Patients' perspectives on a new delivery model in primary care
a propensity score matched analysis of patient-reported outcomes in a Dutch cohort studyPatients' perspectives on a new delivery model in primary care
a propensity score matched analysis of patient-reported outcomes in a Dutch cohort studySamenvatting
Rationale, aims and objective: Primary Care Plus (PC+) focuses on the substitution of hospital-based medical care to the primary care setting without moving hospital facilities. The aim of this study was to examine whether population health and experience of care in PC+ could be maintained. Therefore, health-related quality of life (HRQoL) and experienced quality of care from a patient perspective were compared between patients referred to PC+ and to hospital-based outpatient care (HBOC).
Methods: This cohort study included patients from a Dutch region, visiting PC+ or HBOC between December 2014 and April 2018. With patient questionnaires (T0, T1 and T2), the HRQoL and experience of care were measured. One-to-two nearest neighbour calliper propensity score matching (PSM) was used to control for potential selection bias. Outcomes were compared using marginal linear models and Pearson chi-square tests.
Results: One thousand one hundred thirteen PC+ patients were matched to 606 HBOC patients with well-balanced baseline characteristics (SMDs <0.1). Regarding HRQoL outcomes, no significant interaction terms between time and group were found (P > .05), indicating no difference in HRQoL development between the groups over time. Regarding experienced quality of care, no differences were found between PC+ and HBOC patients. Only travel time was significantly shorter in the HBOC group (P ≤ .001).
Conclusion: Results show equal effects on HRQoL outcomes over time between the groups. Regarding experienced quality of care, only differences in travel time were found. Taken as a whole, population health and quality of care were maintained with PC+ and future research should focus more on cost-related outcomes.
Organisatie | Zuyd Hogeschool |
Afdeling | Faculteit Gezondheidszorg |
Lectoraat | Lectoraat Wijkgerichte Zorg |
Gepubliceerd in | Journal of Evaluation in Clinical Practice Vol. 27, Uitgave: 2, Pagina's: 344-355 |
Datum | 2020-06-17 |
Type | Artikel |
DOI | 10.1111/jep.13426 |
Taal | Engels |