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LINH. The Netherlands Information Network of General Practice. Overview. position of the GP in the Netherlands organisation and funding what data are collected and how research projects the future. Organisation and funding. A j oint project of: Dutch association of GPs

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The netherlands information network of general practice linh

LINH


The netherlands information network of general practice linh

The Netherlands Information Network of General Practice


Overview

Overview

  • position of the GP in the Netherlands

  • organisation and funding

  • what data are collected and how

  • research projects

  • the future


Organisation and funding

Organisation and funding

A joint project of:

  • Dutch association of GPs

  • Dutch College of GPs

  • Centre for Quality of Care Research (WOK)

  • NIVEL

    Basic infrastructure funded by the Dutch Ministry of Health


Aims of linh

Aims of LINH:

Collect information in GP practices for:

  • health services research

  • quality of care research

  • public health monitoring


Representativeness

Representativeness

  • 80 computerised general practices (about 350.000 patients)

  • 6 major GP software packages


Data flow

Data flow

1. Every day: full morbidity and interventions recording in general practice.

2. Every six months:

  • extraction software sent to GPs

  • GPs retrieve data and send it to LINH

  • storage in central database


Data flow 2

Data flow (2)

3. Every week:

  • extraction and upload of selection of diseases in 45 practices

  • influenza surveillance


Quality assurance

Quality assurance

  • practice selection procedures

  • support for ICPC coding

  • extensive software testing and checking

  • data-flow procedures, quality checks

  • feedback reports to practices

  • practice visits (at least bi-annually)


History of linh

History of LINH


What data are collected

What data are collected?

  • contacts + diagnosis + episode typing (new/existing)

  • referrals + associated diagnosis

  • prescriptions (ATC codes) + associate diagnosis

  • diagnoses coded using ICPC

  • patient characteristics (sex, date of birth, postcode area, type of insurance)


Individual patient records

Individual patient records

  • follow patients in time (care chains)

  • comorbidity

  • comedication

  • linkage to hospital databases

  • linkage to CBS databases (eg. occupation, ethnicity)


Output some examples

Output: some examples


Annual reports on morbidity contacts prescription referrals at www linh nl

Mean number of home visits and contacts during consultation hours with the GP per patient per year, classified according to age, 2003

Annual reports on morbidity, contacts, prescription referrals at www.linh.nl


Monthly column in the journal of the dutch college of gps huisarts wetenschap

Monthly column in the Journal of the Dutch college of GPs (Huisarts & Wetenschap)


Health effects of firework disaster enschede 2000

Health effects of firework disaster Enschede (2000)


Prescription studies

Prescription studies

  • off-label prescribing

  • changes in reimbursed package


Monitoring annual influenza vaccination campaign

Monitoring annual Influenza vaccination campaign


Evaluation electronic prescribing system

Evaluation electronic prescribing system


Sudden changes in morbidity bioterrorism

Sudden changes in morbidity (bioterrorism)


Towards a european morbidity network the ehid project

Towards a European morbidity network?(the eHID project)


Antibiotics prescription in france and netherlands

Antibiotics prescription in France and Netherlands


Gp reimbursement in relation to workload

GP reimbursement in relation to workload


Information network out of hours services

Information Network out of hours services


Evaluation task delegation

Evaluation task delegation


The future 1 need to adapt to changes in the organisation of gp care

The future (1): Need to adapt to changes in the organisation of GP care

  • introduction of ‘call centers’ (triage)

  • introduction of GP co-ops for out of hours services

  • extending role of practice nurses/nurse practitioners/physician assistants

  • new referrer: occupational health care

  • no referral needed for physiotherapy


The future 2 the next step in public health monitoring

The future (2):The next step in public health monitoring

weekly extraction of data creates opportunities for:

  • monitoring infectious diseases (influenza)

  • monitoring rare diseases and sudden changes in morbidity patterns (bioterrorist attacks)


The future 3 technological innovations

The future (3):Technological innovations

  • ICPC-triggered pop-up screens

    • with extra in-depth questions

    • to investigate morbidity not covered by ICPC


More about linh at

More about LINH at:

www.linh.nl

Graph and table headings in English


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