What's the effect of the implementation of general practitioner cooperatives on caseload? Prospective intervention study on primary and secondary care.
Identifieur interne : 000049 ( PubMed/Checkpoint ); précédent : 000048; suivant : 000050What's the effect of the implementation of general practitioner cooperatives on caseload? Prospective intervention study on primary and secondary care.
Auteurs : Hilde Philips [Belgique] ; Roy Remmen ; Paul Van Royen ; Marc Teblick ; Leo Geudens ; Marc Bronckaers ; Herman MeeuwisSource :
- BMC health services research [ 1472-6963 ] ; 2010.
Descripteurs français
- Wicri :
- geographic : Belgique.
English descriptors
- KwdEn :
- MESH :
- geographic : Belgium.
- organization & administration : After-Hours Care.
- Adolescent, Adult, Child, Cooperative Behavior, Diffusion of Innovation, Efficiency, Organizational, Female, Humans, Male, Middle Aged, Physicians, Family, Primary Health Care, Prospective Studies, Young Adult.
Abstract
Out-of-hours care in the primary care setting is rapidly changing and evolving towards general practitioner 'cooperatives' (GPC). GPCs already exist in the Netherlands, the United Kingdom and Scandinavia, all countries with strong general practice, including gatekeepers' role. This intervention study reports the use and caseload of out-of-hours care before and after implementation of a GPC in a well subscribed region in a country with an open access health care system and no gatekeepers' role for general practice.
DOI: 10.1186/1472-6963-10-222
PubMed: 20673342
Affiliations:
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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">What's the effect of the implementation of general practitioner cooperatives on caseload? Prospective intervention study on primary and secondary care.</title><author><name sortKey="Philips, Hilde" sort="Philips, Hilde" uniqKey="Philips H" first="Hilde" last="Philips">Hilde Philips</name><affiliation wicri:level="4"><nlm:affiliation>Department of General Practice, University of Antwerp, Universiteitsplein 1, Gebouw R, 3de verd, B-2610 Wilrijk, Belgium. hilde.philips@ua.ac.be</nlm:affiliation><country xml:lang="fr">Belgique</country><wicri:regionArea>Department of General Practice, University of Antwerp, Universiteitsplein 1, Gebouw R, 3de verd, B-2610 Wilrijk</wicri:regionArea><orgName type="university">Université d'Anvers</orgName><placeName><settlement type="city">Anvers</settlement><region type="district" nuts="2">Province d'Anvers</region></placeName></affiliation></author><author><name sortKey="Remmen, Roy" sort="Remmen, Roy" uniqKey="Remmen R" first="Roy" last="Remmen">Roy Remmen</name></author><author><name sortKey="Van Royen, Paul" sort="Van Royen, Paul" uniqKey="Van Royen P" first="Paul" last="Van Royen">Paul Van Royen</name></author><author><name sortKey="Teblick, Marc" sort="Teblick, Marc" uniqKey="Teblick M" first="Marc" last="Teblick">Marc Teblick</name></author><author><name sortKey="Geudens, Leo" sort="Geudens, Leo" uniqKey="Geudens L" first="Leo" last="Geudens">Leo Geudens</name></author><author><name sortKey="Bronckaers, Marc" sort="Bronckaers, Marc" uniqKey="Bronckaers M" first="Marc" last="Bronckaers">Marc Bronckaers</name></author><author><name sortKey="Meeuwis, Herman" sort="Meeuwis, Herman" uniqKey="Meeuwis H" first="Herman" last="Meeuwis">Herman Meeuwis</name></author></titleStmt><publicationStmt><idno type="wicri:source">PubMed</idno><date when="2010">2010</date><idno type="RBID">pubmed:20673342</idno><idno type="pmid">20673342</idno><idno type="doi">10.1186/1472-6963-10-222</idno><idno type="wicri:Area/PubMed/Corpus">000049</idno><idno type="wicri:Area/PubMed/Curation">000049</idno><idno type="wicri:Area/PubMed/Checkpoint">000049</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en">What's the effect of the implementation of general practitioner cooperatives on caseload? Prospective intervention study on primary and secondary care.