Shifting hospital care to primary care: An evaluation of cardiology care in a primary care setting in the Netherlands

T.C.C. Quanjel, J.M. Struijs, M.D. Spreeuwenberg, C. Baan, D. Ruwaard

Research output: Contribution to journalArticleScientificpeer-review

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Abstract

Background:
In an attempt to deal with the pressures on the healthcare system and to guarantee sustainability, changes are needed. This study is focused on a cardiology Primary Care Plus intervention in which cardiologists provide consultations with patients in a primary care setting in order to prevent unnecessary referrals to the hospital. This study explores which patients with non-acute and low-complexity cardiology-related health complaints should be excluded from Primary Care Plus and referred directly to specialist care in the hospital.

Methods:
This is a retrospective observational study based on quantitative data. Data collected between January 1 and December 31, 2015 were extracted from the electronic medical record system. Logistic regression analyses were used to select patient groups that should be excluded from referral to Primary Care Plus.

Results:
In total, 1525 patients were included in the analyses. Results showed that male patients, older patients, those with the referral indication ‘Stable Angina Pectoris’ or ‘Dyspnoea’ and patients whose reason for referral was ‘To confirm disease’ or ‘Screening of unclear pathology’ had a significantly higher probability of being referred to hospital care after Primary Care Plus.

Conclusions:
To achieve efficiency one should exclude patient groups with a significantly higher probability of being referred to hospital care after Primary Care Plus.
Original languageEnglish
Article number55
Number of pages8
JournalBMC Family Practice
Volume19
Issue number1
DOIs
Publication statusPublished - 2018

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Netherlands
Stable Angina
Electronic Health Records
Logistic Models
Pathology
Delivery of Health Care

Keywords

  • COST
  • GENERAL-PRACTITIONERS
  • HEALTH-CARE
  • Hospital care
  • JOINT CONSULTATION
  • OUTREACH CLINICS
  • PRESSURE
  • Primary care
  • Referrals
  • SPECIALISTS
  • Substitution
  • TRIPLE AIM

Cite this

Quanjel, T.C.C. ; Struijs, J.M. ; Spreeuwenberg, M.D. ; Baan, C. ; Ruwaard, D. / Shifting hospital care to primary care : An evaluation of cardiology care in a primary care setting in the Netherlands. In: BMC Family Practice. 2018 ; Vol. 19, No. 1.
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abstract = "Background:In an attempt to deal with the pressures on the healthcare system and to guarantee sustainability, changes are needed. This study is focused on a cardiology Primary Care Plus intervention in which cardiologists provide consultations with patients in a primary care setting in order to prevent unnecessary referrals to the hospital. This study explores which patients with non-acute and low-complexity cardiology-related health complaints should be excluded from Primary Care Plus and referred directly to specialist care in the hospital.Methods: This is a retrospective observational study based on quantitative data. Data collected between January 1 and December 31, 2015 were extracted from the electronic medical record system. Logistic regression analyses were used to select patient groups that should be excluded from referral to Primary Care Plus.Results:In total, 1525 patients were included in the analyses. Results showed that male patients, older patients, those with the referral indication ‘Stable Angina Pectoris’ or ‘Dyspnoea’ and patients whose reason for referral was ‘To confirm disease’ or ‘Screening of unclear pathology’ had a significantly higher probability of being referred to hospital care after Primary Care Plus.Conclusions: To achieve efficiency one should exclude patient groups with a significantly higher probability of being referred to hospital care after Primary Care Plus.",
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Shifting hospital care to primary care : An evaluation of cardiology care in a primary care setting in the Netherlands. / Quanjel, T.C.C.; Struijs, J.M.; Spreeuwenberg, M.D.; Baan, C.; Ruwaard, D.

In: BMC Family Practice, Vol. 19, No. 1, 55, 2018.

Research output: Contribution to journalArticleScientificpeer-review

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AU - Ruwaard, D.

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