Substitution or addition: An observational study of a new primary care initiative in the Netherlands.

Objective: In 2014, the Primary Care Plus (PC+) model was introduced in the Netherlands to shift low-complex specialised care from the hospital to the primary care setting. While positive effects of PC+ have been documented at individual patient level concerning health-related quality of life, perceived quality of care and care costs, its impacts on service use at the population level remain uncertain.

Methods: In this observational study, we used retrospective health insurance reimbursement claims data from the largest health insurer in the intervention region to determine service use.

Reorganising dermatology care: predictors of the substitution of secondary care with primary care.

Background: The substitution of healthcare is a way to control rising healthcare costs. The Primary Care Plus (PC+) intervention of the Dutch 'Blue Care' pioneer site aims to achieve this feat by facilitating consultations with medical specialists in the primary care setting. One of the specialties involved is dermatology.

Referral decisions and its predictors related to orthopaedic care. A retrospective study in a novel primary care setting.

Due to the ageing population, the prevalence of musculoskeletal disorders will continue to rise, as well as healthcare expenditure. To overcome these increasing expenditures, integration of orthopaedic care should be stimulated. The Primary Care Plus (PC+) intervention aimed to achieve this by facilitating collaboration between primary care and the hospital, in which specialised medical care is shifted to a primary care setting.

Does the implementation of a care pathway for patients with hip or knee osteoarthritis lead to fewer diagnostic imaging and referrals by general practitioners? A pre-post-implementation study of claims data.

Background: The Dutch care for hip and knee osteoarthritis (OA) is of good quality, but there is room for improvement regarding the efficient use of diagnostic imaging and conservative treatment. Therefore a stepped-care approach, in the shape of the care pathway 'Better exercise in osteoarthritis', was implemented to reduce the number of diagnostic imaging requested by GPs and referrals of GPs to orthopaedic care.

Methods: In 2015, the pathway is implemented with the use of educational meetings, distributing guidelines and incorporating reminders in the GPs' referral application.

Substitution of outpatient hospital care with specialist care in the primary care setting: A systematic review on quality of care, health and costs.

Rationale, Aims And Objective: Substituting outpatient hospital care with primary care is seen as a solution to decrease unnecessary referrals to outpatient hospital care and decrease rising healthcare costs. This systematic review aimed to evaluate the effects on quality of care, health and costs outcomes of substituting outpatient hospital care with primary care-based interventions, which are performed by medical specialists in face-to-face consultations in a primary care setting.

Method: The systematic review was performed using the PICO framework.

Substitution of hospital care with Primary Care Plus: differences in referral patterns according to specialty, specialist and diagnosis group.

Background: Primary Care Plus (PC+) is an intervention where patients consult specialists in a primary care setting outside the hospital. Two facilities have been founded in the city of Maastricht, the Netherlands. Main aim is to achieve substitution of hospital care with primary care and hence reduce costs.

Substituting hospital-based outpatient cardiology care: The impact on quality, health and costs.

Background: Many Western countries face the challenge of providing high-quality care while keeping the healthcare system accessible and affordable. In an attempt to deal with this challenge a new healthcare delivery model called primary care plus (PC+) was introduced in the Netherlands. Within the PC+ model, medical specialists perform consultations in a primary care setting.

Measuring Population Health from a Broader Perspective: Assessing the My Quality of Life Questionnaire.

Introduction: Population health perspectives increasingly focus on people's perception of resilience, ability to adapt and self-manage. The goal of this study is to determine whether the ("MyQualityOfLife.nl") survey is a valid and reliable instrument for assessing the broader health perspectives at population level.

Harvesting the wisdom of the crowd: using online ratings to explore care experiences in regions.

Background: Regional population health management (PHM) initiatives need an understanding of regional patient experiences to improve their services. Websites that gather patient ratings have become common and could be a helpful tool in this effort. Therefore, this study explores whether unsolicited online ratings can provide insight into (differences in) patient's experiences at a (regional) population level.

Shifting hospital care to primary care: An evaluation of cardiology care in a primary care setting in the Netherlands.

Background: In an attempt to deal with the pressures on the healthcare system and to guarantee sustainability, changes are needed. This study is focused on a cardiology Primary Care Plus intervention in which cardiologists provide consultations with patients in a primary care setting in order to prevent unnecessary referrals to the hospital. This study explores which patients with non-acute and low-complexity cardiology-related health complaints should be excluded from Primary Care Plus and referred directly to specialist care in the hospital.

Does an in-house internist at a GP practice result in reduced referrals to hospital-based specialist care?

Objective: Consistent evidence on the effects of specialist services in the primary care setting is lacking. Therefore, this study evaluated the effects of an in-house internist at a GP practice on the number of referrals to specialist care in the hospital setting. Additionally, the involved GPs and internist were asked to share their experiences with the intervention.

How to Measure Population Health: An Exploration Toward an Integration of Valid and Reliable Instruments.

Population health management initiatives are introduced to transform health and community services by implementing interventions that combine various services and address the continuum of health and well-being of populations. Insight is required into a population's health to evaluate implementation of these initiatives. This study aims to determine the performance of commonly used instruments for measuring a population's experienced health and explores the assessed concepts of population health.

