TY - JOUR
T1 - Patient experiences with family medicine
T2 - A longitudinal study after the Dutch health care reforms in 2006
AU - Van Den Hombergh, Pieter
AU - Van Doorn-Klomberg, Arna
AU - Campbell, Stephen
AU - Wensing, Michel
AU - Braspenning, Jozé
PY - 2016
Y1 - 2016
N2 - Background: In 2006 The Dutch Health Care system changed to a market oriented system. The GP remuneration changed from ± 2/3 capitation patients and 1/3 private patients before 2006 to a mixed payment scheme. From 2006 onward every patient was insured and the GP received partly capitation, partly fees for consultations and for specific services. This change coincided with many other organisational changes in General Practice care. Our research question was if during the years after 2006 patient experiences of Dutch family practice had changed. We also wanted to explore the influence of patient and practice characteristics on patient experiences. Data on patient experiences were available from 2007 to 2012. Method: In a series of annual cross sectional patient surveys the performance of GPs and practices was measured. Patient sampling took place as a part of the Dutch accreditation program in 1657 practices involving 2966 GPs. Patients' experiences, gender, age, health status, and number of annual consultations were documented as well as the type and location of practices. Linear regression analysis was used to examine time trends in patient experiences and the impact of patient and practice characteristics. Results: 78,985 patients assessed the performance of 2966 GPs, and 45,773 patients assessed the organisation of 1657 practices. The number of patients with positive experiences increased significantly between 2007 and 2012; respectively 4.8 % for GPs (beta 0.20 and p <0.0001) and 6.6 % for practices (beta 0.10, p <0.004). Higher age, having no chronic illness, more frequent consultations and attending single-handed practices, predicted better patient experiences. Conclusions: In our evaluation of patient experiences with general practice care from 2007 to 2012 we found an increase of 4.8 % for GPs and 6.6 % for practices respectively. This improvement is significant. While no direct causation can be made, possible explanations may be found in the various reforms in Dutch family practice since 2006. More insight is needed into key determinants of this improvement before policymakers and care providers can attribute the improvement to these reforms.
AB - Background: In 2006 The Dutch Health Care system changed to a market oriented system. The GP remuneration changed from ± 2/3 capitation patients and 1/3 private patients before 2006 to a mixed payment scheme. From 2006 onward every patient was insured and the GP received partly capitation, partly fees for consultations and for specific services. This change coincided with many other organisational changes in General Practice care. Our research question was if during the years after 2006 patient experiences of Dutch family practice had changed. We also wanted to explore the influence of patient and practice characteristics on patient experiences. Data on patient experiences were available from 2007 to 2012. Method: In a series of annual cross sectional patient surveys the performance of GPs and practices was measured. Patient sampling took place as a part of the Dutch accreditation program in 1657 practices involving 2966 GPs. Patients' experiences, gender, age, health status, and number of annual consultations were documented as well as the type and location of practices. Linear regression analysis was used to examine time trends in patient experiences and the impact of patient and practice characteristics. Results: 78,985 patients assessed the performance of 2966 GPs, and 45,773 patients assessed the organisation of 1657 practices. The number of patients with positive experiences increased significantly between 2007 and 2012; respectively 4.8 % for GPs (beta 0.20 and p <0.0001) and 6.6 % for practices (beta 0.10, p <0.004). Higher age, having no chronic illness, more frequent consultations and attending single-handed practices, predicted better patient experiences. Conclusions: In our evaluation of patient experiences with general practice care from 2007 to 2012 we found an increase of 4.8 % for GPs and 6.6 % for practices respectively. This improvement is significant. While no direct causation can be made, possible explanations may be found in the various reforms in Dutch family practice since 2006. More insight is needed into key determinants of this improvement before policymakers and care providers can attribute the improvement to these reforms.
KW - Health care reform
KW - Investment in Family Medicine
KW - Patient experience
KW - Payment system
KW - Practice performance
KW - Primary care
KW - Quality of care
KW - Health Care Reform
KW - Age Factors
KW - Humans
KW - Middle Aged
KW - Private Practice/statistics & numerical data
KW - Male
KW - Netherlands
KW - Reimbursement Mechanisms
KW - Adult
KW - Female
KW - Group Practice/statistics & numerical data
KW - Surveys and Questionnaires
KW - Quality of Health Care/trends
KW - Cross-Sectional Studies
KW - Patient Satisfaction/statistics & numerical data
KW - Office Visits/statistics & numerical data
KW - Aged
KW - Chronic Disease
KW - Longitudinal Studies
KW - Family Practice/organization & administration
UR - http://www.scopus.com/inward/record.url?scp=84984601426&partnerID=8YFLogxK
UR - http://www.mendeley.com/research/patient-experiences-family-medicine-longitudinal-study-after-dutch-health-care-reforms-2006-1
U2 - 10.1186/s12875-016-0519-7
DO - 10.1186/s12875-016-0519-7
M3 - Article
C2 - 27561993
SN - 1471-2296
VL - 17
SP - 1
EP - 8
JO - BMC Family Practice
JF - BMC Family Practice
IS - 1
M1 - 118
ER -