Senior researcher Disasters and Environmental Hazards
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The first general practitioner hospital in The Netherlands: towards a new form of integrated care?
Moll van Charante, E., Hartman, E., IJzermans, J., Voogt, E., Klazinga, N., Bindels, P. The first general practitioner hospital in The Netherlands: towards a new form of integrated care? Scandinavian Journal of Primary Health Care: 2004, 22(1), 38-43
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Objective: To describe the types of patients admitted to the first Dutch general practitioner (GP) hospital, their health-related quality of life and its substitute function. Design: A prospective observational study. Setting. The remaining 20-bed ward of a former district general hospital west of Amsterdam; a region with 62 000 inhabitants and 26 GPs. Subjects: All patients admitted during the 12 months between 1 June 1999 and 1 June 2000. Main outcome measures: Patients' health-related quality of life (Medical Outcome Study 36-item Short Form Health Survey, Groningen Activities Restriction Scale), GPs assessments of severity of illness (DUSOI/WONCA Severity of Illness checklist) and alternative modes of care. Results: In total, 218 admissions were recorded beds (n=62) and nursing home beds (n=25). The mean age of all patients was 76 years. Main reasons for admission were immobilization due to trauma at home (GP beds), rehabilitation from surgery (rehabilitation beds) and stroke (nursing home beds). Overall, patients showed a poor health-related quality of life on admission. If the GP beds had not been available, the GPs estimated that the admissions would have been almost equally divided among home care, nursing home and hospital care. The severity of the diagnosis on admission of the 'hospital-care group' appeared to be significant higher than the other care groups. Conclusion: The GP hospital appears to provide a valuable alternative to home care, nursing home care and hospital care, especially for elderly patients with a poor health-related quality of life who are in need of short medical and nursing care. (aut.ref.)
Objective: To describe the types of patients admitted to the first Dutch general practitioner (GP) hospital, their health-related quality of life and its substitute function. Design: A prospective observational study. Setting. The remaining 20-bed ward of a former district general hospital west of Amsterdam; a region with 62 000 inhabitants and 26 GPs. Subjects: All patients admitted during the 12 months between 1 June 1999 and 1 June 2000. Main outcome measures: Patients' health-related quality of life (Medical Outcome Study 36-item Short Form Health Survey, Groningen Activities Restriction Scale), GPs assessments of severity of illness (DUSOI/WONCA Severity of Illness checklist) and alternative modes of care. Results: In total, 218 admissions were recorded beds (n=62) and nursing home beds (n=25). The mean age of all patients was 76 years. Main reasons for admission were immobilization due to trauma at home (GP beds), rehabilitation from surgery (rehabilitation beds) and stroke (nursing home beds). Overall, patients showed a poor health-related quality of life on admission. If the GP beds had not been available, the GPs estimated that the admissions would have been almost equally divided among home care, nursing home and hospital care. The severity of the diagnosis on admission of the 'hospital-care group' appeared to be significant higher than the other care groups. Conclusion: The GP hospital appears to provide a valuable alternative to home care, nursing home care and hospital care, especially for elderly patients with a poor health-related quality of life who are in need of short medical and nursing care. (aut.ref.)