Comparing the Health of Populations: Methods to Evaluate and Tailor Population Management Initiatives in the Netherlands.

Health care no longer focuses solely on patients and increasingly emphasizes regions and their populations. Strategies, such as population management (PM) initiatives, aim to improve population health and well-being by redesigning health care and community services. Hence, insight into population health is needed to tailor interventions and evaluate their effects.

The process of co-creating the interface for VENSTER, an interactive artwork for nursing home residents with dementia.

Introduction: Interactive art installations might engage nursing home residents with dementia. The main aim of this article was to describe the challenging design process of an interactive artwork for nursing home residents, in co-creation with all stakeholders and to share the used methods and lessons learned. This process is illustrated by the design of the interface of VENSTER as a case.

Evaluating a Dutch cardiology primary care plus intervention on the Triple Aim outcomes: study design of a practice-based quantitative and qualitative research.

Background: In an attempt to deal with the pressures on the health-care system and to guarantee sustainability, changes are needed. This study focuses on a cardiology primary care plus intervention. Primary care plus (PC+) is a new health-care delivery model focused on substitution of specialist care in the hospital setting with specialist care in the primary care setting.

Acceptance and usability of a home-based monitoring tool of health indicators in children of people with dementia: a Proof of Principle (POP) study.

Background: Large-scale cohort studies are needed to confirm the relation between dementia and its possible risk factors. The inclusion of people with dementia in research is a challenge, however, children of people with dementia are at risk and are highly motivated to participate in dementia research. For technologies to support home-based data collection during large-scale studies, participants should be able and willing to use technology for a longer period of time.

How nursing home residents with dementia respond to the interactive art installation 'VENSTER': a pilot study.

The goal of this study was (1) to determine whether and how nursing home residents with dementia respond to the interactive art installation in general and (2) to identify whether responses change when the content type and, therefore, the nature of the interaction with the artwork changes. The interactive art installation 'VENSTER' evokes responses in nursing home residents with dementia, illustrating the potential of interactive artworks in the nursing home environment. Frequently observed responses were naming, recognizing or asking questions about depicted content and how the installation worked, physically gesturing towards or tapping on the screen and tapping or singing along to the music.

Substitution of outpatient care with primary care: a feasibility study on the experiences among general practitioners, medical specialists and patients.

Background: Reinforcing the gatekeeping role of general practitioners (GPs) by embedding specialist knowledge into primary care is seen as a possibility for stimulating a more sustainable healthcare system and avoiding unnecessary referrals to outpatient care. An intervention called Primary Care Plus (PC+) was developed to achieve these goals. The objective of this study is to gain insight into: (1) the content and added value of PC+ consultations according to stakeholders, and (2) patient satisfaction with PC+ compared to outpatient care.

Which Triple Aim related measures are being used to evaluate population management initiatives? An international comparative analysis.

Introduction: Population management (PM) initiatives are introduced in order to create sustainable health care systems. These initiatives should focus on the continuum of health and well-being of a population by introducing interventions that integrate various services. To be successful they should pursue the Triple Aim, i.

The perceived functional benefit of dynamic arm supports in daily life.

Dynamic arm supports are provided to assist with activities of daily living (ADLs) in people with limited upper-limb function. However, the perceived functional benefit of these devices in daily life is unknown. Insight into the functional benefit may give direction to the development of new devices and may affect the factors that patients and their health care providers consider during the selection process of a device.

Robots and ICT to support play in children with severe physical disabilities: a systematic review.

Purpose: Play is an essential part of children's lives. Children with physical disabilities experience difficulties in play, especially those with severe physical disabilities. With the progress of innovative technology, the possibilities to support play are increasing.

Multidisciplinary Views on Applying Explicit and Implicit Motor Learning in Practice: An International Survey.

Background: A variety of options and techniques for causing implicit and explicit motor learning have been described in the literature. The aim of the current paper was to provide clearer guidance for practitioners on how to apply motor learning in practice by exploring experts' opinions and experiences, using the distinction between implicit and explicit motor learning as a conceptual departure point.

Methods: A survey was designed to collect and aggregate informed opinions and experiences from 40 international respondents who had demonstrable expertise related to motor learning in practice and/or research.

ICT based technology to support play for children with severe physical disabilities.

Introduction: Play is important for a child's development. Children with severe physical disabilities experience difficulties engaging in play. With the progress of technology the possibilities to support play are increasing.

The development of the MIBBO: A measure of resident preferences for physical activity in long term care settings.

Offering physical activities matching with the preferences of residents in long-term care facilities could increase compliance and contribute to client-centered care. A measure to investigate meaningful activities by using a photo-interview has been developed ("MIBBO"). In two pilot studies including 133 residents living on different wards in long-term care facilities, feasibility, most chosen activities, and consistency of preferences were investigated.

Satisfaction of users with assistive technology service delivery: An exploratory analysis of experiences of parents of children with physical and multiple disabilities.

Objective: To describe experience of assistive technology service delivery (ATSD) by parents of children with physical or multiple disabilities (aged 3-18 years).

Method: Forty-seven of 115 parents participated in a postal survey assessing satisfaction with the ATSD process, employing the QUEST 2.0 and the KWAZO scales.