</title><author><name sortKey="Philips, Hilde" sort="Philips, Hilde" uniqKey="Philips H" first="Hilde" last="Philips">Hilde Philips</name><affiliation wicri:level="4"><nlm:affiliation>Department of General Practice, University of Antwerp, Universiteitsplein 1, Gebouw R, 3de verd, B-2610 Wilrijk, Belgium. hilde.philips@ua.ac.be</nlm:affiliation><country xml:lang="fr">Belgique</country><wicri:regionArea>Department of General Practice, University of Antwerp, Universiteitsplein 1, Gebouw R, 3de verd, B-2610 Wilrijk</wicri:regionArea><orgName type="university">Université d'Anvers</orgName><placeName><settlement type="city">Anvers</settlement><region type="district" nuts="2">Province d'Anvers</region></placeName></affiliation></author><author><name sortKey="Remmen, Roy" sort="Remmen, Roy" uniqKey="Remmen R" first="Roy" last="Remmen">Roy Remmen</name></author><author><name sortKey="Van Royen, Paul" sort="Van Royen, Paul" uniqKey="Van Royen P" first="Paul" last="Van Royen">Paul Van Royen</name></author><author><name sortKey="Teblick, Marc" sort="Teblick, Marc" uniqKey="Teblick M" first="Marc" last="Teblick">Marc Teblick</name></author><author><name sortKey="Geudens, Leo" sort="Geudens, Leo" uniqKey="Geudens L" first="Leo" last="Geudens">Leo Geudens</name></author><author><name sortKey="Bronckaers, Marc" sort="Bronckaers, Marc" uniqKey="Bronckaers M" first="Marc" last="Bronckaers">Marc Bronckaers</name></author><author><name sortKey="Meeuwis, Herman" sort="Meeuwis, Herman" uniqKey="Meeuwis H" first="Herman" last="Meeuwis">Herman Meeuwis</name></author></analytic><series><title level="j">BMC health services research</title><idno type="eISSN">1472-6963</idno><imprint><date when="2010" type="published">2010</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Adolescent</term><term>Adult</term><term>After-Hours Care (organization & administration)</term><term>Belgium</term><term>Child</term><term>Cooperative Behavior</term><term>Diffusion of Innovation</term><term>Efficiency, Organizational</term><term>Female</term><term>Humans</term><term>Male</term><term>Middle Aged</term><term>Physicians, Family</term><term>Primary Health Care</term><term>Prospective Studies</term><term>Young Adult</term></keywords><keywords scheme="MESH" type="geographic" xml:lang="en"><term>Belgium</term></keywords><keywords scheme="MESH" qualifier="organization & administration" xml:lang="en"><term>After-Hours Care</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Adolescent</term><term>Adult</term><term>Child</term><term>Cooperative Behavior</term><term>Diffusion of Innovation</term><term>Efficiency, Organizational</term><term>Female</term><term>Humans</term><term>Male</term><term>Middle Aged</term><term>Physicians, Family</term><term>Primary Health Care</term><term>Prospective Studies</term><term>Young Adult</term></keywords><keywords scheme="Wicri" type="geographic" xml:lang="fr"><term>Belgique</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Out-of-hours care in the primary care setting is rapidly changing and evolving towards general practitioner 'cooperatives' (GPC). GPCs already exist in the Netherlands, the United Kingdom and Scandinavia, all countries with strong general practice, including gatekeepers' role. This intervention study reports the use and caseload of out-of-hours care before and after implementation of a GPC in a well subscribed region in a country with an open access health care system and no gatekeepers' role for general practice.</div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">20673342</PMID><DateCreated><Year>2010</Year><Month>8</Month><Day>17</Day></DateCreated><DateCompleted><Year>2010</Year><Month>11</Month><Day>08</Day></DateCompleted><DateRevised><Year>2014</Year><Month>12</Month><Day>3</Day></DateRevised><Article PubModel="Electronic"><Journal><ISSN IssnType="Electronic">1472-6963</ISSN><JournalIssue CitedMedium="Internet"><Volume>10</Volume><PubDate><Year>2010</Year><Month>Jul</Month><Day>30</Day></PubDate></JournalIssue><Title>BMC health services research</Title><ISOAbbreviation>BMC Health Serv Res</ISOAbbreviation></Journal><ArticleTitle>What's the effect of the implementation of general practitioner cooperatives on caseload? Prospective intervention study on primary and secondary care.