Patient experiences with family medicine

A longitudinal study after the Dutch health care reforms in 2006

Pieter Van Den Hombergh, Arna Van Doorn-Klomberg, Stephen Campbell, Michel Wensing, Jozé Braspenning

Research output: Contribution to journalArticle

Abstract

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.
Original languageEnglish
Article number118
Pages (from-to)1-8
Number of pages8
JournalBMC Family Practice
Volume17
Issue number1
DOIs
Publication statusPublished - 2016

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Health Care Reform
Longitudinal Studies
Medicine
Referral and Consultation
Family Practice
General Practice
Capitation Fee
Remuneration
Organizational Innovation
Accreditation

Cite this

Van Den Hombergh, P., Van Doorn-Klomberg, A., Campbell, S., Wensing, M., & Braspenning, J. (2016). Patient experiences with family medicine: A longitudinal study after the Dutch health care reforms in 2006. BMC Family Practice, 17(1), 1-8. [118]. https://doi.org/10.1186/s12875-016-0519-7
Van Den Hombergh, Pieter ; Van Doorn-Klomberg, Arna ; Campbell, Stephen ; Wensing, Michel ; Braspenning, Jozé. / Patient experiences with family medicine : A longitudinal study after the Dutch health care reforms in 2006. In: BMC Family Practice. 2016 ; Vol. 17, No. 1. pp. 1-8.
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title = "Patient experiences with family medicine: A longitudinal study after the Dutch health care reforms in 2006",
abstract = "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.",
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Van Den Hombergh, P, Van Doorn-Klomberg, A, Campbell, S, Wensing, M & Braspenning, J 2016, 'Patient experiences with family medicine: A longitudinal study after the Dutch health care reforms in 2006', BMC Family Practice, vol. 17, no. 1, 118, pp. 1-8. https://doi.org/10.1186/s12875-016-0519-7

Patient experiences with family medicine : A longitudinal study after the Dutch health care reforms in 2006. / Van Den Hombergh, Pieter; Van Doorn-Klomberg, Arna; Campbell, Stephen; Wensing, Michel; Braspenning, Jozé.

In: BMC Family Practice, Vol. 17, No. 1, 118, 2016, p. 1-8.

Research output: Contribution to journalArticle

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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.

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KW - Chronic Disease

KW - Longitudinal Studies

KW - Family Practice/organization & administration

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