[Burning ankle sensation after partial nail extraction].

A59-year-old patient reports back to general practice with a burning sensation at the ankle a few hours after a partial nail extraction with phenolization of the nail bed. There is a chemical burn caused by a drop of phenol spilt during the procedure.

Reducing disability in community-dwelling frail older people: cost-effectiveness study alongside a cluster randomised controlled trial.

Background: although proactive primary care, including early detection and treatment of community-dwelling frail older people, is a part of the national healthcare policy in several countries, little is known about its cost-effectiveness.

Objective: to evaluate the cost-effectiveness of a proactive primary care approach in community-dwelling frail older people.

Design And Setting: embedded in a cluster randomised trial among 12 Dutch general practitioner practices, an economic evaluation was performed from a societal perspective with a time horizon of 24 months.

The challenge of transferring an implementation strategy from academia to the field: a process evaluation of local quality improvement collaboratives in Dutch primary care using the normalization process theory.

Rationale, Aims And Objectives: A quality improvement strategy consisting of comparative feedback and peer review embedded in available local quality improvement collaboratives proved to be effective in changing the test-ordering behaviour of general practitioners. However, implementing this strategy was problematic. We aimed for large-scale implementation of an adapted strategy covering both test ordering and prescribing performance.

[Securing the financing of care for the frail elderly: problems and solutions].

Projects within the Dutch National Program for Elderly Care (NPO) have been experimenting since 2008 to increase coherence in care for the frail elderly. Invest-NPO explored the problems and solutions to secure the financing of these innovative projects. Problems were expected with coordination because there was not yet a structural reimbursement for such an activity for the frail elderly.

Effectiveness of interdisciplinary primary care approach to reduce disability in community dwelling frail older people: cluster randomised controlled trial.

Objective: To evaluate whether an interdisciplinary primary care approach for community dwelling frail older people is more effective than usual care in reducing disability and preventing (further) functional decline.

Design: Cluster randomised controlled trial.

Setting: 12 general practices in the south of the Netherlands

Participants: 346 frail older people (score ≥ 5 on Groningen Frailty Indicator) were included; 270 (78%) completed the study.