</ArticleTitle><Pagination><MedlinePgn>222</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.1186/1472-6963-10-222</ELocationID><Abstract><AbstractText Label="BACKGROUND" NlmCategory="BACKGROUND">Out-of-hours care in the primary care setting is rapidly changing and evolving towards general practitioner 'cooperatives' (GPC). GPCs already exist in the Netherlands, the United Kingdom and Scandinavia, all countries with strong general practice, including gatekeepers' role. This intervention study reports the use and caseload of out-of-hours care before and after implementation of a GPC in a well subscribed region in a country with an open access health care system and no gatekeepers' role for general practice.</AbstractText><AbstractText Label="METHODS" NlmCategory="METHODS">We used a prospective before/after interventional study design. The intervention was the implementation of a GPC.</AbstractText><AbstractText Label="RESULTS" NlmCategory="RESULTS">One year after the implementation of a GPC, the number of patient contacts in the intervention region significantly increased at the GPC (OR: 1.645; 95% CI: 1.439-1.880), while there were no significant changes in patient contacts at the Emergency Department (ED) or in other regions where a simultaneous registration was performed. Although home visits decreased in all general practitioner registrations, the difference was more pronounced in the intervention region (intervention region: OR: 0.515; 95% CI: 0.411-0.646, other regions: OR: 0.743; 95% CI: 0.608-0.908). At the ED we observed a decrease in the number of trauma cases (OR: 0.789; 95% CI: 0.648-0.960) and of patients who came to hospital by ambulance (OR: 0.687; 95% CI: 0.565-0.836).</AbstractText><AbstractText Label="CONCLUSIONS" NlmCategory="CONCLUSIONS">One year after its implementation more people seek help at the GPC, while the number of contacts at the ED remains the same. The most prominent changes in caseload are found in the trauma cases. Establishing a GPC in an open health care system, might redirect some patients with particular medical problems to primary care. This could lead to a lowering of costs or a more cost-effective out of hours care, but further research should focus on effective usage to divert patient flows and on quality and outcome of care.</AbstractText></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Philips</LastName><ForeName>Hilde</ForeName><Initials>H</Initials><AffiliationInfo><Affiliation>Department of General Practice, University of Antwerp, Universiteitsplein 1, Gebouw R, 3de verd, B-2610 Wilrijk, Belgium. hilde.philips@ua.ac.be</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Remmen</LastName><ForeName>Roy</ForeName><Initials>R</Initials></Author><Author ValidYN="Y"><LastName>Van Royen</LastName><ForeName>Paul</ForeName><Initials>P</Initials></Author><Author ValidYN="Y"><LastName>Teblick</LastName><ForeName>Marc</ForeName><Initials>M</Initials></Author><Author ValidYN="Y"><LastName>Geudens</LastName><ForeName>Leo</ForeName><Initials>L</Initials></Author><Author ValidYN="Y"><LastName>Bronckaers</LastName><ForeName>Marc</ForeName><Initials>M</Initials></Author><Author ValidYN="Y"><LastName>Meeuwis</LastName><ForeName>Herman</ForeName><Initials>H</Initials></Author></AuthorList><Language>ENG</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2010</Year><Month>Jul</Month><Day>30</Day></ArticleDate></Article><MedlineJournalInfo><Country>England</Country><MedlineTA>BMC Health Serv Res</MedlineTA><NlmUniqueID>101088677</NlmUniqueID><ISSNLinking>1472-6963</ISSNLinking></MedlineJournalInfo><CitationSubset>IM</CitationSubset><CommentsCorrectionsList><CommentsCorrections RefType="Cites"><RefSource>Health Aff (Millwood). 