The World Health Organization supports collaborative practice in primary care, defining it as "when multiple health professionals from different professional backgrounds work together with patients, families, carers and communities to deliver the highest quality of care across settings" (1). Previous research have shown that collaborative practice in primary care improves care pathways, efficiency of care (2,3), job satisfaction among health professionals (4-6), and economic efficiency (3,7). Riverin et al. found a reduction in post-hospitalization mortality with collaborative practice (8). In France, the establishment of primary care teams following the American model of Centered Medical Homes is encouraged. In the Pays de la Loire region, two models exist: A national and a regional model. A major issue for patient care team is the care of seniors (9,10).Hospitalizations can have adverse health effects for this population (11,12). 45% of emergency admissions follow by a hospitalization concern them (13). The hypothesis of the study is that collaborative practice could reduce the global rate of potential avoidable hospitalizations among seniors.
Study Type
OBSERVATIONAL
Enrollment
500,000
Patients whose general practitioner is a member of a primary care team since at least 12 months
University Hospital
Nantes, France
Comparison of Global rate of potentially avoidable hospitalization
Comparison of the global rate of potentially avoidable hospitalization of seniors, depending on whether their general practitioner is a member of a primary care team. Use of reimbursement data of Health Insurance System.
Time frame: 36 months
Comparison of criterion of quality
Comparison of criterion of quality (rate of potentially avoidable hospitalization with emergency enter, rate of potentially avoidable hospitalization for patients with chronic disease(s), rate of rehospitalization at one month, mortality in post-hospitalization and rate of emergency admission), depending on whether their general practitioner is a member of a primary care team. Use of reimbursement data of Health Insurance System.
Time frame: 36 months
Comparison of Global rate of potentially avoidable hospitalization depending the model of primary care team
Comparison of Global rate of potentially avoidable hospitalization depending the model of primary care team Description: comparison of global rate of potentially avoidable hospitalization depending general practitioner is a member of a national model of primary care team or a regional model of primary care team. Use of reimbursement data of Health Insurance System.
Time frame: 36 months
Medico-economic evaluation
To determine health expenditures per patient, annual and total. Use of reimbursement data of Health Insurance System.
Time frame: 36 months
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