A digital platform to support communication and organization in the general practice: Evaluation of healthcare usage and costs using claims data of a health insurer

R F Willemsen; J J Aardoom; O P van der Galiën; S van de Vijver; N H Chavannes; A Versluis

doi:10.1016/j.ijmedinf.2023.105296

A digital platform to support communication and organization in the general practice: Evaluation of healthcare usage and costs using claims data of a health insurer

Int J Med Inform. 2024 Jan:181:105296. doi: 10.1016/j.ijmedinf.2023.105296. Epub 2023 Nov 19.

Authors

R F Willemsen¹, J J Aardoom¹, O P van der Galiën², S van de Vijver³, N H Chavannes¹, A Versluis⁴

Affiliations

¹ Department of Public Health and Primary Care, Leiden University Medical Center, Hippocratespad 21, 2333 ZD Leiden, the Netherlands; National eHealth Living Lab (NeLL), Leiden University Medical Center, Hippocratespad 21, 2333 ZD Leiden, the Netherlands.
² Strategy & Innovation, Zilveren Kruis Achmea, Zeist, the Netherlands.
³ Amsterdam Health & Technology Institute, Amsterdam University Medical Center, Paasheuvelweg 25, 1105 BP Amsterdam, the Netherlands; Family Medicine Department, OLVG, Oosterpark 9, 1091 AC Amsterdam, Amsterdam, the Netherlands.
⁴ Department of Public Health and Primary Care, Leiden University Medical Center, Hippocratespad 21, 2333 ZD Leiden, the Netherlands; National eHealth Living Lab (NeLL), Leiden University Medical Center, Hippocratespad 21, 2333 ZD Leiden, the Netherlands. Electronic address: a.versluis@lumc.nl.

PMID: 37992559
DOI: 10.1016/j.ijmedinf.2023.105296

Abstract

Introduction: The pressure on general practitioners (GPs) is rising due to the increasing demand for care and a decreasing availability of GPs. eHealth is seen as one of the solutions to enhance accessibility and reduce workload. A platform supporting the organization and communication in general practice has been developed offering services, such as econsultations. This study aims to evaluate healthcare usage and costs of patients using this platform by comparing these outcomes (1) before and after implementation and (2) an intervention with a matched control group.

Material and methods: This study is a retrospective observational cohort study. To evaluate the longitudinal impact of the implementation on healthcare usage, mixed model Poisson analyses were used with time as a factor term for the within-subject analysis and exposure to the platform as a factor term and an interaction term (i.e., exposure X 6-months) in the between-subject analysis. Cost analyses were done with mixed model analyses of variance over time.

Results: The total number of GP consultations significantly increased after compared to before implementation (i.e., Rate = 1.52; p < 0.001). The number of GP consultations was higher in the intervention compared to the control group (respectively, Rate = 1.23; p = 0.035). Healthcare costs increased for GP consultations after compared to before implementation (€13,57; p < 0.001). The costs for GP consults were significantly higher in the intervention compared to the control group (€7,06; p 0.018).

Conclusion: This study showed a rise in GP consultations and costs when implementing a digital platform. This increase was presumably and partly caused by circumstances in one of the two included practices. Moreover, creating new options for contacting and communicating with the GP can enhance care accessibility and thereby driving an increase in consultations. This digital platform is a promising working method in general practice to facilitate patients and provide GPs with more flexibility.

Keywords: General practice; Health care costs; Health care utilization; Retrospective study; Teleconsultations; eHealth.

Publication types

Observational Study

MeSH terms

Communication
Delivery of Health Care
General Practice*
General Practitioners*
Health Care Costs
Humans
Insurance Carriers
Retrospective Studies