Hurdles That Impede Economic Evaluations of Health Care Interventions Tested By General Practitioners In Flanders: A Qualitative Study

The threat of antimicrobial resistance has global health and economic consequences. Medical strategies to reduce unnecessary antibiotic prescribing, to conserve the effectiveness of current antimicrobials in the long term, inevitably result in short-term costs to health care providers. Economic evaluations of health care interventions therefore need to consider the short-term costs of interventions, to gain future benefits. This represents a challenge for health economists, not only in terms of the most appropriate methods for evaluation, but also in attributing the potential budget impact over time and considering health impacts on future populations. This commentary discusses the challenge of accurately capturing the cost-effectiveness of health care interventions aimed at tackling antimicrobial resistance. We reflect on methods to capture and incorporate the costs and health outcomes associated with antimicrobial resistance, the appropriateness of the quality-adjusted-life year (QALY), individual time preferences, and perspectives in economic evaluation.

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General practitioners’ perspectives on care coordination in primary health care: A qualitative study

International Journal of Care Coordination ◽

10.1177/2053434518816792 ◽

2018 ◽

Vol 21 (4) ◽

pp. 153-159 ◽

Cited By ~ 4

Author(s):

Ane Drougge Vassbotn ◽

Hege Sjøvik ◽

Trond Tjerbo ◽

Jan Frich ◽

Ivan Spehar

Keyword(s):

Health Care ◽

Primary Health Care ◽

Qualitative Study ◽

General Practitioners ◽

Care Coordination ◽

Health Care Professionals ◽

System Level ◽

Financial Barriers ◽

Financial Compensation ◽

Primary Health

Introduction To explore Norwegian general practitioners’ experiences with care coordination in primary health care. Methods Qualitative study using data from five focus groups with 32 general practitioners in Norway. We analysed the data using systematic text condensation, a descriptive and explorative method for thematic cross-case analysis of qualitative data. Results The general practitioners had different notions of care pathways. They expressed a wish and an obligation to be involved in planning and coordination of primary health-care services, but they experienced organisational and financial barriers that limited their involvement and contribution. General practitioners reported lack of information about and few opportunities for involvement in formal coordination initiatives, and they missed informal arenas for dialogue with other primary health-care professionals. They argued that the general practitioner’s role as coordinator should be recognised by other parties and that they needed financial compensation for contributions and attendance in meetings with the municipality. Discussion General practitioners need informal arenas for dialogue with other primary health-care professionals and access to relevant information to promote coordinated care. There might be an untapped potential for improving patient care involving general practitioners more in planning and coordinating services at the system level. Financial compensation of general practitioners contribution may promote increased involvement by general practitioners.

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Self-help organisations: A qualitative study of successful collaboration with general practice

Australian Journal of Primary Health ◽

10.1071/py03027 ◽

2003 ◽

Vol 9 (3) ◽

pp. 75 ◽

Cited By ~ 6

Author(s):

Frances M Boyle ◽

T. Natasha Posner ◽

Christopher B Del Mar ◽

Jill McLean ◽

Robert A Bush

Keyword(s):

Health Care ◽

General Practice ◽

Qualitative Study ◽

General Practitioners ◽

Health Care System ◽

Cross Section ◽

Structured Interviews ◽

Self Help ◽

Successful Collaboration ◽

Two Sectors

Thousands of self-help organisations (SHOs) exist in Australia but little is known about how they relate to the mainstream health care system. This qualitative study, based in south-east Queensland, aimed to identify examples of collaboration between general practitioners (GPs) and SHOs in order to examine the attributes of successful partnerships. Representatives of six SHOs, identified by key informants as having good collaborative links with GPs, and seven GPs with whom they collaborated, completed semi-structured interviews. The interviews focused on evidence of collaboration and perceptions of benefits and barriers experienced. Maximum variation sampling enabled a cross-section of SHOs in terms of size, funding, and health issue. Although GPs readily identified SHO benefits, they referred patients to them only rarely. SHO credibility, evidence of tangible benefits for patients, ease of contacting the SHO, and correspondence between the SHO?s focus and the GP?s personal and professional interests appear to contribute to the success of partnerships. We conclude that mutually beneficial partnerships between GPs and SHOs exist but are under-utilised. A more coordinated effort is needed to strengthen links between the two sectors.

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