• J Eval Clin Pract · Apr 2021

    Patients' perspectives on a new delivery model in primary care: A propensity score matched analysis of patient-reported outcomes in a Dutch cohort study.

    • van den BogaartEsther H AEHA0000-0001-6489-9586Department of Health Services Research Care and Public Health Research Institute (CAPHRI) Faculty of Health Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands., Marieke D Spreeuwenberg, Mariëlle E A L Kroese, Sofie J M van Hoof, Niels Hameleers, and Dirk Ruwaard.
    • Department of Health Services Research Care and Public Health Research Institute (CAPHRI) Faculty of Health Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands.
    • J Eval Clin Pract. 2021 Apr 1; 27 (2): 344355344-355.

    Rationale, Aims And ObjectivePrimary 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).MethodsThis 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.ResultsOne 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).ConclusionResults 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.© 2020 The Authors. Journal of Evaluation in Clinical Practice published by John Wiley & Sons Ltd.

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