GrippeBelgiqueV4, Main, Exploration, bibRecord, 000030

Impact of the medical home model on the quality of primary care: the Belgian experience.

Identifieur interne : 000030 ( Main/Exploration ); précédent : 000029; suivant : 000031

Impact of the medical home model on the quality of primary care: the Belgian experience.

Auteurs : Catherine Moureaux [Belgique] ; Julian Perelman ; Elise Mendes Da Costa ; Isabelle Roch ; Lieven Annemans ; Isabelle Heymans ; Marie-Christine Closon

Source :

Medical care [ 1537-1948 ] ; 2015.

RBID : pubmed:25811631

Descripteurs français

KwdFr :
- Adhésion aux directives (), Adolescent, Adulte, Adulte d'âge moyen, Antibactériens (administration et posologie), Belgique, Diabète (), Diabète (diagnostic), Détection précoce de cancer (), Enfant, Enfant d'âge préscolaire, Examen des demandes de remboursement d'assurance, Femelle, Guides de bonnes pratiques cliniques comme sujet, Humains, Jeune adulte, Mâle, Nourrisson, Qualité des soins de santé (organisation et administration), Soins centrés sur le patient (), Soins centrés sur le patient (organisation et administration), Soins de santé primaires (), Soins de santé primaires (organisation et administration), Sujet âgé, Sujet âgé de 80 ans ou plus, Vaccins antigrippaux (administration et posologie), Études rétrospectives.
MESH :
- administration et posologie : Antibactériens, Vaccins antigrippaux.
- diagnostic : Diabète.
- organisation et administration : Qualité des soins de santé, Soins centrés sur le patient, Soins de santé primaires.
- Adhésion aux directives, Adolescent, Adulte, Adulte d'âge moyen, Belgique, Diabète, Détection précoce de cancer, Enfant, Enfant d'âge préscolaire, Examen des demandes de remboursement d'assurance, Femelle, Guides de bonnes pratiques cliniques comme sujet, Humains, Jeune adulte, Mâle, Nourrisson, Soins centrés sur le patient, Soins de santé primaires, Sujet âgé, Sujet âgé de 80 ans ou plus, Études rétrospectives.
Wicri :
- geographic : Belgique.

English descriptors

KwdEn :
- Adolescent, Adult, Aged, Aged, 80 and over, Anti-Bacterial Agents (administration & dosage), Belgium, Child, Child, Preschool, Diabetes Mellitus (diagnosis), Diabetes Mellitus (therapy), Early Detection of Cancer (statistics & numerical data), Female, Guideline Adherence (statistics & numerical data), Humans, Infant, Influenza Vaccines (administration & dosage), Insurance Claim Review, Male, Middle Aged, Patient-Centered Care (organization & administration), Patient-Centered Care (statistics & numerical data), Practice Guidelines as Topic, Primary Health Care (organization & administration), Primary Health Care (statistics & numerical data), Quality of Health Care (organization & administration), Retrospective Studies, Young Adult.
MESH :
- chemical , administration & dosage : Anti-Bacterial Agents, Influenza Vaccines.
- geographic : Belgium.
- diagnosis : Diabetes Mellitus.
- organization & administration : Patient-Centered Care, Primary Health Care, Quality of Health Care.
- statistics & numerical data : Early Detection of Cancer, Guideline Adherence, Patient-Centered Care, Primary Health Care.
- therapy : Diabetes Mellitus.
- Adolescent, Adult, Aged, Aged, 80 and over, Child, Child, Preschool, Female, Humans, Infant, Insurance Claim Review, Male, Middle Aged, Practice Guidelines as Topic, Retrospective Studies, Young Adult.

Abstract

BACKGROUND

The Belgium medical home (MH) model, which has been garnering support of late, resembles its US counterpart in that it aims at improving the quality of health care while containing costs.

OBJECTIVES

To compare the quality of care offered by MHs with that offered by traditional individual practices (IPs) in Belgium in terms of the extent of their adherence to clinical practice guidelines in antibiotherapy, cervical-cancer screening, influenza vaccination, and the management of diabetes.

