TY - JOUR
T1 - Cross-sectional study evaluating the association between integrated care and health-related quality of life (HRQOL) in Dutch primary care
AU - Valentijn, Pim P
AU - Kerkhoven, Marcel
AU - Heideman, Jantien
AU - Arends, Rosa
N1 - © Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.
PY - 2021/4/2
Y1 - 2021/4/2
N2 - OBJECTIVES: The aim of this study was to evaluate the association between integrated care and health-related quality of life (HRQOL) in a primary care practice population.DESIGN: A cross-sectional survey study.SETTING: Primary care practice population.PARTICIPANTS: A sample (n=5562) of patients in two general practitioner practices in the Netherlands.PRIMARY OUTCOME MEASURES: The Rainbow Model of Integrated Care Measurement Tool patient version and EQ-5D was used to assess integrated service delivery and HRQOL. The association between integrated care and HRQOL groups was analysed using multivariate logistic regression.RESULTS: Overall, 933 respondents with a mean age of 62 participated (20% response rate) in this study. The multivariate analysis revealed that positive organisational coordination experiences were linked to better HRQOL (OR=1.87, 95% CI 1.18 to 2.95), and less anxiety and depression problems (OR=0.36, 95% CI 0.20 to 0.63). Unemployment was associated with a poor HRQOL (OR=0.15, 95% CI 0.08 to 0.28). Ageing was associated with more mobility (OR=1.06, 95% CI 1.04 to 1.09), self-care (OR=1.06, 95% CI 1.02 to 1.11), usual activity (OR=1.03, 95% CI 1.01 to 1.05) and pain problems (OR=1.02, 95% CI 1.01 to 1.04). Being married improved the overall HRQOL (OR=1.60, 95% CI 1.13 to 2.26) and decreased anxiety and depression (OR=0.47, 95% CI 0.31 to 0.72). Finally, females had a poor overall HRQOL (OR=1.67, 95% CI 0.48 to 0.93) and more pain and discomfort problems (OR=1.47, 95% CI 1.11 to 1.95).CONCLUSION: This study shows for the first time that organisational coordination activities are positively associated with HROQL of adult patients in a primary care context, adding to the evidence of an association between integrated care and HRQOL. Also, unemployment, ageing and being female are accumulating risk factors that should be considered when designing integrated primary care programmes. Further research is needed to explore how various integration types relate to HRQOL for people in local communities.
AB - OBJECTIVES: The aim of this study was to evaluate the association between integrated care and health-related quality of life (HRQOL) in a primary care practice population.DESIGN: A cross-sectional survey study.SETTING: Primary care practice population.PARTICIPANTS: A sample (n=5562) of patients in two general practitioner practices in the Netherlands.PRIMARY OUTCOME MEASURES: The Rainbow Model of Integrated Care Measurement Tool patient version and EQ-5D was used to assess integrated service delivery and HRQOL. The association between integrated care and HRQOL groups was analysed using multivariate logistic regression.RESULTS: Overall, 933 respondents with a mean age of 62 participated (20% response rate) in this study. The multivariate analysis revealed that positive organisational coordination experiences were linked to better HRQOL (OR=1.87, 95% CI 1.18 to 2.95), and less anxiety and depression problems (OR=0.36, 95% CI 0.20 to 0.63). Unemployment was associated with a poor HRQOL (OR=0.15, 95% CI 0.08 to 0.28). Ageing was associated with more mobility (OR=1.06, 95% CI 1.04 to 1.09), self-care (OR=1.06, 95% CI 1.02 to 1.11), usual activity (OR=1.03, 95% CI 1.01 to 1.05) and pain problems (OR=1.02, 95% CI 1.01 to 1.04). Being married improved the overall HRQOL (OR=1.60, 95% CI 1.13 to 2.26) and decreased anxiety and depression (OR=0.47, 95% CI 0.31 to 0.72). Finally, females had a poor overall HRQOL (OR=1.67, 95% CI 0.48 to 0.93) and more pain and discomfort problems (OR=1.47, 95% CI 1.11 to 1.95).CONCLUSION: This study shows for the first time that organisational coordination activities are positively associated with HROQL of adult patients in a primary care context, adding to the evidence of an association between integrated care and HRQOL. Also, unemployment, ageing and being female are accumulating risk factors that should be considered when designing integrated primary care programmes. Further research is needed to explore how various integration types relate to HRQOL for people in local communities.
KW - cross-sectional studies
KW - delivery of health care, integrated
KW - female
KW - humans
KW - male
KW - middle aged
KW - Netherlands
KW - primary health care
KW - quality of life
KW - surveys and questionnaires
KW - cross-sectionele studies
KW - levering van gezondheidszorg, geïntegreerd
KW - vrouwelijk
KW - mensen
KW - mannelijk
KW - middelbare leeftijd
KW - Nederland
KW - basisgezondheidszorg
KW - kwaliteit van leven
KW - vragenlijsten en enquêtes
U2 - 10.1136/bmjopen-2020-040781
DO - 10.1136/bmjopen-2020-040781
M3 - Article
C2 - 33811050
SN - 2044-6055
VL - 11
JO - BMJ Open
JF - BMJ Open
IS - 4
M1 - e040781
ER -