ArticlePloS one2019
Substituting hospital-based outpatient cardiology care: The impact on quality, health and costs.
Article in PloS one, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
11 citing papers in PubMed, 1 synthesis or guideline pooled it, 29 citations in OpenAlex.
- Evidence on bringing specialised care to the primary level-effects on the Quadruple Aim and cost-effectiveness: a systematic review.BMC health services research · 2024Pooled it
- Relocating pediatric, hospital-based care towards preventive care: a qualitative study on modular care provision for children with developmental disabilities.European journal of pediatrics · 2026Article
- Geriatricians' perceptions on multidisciplinary heart failure care in Belgium an exploratory qualitative study.BMC health services research · 2026Article
- Integrating dermatologists in primary care: impact on delays, patient and professional experiences.BMC health services research · 2024Article
- Healthcare utilization patterns of individuals with depression after national policy to increase the mental health workforce in primary care: a data linkage study.BMC primary care · 2024Article
- A care substitution service in the Netherlands: impact on referral, cost, and patient satisfaction.BMC primary care · 2023Article
- Interdisciplinary Care Networks in Rehabilitation Care for Patients with Chronic Musculoskeletal Pain: A Systematic Review.Journal of clinical medicine · 2021Review
- Patients' perspectives on a new delivery model in primary care: A propensity score matched analysis of patient-reported outcomes in a Dutch cohort study.Journal of evaluation in clinical practice · 2021Article
- Physician Assistants and Nurse Practitioners in Primary Care Plus: A Systematic Review.International journal of integrated care · 2021Article
- The Monitoring of Psychosocial Factors During Hospitalization Before and After Cardiac Surgery Until Discharge From Cardiac Rehabilitation: A Research Protocol.Frontiers in psychology · 2020Article
- Economic Analysis of Specialist Referral Patterns in Mackay, Queensland Following HealthPathways Implementation.Journal of primary care & community healthArticle
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors at 4 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundMany Western countries face the challenge of providing high-quality care while keeping the healthcare system accessible and affordable. In an attempt to deal with this challenge a new healthcare delivery model called primary care plus (PC+) was introduced in the Netherlands. Within the PC+ model, medical specialists perform consultations in a primary care setting. PC+ aims to support the general practitioners in gatekeeping and prevent unnecessary referrals to hospital care. The aim of this study was to examine the effects of a cardiology PC+ intervention on the Triple Aim outcomes, which were operationalized by patient-perceived quality of care, health-related quality of life (HRQoL) outcomes, and healthcare costs per patient.
methodsThis is a quantitative study with a longitudinal observational design. The study population consisted of patients, with non-acute and low-complexity cardiology-related health complaints, who were referred to the PC+ centre (intervention group) or hospital-based outpatient care (control group; care-as-usual). Patient-perceived quality of care and HRQoL (EQ-5D-5L, EQ-VAS and SF-12) were measured through questionnaires at three different time points. Healthcare costs per patient were obtained from administrative healthcare data and patients were followed for nine months. Chi-square tests, independent t-tests and multilevel linear models were used to analyse the data.
resultsThe patient-perceived quality of care was significantly higher within the intervention group for 26 out of 27 items. HRQoL outcomes did significantly increase in both groups (P <0.05) but there was no significant interaction between group and time. At baseline and also at three, six and nine months' follow-up the healthcare costs per patient were significantly lower for patients in the intervention group (P<0.001).
conclusionsWhile this study showed no improvements on HRQoL outcomes, PC+ seemed to be promising as it results in improved quality of care as experienced by patients and lower healthcare costs per patient.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.