RESEARCH DESIGN

This is a retrospective study using public insurance claims data. Data consisted of a random sample of patients using the services of MHs and IPs who were previously matched according to sex, age category, location, disability, and socioeconomic status. We applied the McNemar test, the t test, or the Wilcoxon test, depending on the type of variable being compared.

SUBJECTS

The final sample comprised 43,678 patients in the year 2004.

MEASURES

On the basis of a review of the literature, we selected 4 themes, corresponding to 25 indicators: antibiotherapy, cervical-cancer screening, influenza vaccination, and the management of diabetes.

RESULTS

MHs were more likely than IPs to adhere to evidence-based clinical practice guidelines. They prescribed less and more appropriate antibiotherapy, provided wider influenza-vaccination coverage for target groups, and provided a better follow-up for diabetics than did IPs. In regard to cervical-cancer screening, no significant differences were found.

CONCLUSIONS

MHs, as they combine a greater adherence to guidelines and savings in secondary care, are a cost-effective alternative to traditional IPs and therefore should be encouraged.

DOI: 10.1097/MLR.0000000000000347
PubMed: 25811631

Affiliations:

Links toward previous steps (curation, corpus...)

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Le document en format XML

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<term>Belgique</term>
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<term>Diabète (diagnostic)</term>
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<term>Enfant d'âge préscolaire</term>
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<term>Patient-Centered Care</term>
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<front><div type="abstract" xml:lang="en"><p><b>BACKGROUND</b>
</p>
<p>The Belgium medical home (MH) model, which has been garnering support of late, resembles its US counterpart in that it aims at improving the quality of health care while containing costs.</p>
</div>
<div type="abstract" xml:lang="en"><p><b>OBJECTIVES</b>
</p>
<p>To compare the quality of care offered by MHs with that offered by traditional individual practices (IPs) in Belgium in terms of the extent of their adherence to clinical practice guidelines in antibiotherapy, cervical-cancer screening, influenza vaccination, and the management of diabetes.</p>
</div>
<div type="abstract" xml:lang="en"><p><b>RESEARCH DESIGN</b>
</p>
<p>This is a retrospective study using public insurance claims data. Data consisted of a random sample of patients using the services of MHs and IPs who were previously matched according to sex, age category, location, disability, and socioeconomic status. We applied the McNemar test, the t test, or the Wilcoxon test, depending on the type of variable being compared.</p>
</div>
<div type="abstract" xml:lang="en"><p><b>SUBJECTS</b>
</p>
<p>The final sample comprised 43,678 patients in the year 2004.</p>
</div>
<div type="abstract" xml:lang="en"><p><b>MEASURES</b>
</p>
<p>On the basis of a review of the literature, we selected 4 themes, corresponding to 25 indicators: antibiotherapy, cervical-cancer screening, influenza vaccination, and the management of diabetes.</p>
</div>
<div type="abstract" xml:lang="en"><p><b>RESULTS</b>
</p>
<p>MHs were more likely than IPs to adhere to evidence-based clinical practice guidelines. They prescribed less and more appropriate antibiotherapy, provided wider influenza-vaccination coverage for target groups, and provided a better follow-up for diabetics than did IPs. In regard to cervical-cancer screening, no significant differences were found.</p>
</div>
<div type="abstract" xml:lang="en"><p><b>CONCLUSIONS</b>
</p>
<p>MHs, as they combine a greater adherence to guidelines and savings in secondary care, are a cost-effective alternative to traditional IPs and therefore should be encouraged.</p>
</div>
</front>
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<Title>Medical care</Title>
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<ArticleTitle>Impact of the medical home model on the quality of primary care: the Belgian experience.</ArticleTitle>
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<Abstract><AbstractText Label="BACKGROUND" NlmCategory="BACKGROUND">The Belgium medical home (MH) model, which has been garnering support of late, resembles its US counterpart in that it aims at improving the quality of health care while containing costs.</AbstractText>
