Evidence map›Paper›PMID 37658285›Full record

ArticleBMC primary care2023

A care substitution service in the Netherlands: impact on referral, cost, and patient satisfaction.

Trijntje Albada, Marjolein Y Berger, Wim Brunninkhuis, Daphne van Kalken, Karin M Vermeulen, Robert J Damstra, Gea A Holtman

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in BMC primary care, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Article
  2. Article
  3. Observational
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Trijntje AlbadaDepartment of Primary and Long-term Care, University of Groningen, University Medical Center Groningen, PO Box 196, 9700 AD, Groningen, the Netherlands.
Marjolein Y BergerDepartment of Primary and Long-term Care, University of Groningen, University Medical Center Groningen, PO Box 196, 9700 AD, Groningen, the Netherlands.
Wim BrunninkhuisProject Group Care Substitution Service Regiopoli Sunenz Drachten, Drachten, the Netherlands.
Daphne van KalkenProject Group Care Substitution Service Regiopoli Sunenz Drachten, Drachten, the Netherlands.
Karin M VermeulenDepartment of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands.
Robert J DamstraDepartment of Dermatology, Phlebology and Lympho-vascular Medicine, Nij Smellinghe Hospital, Drachten, the Netherlands.
Gea A HoltmanDepartment of Primary and Long-term Care, University of Groningen, University Medical Center Groningen, PO Box 196, 9700 AD, Groningen, the Netherlands. g.a.holtman@umcg.nl.ORCID http://orcid.org/0000-0001-6579-767X

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundIn care substitution services, medical specialists offer brief consultations to provide general practitioners (GPs) with advice on diagnosis, treatment, or hospital referral. When GPs serve as gatekeepers to secondary care, these regional services could reduce pressures on healthcare systems. The aim is to determine the impact of implementing a care substitution service for dermatology, orthopaedics, and cardiology on the hospital referral rate, health care costs, and patient satisfaction.

methodsA before-after study was used to evaluate hospital referral rates and health care costs during a follow-up period of 1 year. The study population comprised patients with eligible International Classification of Primary Care codes for referral to the care substitution service (only dermatology, orthopaedic, cardiology indications), as pre-defined by GPs and medical specialists. We compared referral rates before and after implementation by χ

resultsIn total, 4,930 patients were included, 2,408 before and 2,522 after implementation. The care substitution service decreased hospital referrals during the follow-up period from 15 to 11%. The referral rate decreased most for dermatology (from 15 to 9%), resulting in a cost reduction of €10.59 per patient, while the other two specialisms experienced smaller reductions in referral rates. Patients reported being satisfied, mainly because of the null cost, improved organisation, improved care, and positive experience of the consultation.

conclusionsThe care substitution service showed promise for specialisms that require fewer hospital facilities, as exemplified by dermatology.

Indexed as

Patient SatisfactionReferral and ConsultationHumansNetherlandsPatient PreferenceSecondary Health CarePrimary health careReferral and consultationRight care at the right placeSubstitution

Identifiers

PMID37658285
PMCPMC10472548

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

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.