Aged, Hospitalization, Primary Health Care
Conditions
Keywords
Collaborative practice, Seniors, Potentially avoidable hospitalization, Primary Care Team
Brief summary
The World Health Organization supports collaborative practice in primary care, defining it as when multiple health professionals from different professional backgrounds work together with patients, families, carers and communities to deliver the highest quality of care across settings (1). Previous research have shown that collaborative practice in primary care improves care pathways, efficiency of care (2,3), job satisfaction among health professionals (4-6), and economic efficiency (3,7). Riverin et al. found a reduction in post-hospitalization mortality with collaborative practice (8). In France, the establishment of primary care teams following the American model of Centered Medical Homes is encouraged. In the Pays de la Loire region, two models exist: A national and a regional model. A major issue for patient care team is the care of seniors (9,10).Hospitalizations can have adverse health effects for this population (11,12). 45% of emergency admissions follow by a hospitalization concern them (13). The hypothesis of the study is that collaborative practice could reduce the global rate of potential avoidable hospitalizations among seniors.
Interventions
OTHERPrimary care team
Patients whose general practitioner is a member of a primary care team since at least 12 months
Sponsors
Nantes University Hospital
Study design
Observational model
COHORT
Time perspective
RETROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
65 Years to No maximum
Inclusion criteria
* Patients over 75 years old and over 65 years old with chronic disease(s), with a general practitioner in Pays de la Loire, affiliated with the general health insurance system and have had at least one healthcare encounter, and residing in the Pays de la Loire region.
Exclusion criteria
* Patients whose general practitioner has ceased their practice or changed their affiliation, as well as patients who have switched to a new general practitioner.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Comparison of Global rate of potentially avoidable hospitalization | 36 months | Comparison of the global rate of potentially avoidable hospitalization of seniors, depending on whether their general practitioner is a member of a primary care team. Use of reimbursement data of Health Insurance System. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Comparison of criterion of quality | 36 months | Comparison of criterion of quality (rate of potentially avoidable hospitalization with emergency enter, rate of potentially avoidable hospitalization for patients with chronic disease(s), rate of rehospitalization at one month, mortality in post-hospitalization and rate of emergency admission), depending on whether their general practitioner is a member of a primary care team. Use of reimbursement data of Health Insurance System. |
| Comparison of Global rate of potentially avoidable hospitalization depending the model of primary care team | 36 months | Comparison of Global rate of potentially avoidable hospitalization depending the model of primary care team Description: comparison of global rate of potentially avoidable hospitalization depending general practitioner is a member of a national model of primary care team or a regional model of primary care team. Use of reimbursement data of Health Insurance System. |
| Medico-economic evaluation | 36 months | To determine health expenditures per patient, annual and total. Use of reimbursement data of Health Insurance System. |
Countries
France
Contacts
Primary ContactCédric Rat, Doctor
Outcome results
None listed