2006 Nov-Dec;25(6):1733-7</RefSource><PMID Version="1">17102200</PMID></CommentsCorrections><CommentsCorrections RefType="Cites"><RefSource>Qual Saf Health Care. 2010 Dec;19(6):e3</RefSource><PMID 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UI="D000293" MajorTopicYN="N">Adolescent</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D000328" MajorTopicYN="N">Adult</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D039602" MajorTopicYN="N">After-Hours Care</DescriptorName><QualifierName UI="Q000458" MajorTopicYN="Y">organization & administration</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D001530" MajorTopicYN="N" Type="Geographic">Belgium</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D002648" MajorTopicYN="N">Child</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D003299" MajorTopicYN="Y">Cooperative Behavior</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D004059" MajorTopicYN="N">Diffusion of Innovation</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D017598" MajorTopicYN="Y">Efficiency, Organizational</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D005260" MajorTopicYN="N">Female</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008297" MajorTopicYN="N">Male</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008875" MajorTopicYN="N">Middle Aged</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D010821" MajorTopicYN="Y">Physicians, Family</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D011320" MajorTopicYN="Y">Primary Health Care</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D011446" MajorTopicYN="N">Prospective Studies</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D055815" MajorTopicYN="N">Young Adult</DescriptorName></MeshHeading></MeshHeadingList><OtherID Source="NLM">PMC2922207</OtherID></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="received"><Year>2009</Year><Month>11</Month><Day>24</Day></PubMedPubDate><PubMedPubDate PubStatus="accepted"><Year>2010</Year><Month>7</Month><Day>30</Day></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>2010</Year><Month>8</Month><Day>3</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="pubmed"><Year>2010</Year><Month>8</Month><Day>3</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2010</Year><Month>11</Month><Day>9</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate></History><PublicationStatus>epublish</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">20673342</ArticleId><ArticleId IdType="pii">1472-6963-10-222</ArticleId><ArticleId IdType="doi">10.1186/1472-6963-10-222</ArticleId><ArticleId IdType="pmc">PMC2922207</ArticleId></ArticleIdList></PubmedData></pubmed><affiliations><list><country><li>Belgique</li></country><region><li>Province d'Anvers</li></region><settlement><li>Anvers</li></settlement><orgName><li>Université d'Anvers</li></orgName></list><tree><noCountry><name sortKey="Bronckaers, Marc" sort="Bronckaers, Marc" uniqKey="Bronckaers M" first="Marc" last="Bronckaers">Marc Bronckaers</name><name sortKey="Geudens, Leo" sort="Geudens, Leo" uniqKey="Geudens L" first="Leo" last="Geudens">Leo Geudens</name><name sortKey="Meeuwis, Herman" sort="Meeuwis, Herman" uniqKey="Meeuwis H" first="Herman" last="Meeuwis">Herman Meeuwis</name><name sortKey="Remmen, Roy" sort="Remmen, Roy" uniqKey="Remmen R" first="Roy" last="Remmen">Roy Remmen</name><name sortKey="Teblick, Marc" sort="Teblick, Marc" uniqKey="Teblick M" first="Marc" last="Teblick">Marc Teblick</name><name sortKey="Van Royen, Paul" sort="Van Royen, Paul" uniqKey="Van Royen P" first="Paul" last="Van Royen">Paul Van Royen</name></noCountry><country name="Belgique"><region name="Province d'Anvers"><name sortKey="Philips, Hilde" sort="Philips, Hilde" uniqKey="Philips H" first="Hilde" last="Philips">Hilde Philips</name></region></country></tree></affiliations></record>Pour manipuler ce document sous Unix 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