Scientific article 17. JAN 2019
The effect of assigning dedicated general practitioners to nursing homes
Authors:
- Cecilie Dohlmann Weatherall
- Anne Toft Hansen
- Sean Nicholson
Objective: To determine whether assigning a dedicated general practitioner (GP) to a nursing home reduces hospitalizations and readmissions.
Data Sources/Study Setting: Secondary data on hospitalizations and deaths by month for the universe of nursing home residents in Denmark from January 2011 through February 2014.Study Design: In 2012, Denmark initiated a program in seven nursing homes that volunteered to participate. We used a difference-in-differences model to estimate the effect of assigning a dedicated GP to a nursing home on the likelihood that a nursing home resident will be hospitalized, will experience a preventable hospitaliza-tion, and will be readmitted. The unit of observation is a resident- month.
Data Collection/Extraction Methods: Data were extracted from the Danish public administrative register dataset.Principal Findings: We found that assigning a GP to a nursing home was associated with a 0.55 [95 percent CI, 0.08 to 1.02] percentage point reduction in the monthly probability of a preventable hospitalization, which was a 26 percent reduction from the preintervention level of 2.13 percentage points. The associated reduction in the monthly probability of a readmission was 0.68 [95 percent CI, −0.01 to 1.37] percent-age points, which was a 25 percent reduction from the baseline level of 2.68 percent-age points. Survey results indicated that the likely mechanism for the effect was more efficient and consistent communication between GPs and nursing home personnel.
Conclusions: Assigning a dedicated physician in a nursing home can reduce medical spending and improve patients’ health.
Data Sources/Study Setting: Secondary data on hospitalizations and deaths by month for the universe of nursing home residents in Denmark from January 2011 through February 2014.Study Design: In 2012, Denmark initiated a program in seven nursing homes that volunteered to participate. We used a difference-in-differences model to estimate the effect of assigning a dedicated GP to a nursing home on the likelihood that a nursing home resident will be hospitalized, will experience a preventable hospitaliza-tion, and will be readmitted. The unit of observation is a resident- month.
Data Collection/Extraction Methods: Data were extracted from the Danish public administrative register dataset.Principal Findings: We found that assigning a GP to a nursing home was associated with a 0.55 [95 percent CI, 0.08 to 1.02] percentage point reduction in the monthly probability of a preventable hospitalization, which was a 26 percent reduction from the preintervention level of 2.13 percentage points. The associated reduction in the monthly probability of a readmission was 0.68 [95 percent CI, −0.01 to 1.37] percent-age points, which was a 25 percent reduction from the baseline level of 2.68 percent-age points. Survey results indicated that the likely mechanism for the effect was more efficient and consistent communication between GPs and nursing home personnel.
Conclusions: Assigning a dedicated physician in a nursing home can reduce medical spending and improve patients’ health.
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Published in
Health Services Research
