Implementation of a general practitioner cooperative adjacent to the emergency department of a hospital increases the caseload for the GPC but not for the emergency department.

Background: The implementation of general practitioner cooperatives (GPC) for out-of-hours (OOH) primary care, raises the question if the location of a GPC adjacent to a hospital reduces the OOH caseload of the emergency department (ED).

Methods: Two natural experiments were used in this before-after study, the effect of the implementation of two GPCs in two different regions on the out-of-hours caseload of the local EDs was compared. One GPC was located adjacent to the ED of a general hospital, the other was not.

Improving Care And Research Electronic Data Trust Antwerp (iCAREdata): a research database of linked data on out-of-hours primary care.

Background: Primary out-of-hours care is developing throughout Europe. High-quality databases with linked data from primary health services can help to improve research and future health services.

Methods: In 2014, a central clinical research database infrastructure was established (iCAREdata: Improving Care And Research Electronic Data Trust Antwerp, www.

Staphylococcus aureus, Including Meticillin-Resistant Staphylococcus aureus, among General Practitioners and Their Patients: A Cross-Sectional Study.

Background: The role of general practitioners (GPs) as reservoir and potential source for Staphylococcus aureus (SA) transmission is unknown. Our primary objective was to evaluate the prevalence of SA and community-acquired methicillin resistant SA (CA-MRSA) carrier status (including spa typing) among GPs and their patients in Belgium. The secondary objective was to determine the association between SA/CA-MRSA carriage in patients and their characteristics, SA carriage in GPs, GP and practice characteristics.

Quality of antibiotic prescription during office hours and out-of-hours in Flemish primary care, using European quality indicators.

Background: European disease-specific antibiotic prescribing quality indicators (APQI) were proposed for seven acute indications (bronchitis, upper respiratory infection, cystitis, tonsillitis, sinusitis, otitis media and pneumonia): (a) the percentage of patients prescribed an antibiotic; (b) the percentage of patients receiving the guideline recommended antibiotic; (c) the percentage of patients receiving quinolones.

Objectives: To assess the feasibility of calculating values for these 21 APQI using primary care databases; and to assess the quality of antibiotic prescribing in office hours and out-of-hours general practice.

Methods: Data was extracted from a morbidity registration network ( http://www.

Influence of chronic comorbidity and medication on the efficacy of treatment in patients with diabetes in general practice.

Background: Evidence on the influence of comorbidity and comedication on clinical outcomes in patients with type 2 diabetes mellitus is scarce.

Aim: To ascertain the effect of five chronic diseases (joint disorder, respiratory disease, anaemia, malignancy, depression) and three chronically used drugs (non-steroid anti-inflammatory drugs [NSAIDs], corticosteroids, antidepressants) on treatment for hypoglycaemia in patients with type 2 diabetes.

Design And Setting: Retrospective cohort study in a variety of practices across Flanders, Belgium.

Quality assessment of automatically extracted data from GPs' EPR.

There are many secondary benefits to collecting routine primary care data, but we first need to understand some of the properties of this data. In this paper we describe the method used to assess the PPV and sensitivity of data extracted from Belgian GPs' EPR (diagnoses, drug prescriptions, referrals, and certain parameters), using data collected through an electronic questionnaire as a gold standard. We describe the results of the ResoPrim phase 2 project, which involved 4 software systems and 43 practices (10,307 patients).

Nation-wide primary healthcare research network: a privacy protection assessment.

Efficiency and privacy protection are essential when setting up nationwide research networks. This paper investigates the extent to which basic services developed to support the provision of care can be re-used, whilst preserving an acceptable privacy protection level, within a large Belgian primary care research network. The generic sustainable confidentiality management model used to assess the privacy protection level of the selected network architecture is described.

Relation between diabetes, metformin treatment and the occurrence of malignancies in a Belgian primary care setting.

Background: Associations between type 2 diabetic patients and a higher risk of developing cancer have been reported worldwide. Recently, a protective effect of metformin has been described.

Aim: To examine in the Belgian primary care population the relation between presence of type 2 diabetes with and without metformin treatment and the occurrence of malignancies.

