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An evaluation of a managed care project from the patients perspective.
Groenendijk, J.J., Delnoij, D. An evaluation of a managed care project from the patients perspective. European Journal of Public Health: 2005, 15(suppl. 1) 18. Abstract. 13th Annual EUPHA Meeting "Promoting the public's health: reorienting health policies, linking health promotion and health care", Graz, 10-12 November 2005.
Background: The American concept of managed care has found its way into European health care since
the late nineties. The ultimate goal of managed care is to improve the efficiency of health care
through promoting the quality of care and controlling the costs. A large Dutch health insurer
initiated a managed care project to reduce the consumption of acid suppressant drugs (ASDs). In 2002
a project was set up in which GPs were requested, to stimulate their patients to reduce their ASD
intake. The aim of our study was to investigate how patients experienced the intervention by the GP
and what the effect on their ASD consumption has been. Method: A uestionnaire based on CAHPS and
QUOTE was developed and sent to 770 people who chronically use ASD. Scale construction through
factor analyses with varimax rotation was performed on part of the questionnaire that measures
patients experiences with the intervention of the GP. Experience and importance scores were
calculated on the constructed scales through descriptive statistics. By combining the experiences of
patients with importance scores, which works as a weight factor, a combined measure (Quality impact
indices) is created that indicates where improvement potential in the project is. In general, high
impact indices coincide with bad experiences. The effect on ASD consumption was analyzed through
descriptive statistics of relevant items. Results: Three scales were constructed that measured
patients’ experiences during the intervention: Quality of GP support, Communication by and conduct
of the GP and Patient involvement in decisions. The experience score was relatively low on Quality
of GP support. Quality impact indices was highest on this scale (8.8 on a scale from 0 to 16). Only
47 patients (6%) were approached by their GP with the request to reduce their ASD consumption. Three
of these patients stopped using ASDs (6%), four patients changed to other medication (9%), and six
reduced their consumption of ASDs (13%). Conclusions: The managed care project initiated to reduce
chronic ASD use only seems to have had minor effects. An explanation can be found in the quality of
the support patients received from their GP when trying to stop or reduce their ASD intake.
Information and support are important issues when initiating a managed care project to reduce drugs
consumption. (aut.ref.)
the late nineties. The ultimate goal of managed care is to improve the efficiency of health care
through promoting the quality of care and controlling the costs. A large Dutch health insurer
initiated a managed care project to reduce the consumption of acid suppressant drugs (ASDs). In 2002
a project was set up in which GPs were requested, to stimulate their patients to reduce their ASD
intake. The aim of our study was to investigate how patients experienced the intervention by the GP
and what the effect on their ASD consumption has been. Method: A uestionnaire based on CAHPS and
QUOTE was developed and sent to 770 people who chronically use ASD. Scale construction through
factor analyses with varimax rotation was performed on part of the questionnaire that measures
patients experiences with the intervention of the GP. Experience and importance scores were
calculated on the constructed scales through descriptive statistics. By combining the experiences of
patients with importance scores, which works as a weight factor, a combined measure (Quality impact
indices) is created that indicates where improvement potential in the project is. In general, high
impact indices coincide with bad experiences. The effect on ASD consumption was analyzed through
descriptive statistics of relevant items. Results: Three scales were constructed that measured
patients’ experiences during the intervention: Quality of GP support, Communication by and conduct
of the GP and Patient involvement in decisions. The experience score was relatively low on Quality
of GP support. Quality impact indices was highest on this scale (8.8 on a scale from 0 to 16). Only
47 patients (6%) were approached by their GP with the request to reduce their ASD consumption. Three
of these patients stopped using ASDs (6%), four patients changed to other medication (9%), and six
reduced their consumption of ASDs (13%). Conclusions: The managed care project initiated to reduce
chronic ASD use only seems to have had minor effects. An explanation can be found in the quality of
the support patients received from their GP when trying to stop or reduce their ASD intake.
Information and support are important issues when initiating a managed care project to reduce drugs
consumption. (aut.ref.)
Background: The American concept of managed care has found its way into European health care since
the late nineties. The ultimate goal of managed care is to improve the efficiency of health care
through promoting the quality of care and controlling the costs. A large Dutch health insurer
initiated a managed care project to reduce the consumption of acid suppressant drugs (ASDs). In 2002
a project was set up in which GPs were requested, to stimulate their patients to reduce their ASD
intake. The aim of our study was to investigate how patients experienced the intervention by the GP
and what the effect on their ASD consumption has been. Method: A uestionnaire based on CAHPS and
QUOTE was developed and sent to 770 people who chronically use ASD. Scale construction through
factor analyses with varimax rotation was performed on part of the questionnaire that measures
patients experiences with the intervention of the GP. Experience and importance scores were
calculated on the constructed scales through descriptive statistics. By combining the experiences of
patients with importance scores, which works as a weight factor, a combined measure (Quality impact
indices) is created that indicates where improvement potential in the project is. In general, high
impact indices coincide with bad experiences. The effect on ASD consumption was analyzed through
descriptive statistics of relevant items. Results: Three scales were constructed that measured
patients’ experiences during the intervention: Quality of GP support, Communication by and conduct
of the GP and Patient involvement in decisions. The experience score was relatively low on Quality
of GP support. Quality impact indices was highest on this scale (8.8 on a scale from 0 to 16). Only
47 patients (6%) were approached by their GP with the request to reduce their ASD consumption. Three
of these patients stopped using ASDs (6%), four patients changed to other medication (9%), and six
reduced their consumption of ASDs (13%). Conclusions: The managed care project initiated to reduce
chronic ASD use only seems to have had minor effects. An explanation can be found in the quality of
the support patients received from their GP when trying to stop or reduce their ASD intake.
Information and support are important issues when initiating a managed care project to reduce drugs
consumption. (aut.ref.)
the late nineties. The ultimate goal of managed care is to improve the efficiency of health care
through promoting the quality of care and controlling the costs. A large Dutch health insurer
initiated a managed care project to reduce the consumption of acid suppressant drugs (ASDs). In 2002
a project was set up in which GPs were requested, to stimulate their patients to reduce their ASD
intake. The aim of our study was to investigate how patients experienced the intervention by the GP
and what the effect on their ASD consumption has been. Method: A uestionnaire based on CAHPS and
QUOTE was developed and sent to 770 people who chronically use ASD. Scale construction through
factor analyses with varimax rotation was performed on part of the questionnaire that measures
patients experiences with the intervention of the GP. Experience and importance scores were
calculated on the constructed scales through descriptive statistics. By combining the experiences of
patients with importance scores, which works as a weight factor, a combined measure (Quality impact
indices) is created that indicates where improvement potential in the project is. In general, high
impact indices coincide with bad experiences. The effect on ASD consumption was analyzed through
descriptive statistics of relevant items. Results: Three scales were constructed that measured
patients’ experiences during the intervention: Quality of GP support, Communication by and conduct
of the GP and Patient involvement in decisions. The experience score was relatively low on Quality
of GP support. Quality impact indices was highest on this scale (8.8 on a scale from 0 to 16). Only
47 patients (6%) were approached by their GP with the request to reduce their ASD consumption. Three
of these patients stopped using ASDs (6%), four patients changed to other medication (9%), and six
reduced their consumption of ASDs (13%). Conclusions: The managed care project initiated to reduce
chronic ASD use only seems to have had minor effects. An explanation can be found in the quality of
the support patients received from their GP when trying to stop or reduce their ASD intake.
Information and support are important issues when initiating a managed care project to reduce drugs
consumption. (aut.ref.)