<AbstractText Label="OBJECTIVES" NlmCategory="OBJECTIVE">To compare the quality of care offered by MHs with that offered by traditional individual practices (IPs) in Belgium in terms of the extent of their adherence to clinical practice guidelines in antibiotherapy, cervical-cancer screening, influenza vaccination, and the management of diabetes.</AbstractText>
<AbstractText Label="RESEARCH DESIGN" NlmCategory="METHODS">This is a retrospective study using public insurance claims data. Data consisted of a random sample of patients using the services of MHs and IPs who were previously matched according to sex, age category, location, disability, and socioeconomic status. We applied the McNemar test, the t test, or the Wilcoxon test, depending on the type of variable being compared.</AbstractText>
<AbstractText Label="SUBJECTS" NlmCategory="METHODS">The final sample comprised 43,678 patients in the year 2004.</AbstractText>
<AbstractText Label="MEASURES" NlmCategory="METHODS">On the basis of a review of the literature, we selected 4 themes, corresponding to 25 indicators: antibiotherapy, cervical-cancer screening, influenza vaccination, and the management of diabetes.</AbstractText>
<AbstractText Label="RESULTS" NlmCategory="RESULTS">MHs were more likely than IPs to adhere to evidence-based clinical practice guidelines. They prescribed less and more appropriate antibiotherapy, provided wider influenza-vaccination coverage for target groups, and provided a better follow-up for diabetics than did IPs. In regard to cervical-cancer screening, no significant differences were found.</AbstractText>
<AbstractText Label="CONCLUSIONS" NlmCategory="CONCLUSIONS">MHs, as they combine a greater adherence to guidelines and savings in secondary care, are a cost-effective alternative to traditional IPs and therefore should be encouraged.</AbstractText>
</Abstract>
<AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Moureaux</LastName>
<ForeName>Catherine</ForeName>
<Initials>C</Initials>
<AffiliationInfo><Affiliation>*School of Public Health, Université Libre de Bruxelles, Brussels, Belgium †Escola Nacional de Saúde Pública, Universidade Nova de Lisboa, Lisbon, Portugal ‡Faculté de Santé Publique, Université catholique de Louvain, Brussels, Belgium §Department of Public Health, Faculty of Medicine, Ghent University, Ghent, Belgium ∥Fédération des Maisons Médicales, Brussels, Belgium.</Affiliation>
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<QualifierName UI="Q000706" MajorTopicYN="Y">statistics & numerical data</QualifierName>
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<MeshHeading><DescriptorName UI="D011787" MajorTopicYN="N">Quality of Health Care</DescriptorName>
<QualifierName UI="Q000458" MajorTopicYN="Y">organization & administration</QualifierName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D012189" MajorTopicYN="N">Retrospective Studies</DescriptorName>
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<PubMedPubDate PubStatus="pubmed"><Year>2015</Year>
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<PubMedPubDate PubStatus="medline"><Year>2015</Year>
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<ArticleIdList><ArticleId IdType="pubmed">25811631</ArticleId>
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<affiliations><list><country><li>Belgique</li>
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<region><li>Région de Bruxelles-Capitale</li>
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<settlement><li>Bruxelles</li>
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<orgName><li>Université libre de Bruxelles</li>
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<tree><noCountry><name sortKey="Annemans, Lieven" sort="Annemans, Lieven" uniqKey="Annemans L" first="Lieven" last="Annemans">Lieven Annemans</name>
<name sortKey="Closon, Marie Christine" sort="Closon, Marie Christine" uniqKey="Closon M" first="Marie-Christine" last="Closon">Marie-Christine Closon</name>
<name sortKey="Heymans, Isabelle" sort="Heymans, Isabelle" uniqKey="Heymans I" first="Isabelle" last="Heymans">Isabelle Heymans</name>
<name sortKey="Mendes Da Costa, Elise" sort="Mendes Da Costa, Elise" uniqKey="Mendes Da Costa E" first="Elise" last="Mendes Da Costa">Elise Mendes Da Costa</name>
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<country name="Belgique"><region name="Région de Bruxelles-Capitale"><name sortKey="Moureaux, Catherine" sort="Moureaux, Catherine" uniqKey="Moureaux C" first="Catherine" last="Moureaux">Catherine Moureaux</name>
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Impact of the medical home model on the quality of primary care: the Belgian experience.

Impact of the medical home model on the quality of primary care: the Belgian experience.

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