Substitution of outpatient hospital care with specialist care in the primary care setting: A systematic review on quality of care, health and costs

PloS One
Sofie Johanna Maria van HoofDirk Ruwaard

Abstract

Substituting outpatient hospital care with primary care is seen as a solution to decrease unnecessary referrals to outpatient hospital care and decrease rising healthcare costs. This systematic review aimed to evaluate the effects on quality of care, health and costs outcomes of substituting outpatient hospital care with primary care-based interventions, which are performed by medical specialists in face-to-face consultations in a primary care setting. The systematic review was performed using the PICO framework. Original papers in which the premise of the intervention was to substitute outpatient hospital care with primary care through the involvement of a medical specialist in a primary care setting were eligible. A total of 14 papers were included. A substitution intervention in general practitioner (GP) practices was described in 11 papers, three described a joint consultation intervention in which GPs see patients together with a medical specialist. This study showed that substitution initiatives result mostly in favourable outcomes compared to outpatient hospital care. The initiatives resulted mostly in shorter waiting lists, shorter clinic waiting times and higher patient satisfaction. Costs for treating one extra patien...Continue Reading

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Citations

Jan 9, 2021·European Journal of Vascular and Endovascular Surgery : the Official Journal of the European Society for Vascular Surgery·Yann GouëfficPhilippe Tessier
Jun 18, 2021·The European Journal of Health Economics : HEPAC : Health Economics in Prevention and Care·Yiu-Shing LauMatt Sutton
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Sep 3, 2021·European Journal of Cardiovascular Nursing : Journal of the Working Group on Cardiovascular Nursing of the European Society of Cardiology·Jeroen M HendriksDominik Linz

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Software Mentioned

Prisma
PICO

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