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National Survey Integrated Primary Care

National Survey Integrated Primary Care. Judith Booij. Introduction. Health care in the Netherlands: costs too high Can primary care reduce costs? Works best as part of integrated care?. Integrated Primary Care. More integration since 1960’s More cost-effective

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National Survey Integrated Primary Care

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  1. National Survey Integrated Primary Care Judith Booij

  2. Introduction • Health care in the Netherlands: costs too high • Can primary care reduce costs? • Works best as part of integrated care?

  3. Integrated Primary Care • More integration since 1960’s • More cost-effective • Comparable quality of care

  4. Research question • Which aspects of integrated care are most determinative for effective and efficient care, corrected for quality of life?

  5. Study design Quality of care GP practices Extent of integrated care • Selection of 320 practices (pilot 8, main 312) • Stratification: • In 1 locationwithanother care professional • Contract withother professional • Region of the country • Degree of urbanisation • 41 Quality indicators (Braspenning et al. 2004) • Integrated care questionnaire

  6. Integrated care questionnaire • Literature review & expert panels • Dimensions of integration: • System • Organization • Professional • Clinical • Functional • Normative • 20 questions

  7. Questions to be answered • Q1: Which forms of integrated care can we identify and how often do we see each one? • Q2: Is there a relation between these forms of integrated care and other aspects of the context in which primary care facilities work (eg. forms of financing) • Q3: Is there a relation between the presence of aspects of integrated care and the quality of care delivered, corrected for quality of life in the patient population?

  8. Study design Quality of care GP practices Extent of integrated care Patients Quality of life • 300 patients per practice (total 96,000)

  9. Quality of life questionnaire • Euroqol questionnaire • Background characteristics • 96.000 patients • Mixed mode (paper and online) • Dillman method (four reminders)

  10. Study design Quality of care GP practices Extent of integrated care Patients Quality of life Dutch Insurers organization Costs of care

  11. Questions to be answered • Q4: How do primary care facilities differ from each other concerning their generated costs? • Q5: Is there a relation between the presence of aspects of integrated care and the costs generated by primary care facilities, correcting for quality of life among patients? • Q6: Is there a relation between the presence of aspects of integrated care and cost-efficiency, correcting for patient characteristics?

  12. Goals Determine: • Whatforms of integratedprimary care exist in The Netherlands • How these formsoccur • How the costs of primary care differbased on the extent of integration • If the quality of care differsbetween levels of integration Correctedforquality of life

  13. Thank you for your attention Research project by: NIVEL: Dr. J.C. Booij, Prof dr. D de Bakker Prof. dr. P.F.M. Verhaak RIVM: Dr. S. Mohnen Dr. J. N. Struijs Jan van Es institute: Drs. P. Valentijn Dr. M. Bruijnzeels

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