Publicatie datum

How to measure effects of integrated primary care?

Magnée, T., Mohnen, S.M., Verhaak, P., Hansen, J., Baan, C., Struijs, J., Valentijn, P., Bruijnzeels, M., Bakker, D. de. How to measure effects of integrated primary care? International Journal of Integrated Care: 2014, 14(6)


Project description
The project “Added value of Integrated Primary Health Care” aims to study
the association between integrated primary health care and quality and costs of health care. It is
assumed that integrated primary care is related to more cost-effective care. Empirical evidence for
such relationships is scarce up till now because instruments to measure these components are
missing. The main aim of this project is to develop an instrument to measure “integration of care”
and to relate this to quality of the provided care and the health care costs generated in these
practices by patients. In the first stage of the project, instruments to measure the level of
integration, the quality, and the costs of health care were developed. In a pilot study, it was tested
whether different types of data could be linked on an individual level. In this contribution we
present the early progress of the project.

Questionnaires to measure integrated primary care were developed based on literature
research and a Delphi method with expert interviews. Indicators for quality of care can be
measured by using data from GP’s Electronic Patient Records and with questionnaires among the
three most prevalent providers in primary health care (GPs, physical therapists, pharmacists). At
the information center Vektis, we have access to health claims data on patient level from all Dutch
health care insurance companies. These data include curative and care costs for the whole GP
population and information about which hospital the patients went to. In a pilot study, curative and
care costs of the patient population of 5 GP practices were linked to survey data of over 500
patients by using a Trusted-Third-Party as linking partner.

The project “Added value of Integrated Primary Health Care” includes a number of
innovative elements. First, the development of an integrated care instrument is a novelty. We hope
to inspire other researchers to collaborate with us on further improvements of this instrument. We
developed measures of quality of care from mono-centered to integrated care. The use of health
claims data is still new in health services research and very promising. Next, it was shown that
linking data on patient level is possible which is very important for answering the final research
question whether integrated primary care produces cost-effective care.