Department of Health Services Research, Care and Public Health Research Institute, Faculty of Health, Medicine and Life Sciences, Maastricht University, P.O. Box 616, 6200 MD, Maastricht, the Netherlands.
Research Centre for Technology in Care, Zuyd University of Applied Sciences, Heerlen, the Netherlands.
BMC Health Serv Res. 2017 Sep 6;17(1):628. doi: 10.1186/s12913-017-2580-x.
In an attempt to deal with the pressures on the health-care system and to guarantee sustainability, changes are needed. This study focuses on a cardiology primary care plus intervention. Primary care plus (PC+) is a new health-care delivery model focused on substitution of specialist care in the hospital setting with specialist care in the primary care setting. The intervention consists of a cardiology PC+ centre in which cardiologists, supported by other health-care professionals, provide consultations in a primary care setting. The PC+ centre aims to improve the health of the population and quality of care as experienced by patients, and reduce the number of referrals to hospital-based outpatient specialist care in order to reduce health-care costs. These aims reflect the Triple Aim principle. Hence, the objectives of the study are to evaluate the cardiology PC+ centre in terms of the Triple Aim outcomes and to evaluate the process of the introduction of PC+.
METHODS/DESIGN: The study is a practice-based, quantitative study with a longitudinal observational design, and an additional qualitative study to supplement, interpret and improve the quantitative study. The study population of the quantitative part will consist of adult patients (≥18 years) with non-acute and low-complexity cardiology-related health complaints, who will be referred to the cardiology PC+ centre (intervention group) or hospital-based outpatient cardiology care (control group). All eligible patients will be asked to complete questionnaires at three different time points consisting of questions about their demographics, health status and experience of care. Additionally, quantitative data will be collected about health-care utilization and related health-care costs at the PC+ centre and the hospital. The qualitative part, consisting of semi-structured interviews, focus groups, and observations, is designed to evaluate the process as well as to amplify, clarify and explain quantitative results.
This study will evaluate a cardiology PC+ centre using quantitative and supplementary qualitative methods. The findings of both sub-studies will fill a gap in knowledge about the effects of PC+ and in particular whether PC+ is able to pursue the Triple Aim outcomes.
NTR6629 (Data registered: 25-08-2017) (registered retrospectively).
为了应对医疗体系的压力并确保可持续性，需要进行变革。本研究聚焦于心脏病学初级保健加干预。初级保健加（PC+）是一种新的医疗保健提供模式，专注于将医院环境中的专科护理替代为初级保健环境中的专科护理。该干预措施包括一个心脏病学 PC+中心，其中心脏病专家在其他医疗保健专业人员的支持下，在初级保健环境中提供咨询服务。PC+中心旨在改善人群的健康状况和患者体验到的护理质量，并减少向基于医院的门诊专科护理的转诊数量，以降低医疗保健成本。这些目标反映了三重目标原则。因此，本研究的目的是评估心脏病学 PC+中心在三重目标结果方面的情况，并评估 PC+引入的过程。
方法/设计：本研究是一项基于实践的、定量的、纵向观察性研究，并进行了一项额外的定性研究，以补充、解释和改进定量研究。定量部分的研究人群将包括患有非急性和低复杂性心脏病相关健康问题的成年患者（≥18 岁），他们将被转介到心脏病学 PC+中心（干预组）或基于医院的门诊心脏病护理（对照组）。所有符合条件的患者将被要求在三个不同时间点完成调查问卷，内容包括他们的人口统计学、健康状况和护理体验相关问题。此外，还将收集有关 PC+中心和医院的卫生保健利用情况和相关卫生保健费用的定量数据。定性部分由半结构式访谈、焦点小组和观察组成，旨在评估过程，并放大、澄清和解释定量结果。
本研究将使用定量和补充定性方法评估心脏病学 PC+中心。这两个子研究的结果将填补关于 PC+效果的知识空白，特别是 PC+是否能够追求三重目标结果。
NTR6629（数据注册：2017 年 8 月 25 日）（回顾性注册）。
