Measuring the effects of PC+ on referral rates to hospital care (‘substitution task’) and measuring the effects of PC+ on triple aim outcomes (patient health status, experience of care and health care costs).
Conditions
Interventions
Primary Care Plus (PC+): This
intervention focuses on care substitution in which medical specialists perform consultations within a primary care setting. PC+ is assumed to slow down therising health
Sponsors
Maastricht Universitair Medisch Centrum (MUMC+)
Eligibility
Inclusion criteria
Inclusion criteria: Included in the study are all adult patients (≥18 years) registered with a GP in the region Maastricht-Heuvelland who are referred during the intervention period via the TIPP system or via the GPs service desk with non-acute, non- complex health problems to the medical specialities which provide primary care plus consultations (internal medicine, neurology, orthopaedics, dermatology, ophthalmology, rheumatology, gynecology, urology, ENT and in time possibly other medical specialties) and patients who give informed consent.
Exclusion criteria
Exclusion criteria: Excluded from participation in this study are patients present in general practice with: 1) acute health problems which require immediate referral to hospital care; 2) complex health problems that require more sophisticated diagnostics or treatments not available in a PC+ setting; 3) complaints related to a prior diagnosis of diabetes mellitus, chronic obstructive pulmonary disease and/or vascular risks, i.e. conditions for which bundled payment contracts exist between regional health insurers and ZIO.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| The primary outcome of this study is the referral rate from PC+ to hospital care. | — |
Secondary
| Measure | Time frame |
|---|---|
| Population health: Health status and health-related quality of life (HRQoL) will be measured with two generic, validated questionnaires: the EuroQol-5D (EQ-5D) and the 12-Item Short Form Health Survey (SF-12). Experience of care: Safety: Safety of care is measured using medical data made available by MUMC+ of patients from both study conditions concerning (1) hospital admissions and (2) emergency care visits. Medical data made available by insurance company VGZ is used to measure (3) mortality rates. - Equity: Equity of care is examined by performing subgroup analysis on SES and age. - Timeliness: Timeliness of care is examined by measuring the waiting time (in days) between the day that the patient makes an appointment through TIPP and the day of the 1st consultation with the medical specialist. - Patient centered: Patient centered care is measured using items from the CQ Index Outpatient care and items derived from the CQ Index GP care. - Efficiency: Efficiency of care is measured using TIPP data and medical data made available by the MUMC+ of patients from both experimental conditions concerning 1) average number of consultations within 6 months 2) average number of hospital admissions. In addition, for the PC+ condition the number and percentage of patients that is yet referred to hospital care after PC+ is measured. - Effectiveness: Effectiveness of care is measured with the PAM-13 questionnaire measuring the level of patient engagement in their health care. | — |
Contacts
Public ContactVeronique Frijns
Outcome results
None listed