Incident somatic comorbidity after psychosis: results from a retrospective cohort study based on Flemish general practice data.

Background: Psychotic conditions and especially schizophrenia, have been associated with increased morbidity and mortality. Many studies are performed in specialized settings with a strong focus on schizophrenia. Somatic comorbidity after psychosis is studied, using a general practice comorbidity registration network.

Incidence and outcome of first syncope in primary care: A retrospective cohort study.

ABSTRACT: BACKGROUND: Assessment of risk for serious cardiovascular outcome after syncope is difficult. OBJECTIVES: To determine the incidence of first syncope in primary care. To investigate the relation between syncope and serious cardiovascular (CV) outcome and serious injury.

Higher incidence of common diagnoses in patients with low back pain in primary care.

Most studies on comorbidity in low back pain (LBP) have been conducted in specialized settings with the use of self-reports. This study has an original design using data from family practices: the incidence of the most frequent diseases was compared in patients with and without LBP in 2004. The database includes data from 67 family physicians in 52 family practices in Flanders, Belgium.

Computerized general practice based networks yield comparable performance with sentinel data in monitoring epidemiological time-course of influenza-like illness and acute respiratory illness.

Background: Computerized morbidity registration networks might serve as early warning systems in a time where natural epidemics such as the H1N1 flu can easily spread from one region to another.

Methods: In this contribution we examine whether general practice based broad-spectrum computerized morbidity registration networks have the potential to act as a valid surveillance instrument of frequently occurring diseases. We compare general practice based computerized data assessing the frequency of influenza-like illness (ILI) and acute respiratory infections (ARI) with data from a well established case-specific sentinel network, the European Influenza Surveillance Scheme (EISS).

The use of human tissue in epidemiological research; ethical and legal considerations in two biobanks in Belgium.

This paper discusses the legal implications of setting up two new biobanks in Belgium. The first is hospital-based and will archive tissue from patients with haematologic cancer, whereas the second is linked to a general practice based morbidity registry and will involve storage of blood samples. To date, Belgium has no specific legislation that regulates storage of human tissue and related databases.

Trends in total cholesterol screening and in prescribing lipid-lowering drugs in general practice in the period 1994-2003.

Background: General Practitioners (GPs) play a central role in controlling an important risk factor for cardiovascular diseases, i.e. cholesterol levels in serum.

Epidemiology and comorbidity of erysipelas in primary care.

Background/aims: Most studies on the epidemiology of erysipelas are done in hospitals, resulting in patient selection. The aim of this study is to determine epidemiological characteristics and comorbidity of erysipelas based on primary care data.

Methods: Incidence rate study and nested case-control study.

Time trends in the incidence of peptic ulcers and oesophagitis between 1994 and 2003.

This study examined time trends in the incidence of peptic ulcers and oesophagitis, and the prescription of acid-inhibiting drugs in the period 1994-2003. Data were retrieved from records in general practices in Flanders, Belgium. The incidence of duodenal ulcers decreased by two-thirds and the incidence of gastric ulcers halved, the incidence of oesophagitis initially increased and decreased slowly later on.

Serious infections in children: an incidence study in family practice.

Background: Information on the incidence of serious infections in children in general practice is scarce. However, estimates on the incidence of disease are important for several reasons, for example to assess the burden of disease or as a basis of diagnostic research. We therefore estimated the incidence of serious infections in general practice in Belgium.

The denominator in general practice, a new approach from the Intego database.

Background: To determine the denominator or the 'population at risk' is a problem which has long been encountered in general practice-based epidemiological research. It is important for calculating epidemiological figures.

Objectives: The aim of this article is to demonstrate how in the absence of a patient list, a reliable denominator can be calculated, starting from the number of patients who contacted their GP in the period of one year.

Is herpes zoster a marker for occult or subsequent malignancy?

Background: It has been suggested that herpes zoster may be a marker for occult malignancy.

Aim: To examine the emergence of a subsequent cancer diagnosis in patients with and without herpes zoster.

Design Of Study: Retrospective cohort study.