Patients' perspectives on a new delivery model in primary care: A propensity score matched analysis of patient‐reported outcomes in a Dutch cohort study

Abstract Rationale, aims and objective Primary Care Plus (PC+) focuses on the substitution of hospital‐based medical care to the primary care setting without moving hospital facilities. The aim of this study was to examine whether population health and experience of care in PC+ could be maintained. Therefore, health‐related quality of life (HRQoL) and experienced quality of care from a patient perspective were compared between patients referred to PC+ and to hospital‐based outpatient care (HBOC). Methods This cohort study included patients from a Dutch region, visiting PC+ or HBOC between Dece... Mehr ...

Verfasser: van den Bogaart, Esther H. A.
Spreeuwenberg, Marieke D.
Kroese, Mariëlle E. A. L.
van Hoof, Sofie J. M.
Hameleers, Niels
Ruwaard, Dirk
Dokumenttyp: Artikel
Erscheinungsdatum: 2020
Reihe/Periodikum: Journal of Evaluation in Clinical Practice ; volume 27, issue 2, page 344-355 ; ISSN 1356-1294 1365-2753
Verlag/Hrsg.: Wiley
Sprache: Englisch
Permalink: https://search.fid-benelux.de/Record/base-29051363
Datenquelle: BASE; Originalkatalog
Powered By: BASE
Link(s) : http://dx.doi.org/10.1111/jep.13426

Abstract Rationale, aims and objective Primary Care Plus (PC+) focuses on the substitution of hospital‐based medical care to the primary care setting without moving hospital facilities. The aim of this study was to examine whether population health and experience of care in PC+ could be maintained. Therefore, health‐related quality of life (HRQoL) and experienced quality of care from a patient perspective were compared between patients referred to PC+ and to hospital‐based outpatient care (HBOC). Methods This cohort study included patients from a Dutch region, visiting PC+ or HBOC between December 2014 and April 2018. With patient questionnaires (T0, T1 and T2), the HRQoL and experience of care were measured. One‐to‐two nearest neighbour calliper propensity score matching (PSM) was used to control for potential selection bias. Outcomes were compared using marginal linear models and Pearson chi‐square tests. Results One thousand one hundred thirteen PC+ patients were matched to 606 HBOC patients with well‐balanced baseline characteristics (SMDs <0.1). Regarding HRQoL outcomes, no significant interaction terms between time and group were found ( P > .05), indicating no difference in HRQoL development between the groups over time. Regarding experienced quality of care, no differences were found between PC+ and HBOC patients. Only travel time was significantly shorter in the HBOC group ( P ≤ .001). Conclusion Results show equal effects on HRQoL outcomes over time between the groups. Regarding experienced quality of care, only differences in travel time were found. Taken as a whole, population health and quality of care were maintained with PC+ and future research should focus more on cost‐related outcomes.