The first general practitioner hospital in The Netherlands: towards a new form of integrated care?
OBJECTIVE
To describe the types of patients admitted to the first Dutch general practitioner (GP) hospital, their health-related quality of life and its substitute function.


METHODS
A prospective observational study.


METHODS
The remaining 20-bed ward of a former district general hospital west of Amsterdam; a region with 62000 inhabitants and 26 GPs.


METHODS
All patients admitted during the 12 months between 1 June 1999 and 1 June 2000.


METHODS
Patients' health-related quality of life (Medical Outcome Study 36-item Short Form Health Survey, Groningen Activities Restriction Scale), GPs assessments of severity of illness (DUSOI/WONCA Severity of Illness Checklist) and alternative modes of care.


RESULTS
In total, 218 admissions were recorded divided into 3 bed categories: GP beds (n = 131), rehabilitation beds (n = 62) and nursing home beds (n = 25). The mean age of all patients was 76 years. Main reasons for admission were immobilization due to trauma at home (GP beds), rehabilitation from surgery (rehabilitation beds) and stroke (nursing home beds). Overall, patients showed a poor health-related quality of life on admission. If the GP beds had not been available, the GPs estimated that the admissions would have been almost equally divided among home care, nursing home and hospital care. The severity of the diagnosis on admission of the 'hospital-care group' appeared to be significantly higher than the other care groups.


CONCLUSIONS
The GP hospital appears to provide a valuable alternative to home care, nursing home care and hospital care, especially for elderly patients with a poor health-related quality of life who are in need of short medical and nursing care.
Moll van Charante
Eric
E
Department of General Practice, Academic Medical Center, University of Amsterdam, The Netherlands. e.p.mollvancharante@amc.uva.nl
Hartman
Esther
E
Yzermans
Joris
J
Voogt
Elsbeth
E
Klazinga
Niek
N
Bindels
Patrick
P
D000368:Aged; D019033:Delivery of Health Care, Integrated / Q000458:organization & administration*; D005194:Family Practice / Q000458:organization & administration* / Q000706:statistics & numerical data; D005260:Female; D006302:Health Services Research; D006782:Hospitals, Special / Q000458:organization & administration* / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D009426:Netherlands; D010343:Patient Admission / Q000706:statistics & numerical data; D011446:Prospective Studies; D011788:Quality of Life; D012720:Severity of Illness Index; D014600:Utilization Review