Primary health care replacing hospital care--the effect on quality of care

International Journal for Quality in Health Care : Journal of the International Society for Quality in Health Care
M E KaagD de Jong

Abstract

In order to change current practice concerning hospital stays, a project was initiated in which shortening hospital stay was combined with shifting care to primary health care. Research was aimed at assessing quality of care of shortened hospital stays with home care by the community nurse and/or the general practitioner (GP). A randomized clinical trial was conducted with three subgroups: 1. traditional hospital stay; 2. hospital admission on the day of surgery, discharge the day after; two consultations at the outpatient department; one visit by the community nurse before surgery, two visits after; 3. mostly as for 2. with two GP visits replacing the two consultations at the outpatient department. The selected surgical procedures were: laparoscopic cholecystectomy, varicose veins, removal of osteosynthesis material, hernia surgery and other minor surgery (normal hospital stay 4-6 days). Every motivated patient meeting the inclusion criteria entered the study. During one year 120 patients were thus selected. Only minor differences were found between the three subgroups in the resulting quality of care. It is concluded that late admission and early discharge even without after discharge care is feasible in most cases for health...Continue Reading

Citations

Oct 3, 2008·International Journal of Technology Assessment in Health Care·Sue E Bayliss, Clare Davenport
Aug 3, 2001·Scandinavian Journal of Primary Health Care·S EngströmL Borgquist
Jun 10, 2006·European Journal of Internal Medicine·Gideon Y Stein, Aliza Zeidman
Aug 31, 2001·Epidemiologia e psichiatria sociale·B Moreno KüstnerJ D Luna del Castillo
Apr 13, 2005·Scandinavian Journal of Public Health·Lars Erik Kjekshus
May 15, 2002·The International Journal of Social Psychiatry·Berta Moreno KüstnerFrancisco Torres González
Jan 1, 1998·European Psychiatry : the Journal of the Association of European Psychiatrists·S JohnsonUNKNOWN EPCAT group
Jan 26, 2005·Journal of Health Services Research & Policy·Wim VerstappenRichard Grol

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