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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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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)



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




Prescription studies
Prescription studies (Huisarts & Wetenschap)

  • off-label prescribing

  • changes in reimbursed package




Sudden changes in morbidity bioterrorism
Sudden changes in morbidity (Huisarts & Wetenschap)(bioterrorism)


Towards a european morbidity network the ehid project
Towards a European morbidity network? (Huisarts & Wetenschap)(the eHID project)




Information network out of hours services
Information Network (Huisarts & Wetenschap)out of hours services


Evaluation task delegation
Evaluation task delegation (Huisarts & Wetenschap)


The future 1 need to adapt to changes in the organisation of gp care
The future (1): (Huisarts & Wetenschap)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): (Huisarts & Wetenschap)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): (Huisarts & Wetenschap)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: (Huisarts & Wetenschap)

www.linh.nl

Graph and table headings in English


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