학술논문

Implementation of an integrated care model between general practitioner and cardiologist : The support consultation cardiology
Document Type
JOURNAL
Source
Journal of Integrated Care, 2019, Vol. 27, Issue 4, pp. 305-315.
Subject
research-article
Research paper
cat-HSC
Health & social care
cat-HMAN
Healthcare management
cat-HSC
Health & social care
cat-HSQ
Health service quality
cat-HSD
Health service delivery
Integration
Integrated care
Management of change
Language
English
ISSN
1476-9018
Abstract
Purpose Integrated care models have shown to deliver efficient healthcare, but implementation has proven to be difficult. The Support Consultation is an integrated care model, which enables full integration by bundled payment, insurer involvement, predefined care pathways and strengthening of primary care. The purpose of this paper is to provide an indication of the improvements in healthcare delivery after implementation of this proposed model and to create a base for extension to similar interfaces between primary and secondary care. Design/methodology/approach A retrospective study was used to compare the effect on the number of referred patients with non-acute cardiac complaints and the cost effectiveness before and after implementation of the Support Consultation. Patients who previously would have been referred to the cardiologist were now discussed between general practitioner and cardiologist in a primary care setting. Findings The first consecutive 100 patients (age 55±16 years, male 48 percent), discussed in the Support Consultation, were analyzed. Implementation of the Support Consultation resulted in a net costs (program costs and referral costs) reduction of 61 percent compared with usual care. All involved parties were positive about the program. Research limitations/implications The Support Consultation has the ability to provide more effective healthcare delivery and to reduce net costs. The setting of the current study can be used as example for other specialties in countries with a similar healthcare system. Originality/value This study provides the potential cost savings after implementation of an integrated care model, based on real-life data.