Information exchange between general practitioner and nursing home physician in The Netherlands.
BACKGROUND
In response to the specific characteristics of nursing home residents, the Netherlands has become the only country to develop the specialty of nursing home medicine. The "nursing home physician" has attained independent status. This development has, however, created a division between medical care in the community and medical care in nursing homes, which challenges the quality of the transitional processes taking place when a patient is admitted to or discharged from nursing home care.


OBJECTIVE
To give insight into the type of medical information exchanged between general practitioners (GPs) and nursing home physicians (NHPs) at the time of admission, while a patient is under care of the NHP, and at the time of discharge.


METHODS
Questionnaires were sent to a sample of 780 GPs, who were selected using a 2-phase sample strategy. Three hypothetical patient vignettes, involving the admission of a patient to a nursing home, to day care, and to an outreaching nursing home care project, were constructed and presented in the questionnaire. GPs were asked to answer questions about the information exchanged during the care of a patient illustrated in each vignette only if they were really familiar with a patient such as presented. The advantage of hypothetical patient vignettes is that each physician reacts to a standardized situation.


RESULTS
In the case of admitting a patient to or discharging a patient from the nursing home, results indicate that the continuity of care at those moments will be better ensured if GPs have more frequent personal contacts with NHPs. In the case of day care patients, the study also reveals that GPs who have frequent personal contact with NHPs will share relevant patient information significantly more often at the start of the day care program, both during day care and also when intercurrent medical problems occur. Similar findings can be expected in patients receiving outreaching nursing home care.


CONCLUSIONS
The findings indicate the advantages of personal contacts between different medical professionals in exchanging specific patient information. It can be expected that this will lead to more tailor-made medical care for the patient. Adequate exchange of relevant information is an important aspect of mutual collaboration between professionals. Recommendations as to how to achieve more personal contact and a better collaboration among medical professionals are proposed.
Schols
Jos M G A
JM
Faculty of Social and Behavioural Sciences, Department Tranzo, Tilburg University, Department of Family Medicine, Maastricht University, Maastricht, The Netherlands. jmga.schols@worldonline.nl <jmga.schols@worldonline.nl>
de Veer
Anke J E
AJ
D000368:Aged; D000369:Aged, 80 and over; D001291:Attitude of Health Personnel; D005194:Family Practice / Q000592:standards*; D005260:Female; D015577:Geriatric Assessment; D019538:Health Care Surveys; D006707:Homes for the Aged / Q000458:organization & administration*; D006801:Humans; D007325:Institutional Practice / Q000592:standards*; D033183:Interdisciplinary Communication; D008134:Long-Term Care; D008297:Male; D008503:Medical Staff / Q000523:psychology; D009426:Netherlands; D009735:Nursing Homes / Q000458:organization & administration*; D010317:Partnership Practice; D010821:Physicians, Family / Q000523:psychology; D011787:Quality of Health Care; D011795:Surveys and Questionnaires