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Primary care and avoidable hospitalization for diabetes. Michael van den Berg Tessa van Loenen (tessa.van.loenen@rivm.nl). The QUALICOPC project. General objective: To evaluate European primary care systems on quality, equity and costs

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primary care and avoidable hospitalization for diabetes

Primary careandavoidablehospitalizationfor diabetes

Michael van den Berg

Tessa van Loenen

(tessa.van.loenen@rivm.nl)

the qualicopc project
The QUALICOPC project

General objective: To evaluate European primary care systems on quality, equity and costs

Hypothesis:The way primary care is organized in a country is related to:

  • How patients perceive the quality of pc
  • How providers deliver services
  • Overall health care outcomes (quality, equity and costs)
the qualicopc project1
The QUALICOPC project

Three Surveys

  • Amongrandom samples of GPs(around 220/country)
  • Amongpatientsvisiting GP practices(10/practice)
  • Among the field workersvisiting GP practices(1/practice)

More information on: www.qualicopc.eu

workpackage avoidable hospital admissions
Workpackage: Avoidable hospital admissions
  • Admission rates for ambulatory care sensitive conditions (ACSC)
    • Indicator for primary health care performance, quality and access
  • Which admissions can be avoided?
    • Acute conditions
    • Adverse drugs events
    • Chronic conditions  Diabetes
    • Objective:
      • Gain insight in relationships at country level between the structure and organization of primary care and the prevalence of avoidable hospitalizations for Diabetes
avoidable hospitalization
Avoidable hospitalization:

Source: OECD Health data 2011

avoidable hospital admissions and primary care
Avoidable hospital admissions and Primary care
  • 3 Primary care organizational characteristics:
    • Access
      • Financial or geographical access, ooh-care, waiting times
    • Position primary care in health care system
      • Central or marginal role, medical record keeping, referrals, continuity
    • Task profile
      • Broad or small task profiles

Hypothesis: Systems with easily accessible, central primary care with broad task profile have lower prevalence of avoidable hospitalization

methods
Methods

Data sources:

  • QUALICOPC data: GP questionnaire and Patient questionnaire
  • OECD Health care quality indicators

Analyses:

  • Analyses are based on 22 countries
  • Ecometricsfor scale construction at country level
  • Simple regressions
  • multivariable regression with one control variable: Diabetes prevalence
results taskprofile
Results: Taskprofile

* p-value <0.1

** p-value <0.05

results access
Results: Access

* p-value <0.1

** p-value <0.05

discussion
Discussion
  • Based on these preliminary data:
    • Differences between countries can partly be explained by organization and structural differences
    • Diabetes prevalence : what other factors to take into account?
  • Future steps: Include more countries
    • Update OECD data on avoidable hospitalization
    • Include more QUALICOPC countries