TY - JOUR

T1 - The effect of assigning dedicated general practitioners to nursing homes

AU - Weatherall, Cecilie Dohlmann

AU - Hansen, Anne Toft

AU - Nicholson, Sean

PY - 2019/1/17

Y1 - 2019/1/17

N2 - AbstractObjectiveTo determine whether assigning a dedicated general practitioner (GP ) to a nursing home reduces hospitalizations and readmissions.Data Sources/Study SettingSecondary data on hospitalizations and deaths by month for the universe of nursing home residents in Denmark from January 2011 through February 2014.Study DesignIn 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 hospitalization, and will be readmitted. The unit of observation is a resident‐month.Data Collection/Extraction MethodsData were extracted from the Danish public administrative register dataset.Principal FindingsWe 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] percentage points, which was a 25 percent reduction from the baseline level of 2.68 percentage points. Survey results indicated that the likely mechanism for the effect was more efficient and consistent communication between GP s and nursing home personnel.ConclusionsAssigning a dedicated physician in a nursing home can reduce medical spending and improve patients' health.

AB - AbstractObjectiveTo determine whether assigning a dedicated general practitioner (GP ) to a nursing home reduces hospitalizations and readmissions.Data Sources/Study SettingSecondary data on hospitalizations and deaths by month for the universe of nursing home residents in Denmark from January 2011 through February 2014.Study DesignIn 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 hospitalization, and will be readmitted. The unit of observation is a resident‐month.Data Collection/Extraction MethodsData were extracted from the Danish public administrative register dataset.Principal FindingsWe 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] percentage points, which was a 25 percent reduction from the baseline level of 2.68 percentage points. Survey results indicated that the likely mechanism for the effect was more efficient and consistent communication between GP s and nursing home personnel.ConclusionsAssigning a dedicated physician in a nursing home can reduce medical spending and improve patients' health.

KW - dedicated physicians

KW - nursing home

KW - preventable hospitalizations

KW - readmissions

U2 - 10.1111/1475-6773.13112

DO - 10.1111/1475-6773.13112

M3 - Journal article

C2 - 30653660

VL - 54

SP - 547

EP - 554

JO - Health Services Research

JF - Health Services Research

SN - 0017-9124

IS - 3

ER -