|- candidate number||24426|
|- NTR Number||NTR5886|
|- ISRCTN||ISRCTN no longer applicable|
|- Date ISRCTN created|
|- date ISRCTN requested|
|- Date Registered NTR||1-jun-2016|
|- Secondary IDs||16-N-104 (METC) |
|- Public Title||'Plus Practices' (Dutch: Pluspraktijken) in the pioneer site of MyCare (Dutch: MijnZorg); an evaluation study|
|- Scientific Title||'Plus Practices' (Dutch: Pluspraktijken) in the pioneer site of MyCare (MijnZorg); an evaluation study|
|- hypothesis||The aim is that Pluspraktijken result in lower health care costs compared with usual care, while maintaining or enhancing the health status and experience with care of the patients.|
|- Healt Condition(s) or Problem(s) studied||Health|
|- Inclusion criteria||general practitioners and staff of approximately 19 general practices and their patients within the region of Eastern South Limburg.|
GP practices must meet the following conditions if they want to participate in the project:
- Possess the critical quality attributes (CCC's) chronic care;
- Possess a basic registration set InEen
- Participation in the Pharmacy Project
- Certified in referring to PlusPunt
- Certified (NPA or HaZO24)
- Participation in registration networks of NIVEL
- Have a well functioning multidisciplinary meeting
- Participation in the module elderly care of CZ (health insurance)
- Have sufficient staff and space for the required interventions
- Willing to record and share data (maximum transparency)
- Willing to attend and participate in training in their free time (training in the field of medical knowledge, skills and communication)
- Be prepared to adapt business processes to promote the 'Plus Practices'
- Willing to go with patient-centered and empowerment to work and to improve their service and accessibility
|- Exclusion criteria||GP practices that are not interested in participating in the project or do not meet the inclusion criteria|
|- mec approval received||yes|
|- multicenter trial||no|
|- planned startdate ||1-jun-2016|
|- planned closingdate||1-jun-2020|
|- Target number of participants||106|
|- Interventions||Plus Practices organize care in a different way. This happens on three levels: the content of care, the care organization and financing of care. Plus Practices start with a set of interventions in three areas: Patient empowerment, effective care and care in the neighborhood. Next, we closely monitor what works and what does not.|
|- Primary outcome|| The qualitative part of this study consists of semi-structured interviews and is intended to (1) identify the barriers and facilitators of the 'Plus Practices ", (2) determine the experiences of patients, general practitioners and other stakeholders with regard to the general concept of the' Plus Practices ", (3) to identify the experiences related to the new management model, and (4) to determine the experiences related to the various interventions.
Primary outcomes of the quantitative study are: (1) Health of the population; (2) Experience of care; (3) Cost of care.
|- Secondary outcome||demographics of patients such as age, sex, level of education.
In addition, indicators for all the interventions adopted by the GP organisation (Huisartsen OZL). These indicators are used as control information for the 'Plus Practices'
|- Timepoints||For the qualitative study: The first interviews will be carried out in approximately six months from the start of the project. The follow-up measurements take place every six months until the end of the project.|
For the quantitative study: has seven measuring moments. The first measurement takes place during the start of the study. The purpose of this measurement is to identify the current situation. Next, measurement take place after every six months.
|- Trial web site|
|- CONTACT FOR PUBLIC QUERIES|| Marijn Clement- Verburg|
|- CONTACT for SCIENTIFIC QUERIES||PhD Gijs Brouwer|
|- Sponsor/Initiator ||Maastricht University|
(Source(s) of Monetary or Material Support)
|Huisartsen Oostelijk Zuid Limburg , CZ zorgverzekeringen|
|- Brief summary||‘Plus Practices’ (in Dutch: Pluspraktijken) are general practices who will start with innovation
projects. Besides this, they will work according to the new concept of positive health of Machteld
To change the health care system the Dutch ministry of Health designated nine regions across
the Netherlands in April 2013 which have been labelled as pioneer sites. The ministry will
actively monitor these innovative regions. One of those regions is Eastern South Limburg
located in the southern part of the Netherlands with pioneer site ‘My Care’ (in Dutch ‘Mijn Zorg’).
This initiative is a partnership between the only primary care organization in the region ‘GPs
Eastern South Limburg (in Dutch ‘Huisartsen Oostelijk Zuid Limburg (HOZL)), the regional
hospital Zuyderland Medical Centre, the patient representative foundation House of Care (in
Dutch ‘Huis voor de Zorg’) and the most dominant (62%) health care insurance company in the
region CZ. The pioneer site consists of several interventions that will be implemented in the
upcoming three years; initiative ‘Plus Practices’ is one of them. The basic premise is to improve
the quality of care by organizing it closer to the patient and to encourage better cooperation
between health care organizations and professionals, without increasing of the healthcare costs.
The My Care pioneer site aims to achieve more sustainable care by initiating different
interventions according to the Triple Aim principle of Berwick, Nolan and Whittington. They state
that to achieve high quality improvements of care three aims should be linked; reduced care
costs per capita should go along with improved population health and patient experiences.
In the ‘Plus Practices’ GPs and nurse practitioners will work according to the vision of positive
health. The nurse practitioners will focus more on patients with chronic diseases. GPs will focus
on patients who often visit the clinic with unexplained complaints. In their consultations with
patients they will not just talk about the physical domain, but also discuss the other domains.
The profile of ‘Plus Practices’ are in line with the general practice of the future. Which is a
practice where patients themselves have control, patients are treated effectively and the GP is
the director of the community health. The aim of the ‘Plus Practices’ is achieving the triple aim
targets: improved general health and better care at lower costs.
|- Main changes (audit trail)|
|- RECORD||1-jun-2016 - 26-jan-2018|