complexity cardiology-related health complaints, who were referred to the PC+ centre (intervention group) or hospital-based outpatient care (control group; care-as-usual). Patient-perceived quality of care and HRQoL (EQ-5D-5L, EQ-VAS and SF-12) were measured through questionnaires at three different time points. Healthcare costs per patient were obtained from administrative healthcare data and patients were followed for nine months. Chi-square tests, independent t-tests and multilevel linear models were used to analyse the data.Results:The patient-perceived quality of care was significantly higher within the intervention group for 26 out of 27 items. HRQoL outcomes did significantly increase in both groups (P <0.05) but there was no significant interaction between group and time. At baseline and also at three, six and nine months’ follow-up the healthcare costs per patient were significantly lower for patients in the intervention group (P<0.001). Conclusions: While this study showed no improvements on HRQoL outcomes, PC+ seemed to be promising as it results in improved quality of care as experienced by patients and lower ...