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Implementation of an integrated care model between general practitioner and cardiologist: The support consultation cardiology

Marijke Paula Margaretha Vester (Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands)
Greetje Johanna de Grooth (Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands)
Tobias Nicolaas Bonten (Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands)
Bas Leendert van der Hoeven (Department of Cardiology, Medisch Centrum Haaglanden Westeinde, The Hague, The Netherlands)
Marieke Susanne de Doelder (Department of Cardiology, Medisch Centrum Haaglanden Westeinde, The Hague, The Netherlands)
Danielle Catharina Eindhoven (Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands)
Linda Wilhelmina Barbier (Gezondheidscentrum de Koning, The Hague, The Netherlands)
Jessica Coppens (Department of Cardiology, Medisch Centrum Haaglanden Westeinde, The Hague, The Netherlands)
Martin Jan Schalij (Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands)
Paul Ronald Maria van Dijkman (Department of Cardiology, Medisch Centrum Haaglanden Westeinde, The Hague, The Netherlands) (Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands)

Journal of Integrated Care

ISSN: 1476-9018

Article publication date: 24 September 2019

Issue publication date: 8 October 2019

126

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.

Keywords

Citation

Vester, M.P.M., de Grooth, G.J., Bonten, T.N., van der Hoeven, B.L., de Doelder, M.S., Eindhoven, D.C., Barbier, L.W., Coppens, J., Schalij, M.J. and van Dijkman, P.R.M. (2019), "Implementation of an integrated care model between general practitioner and cardiologist: The support consultation cardiology", Journal of Integrated Care, Vol. 27 No. 4, pp. 305-315. https://doi.org/10.1108/JICA-04-2019-0012

Publisher

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Emerald Publishing Limited

Copyright © 2019, Emerald Publishing Limited

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