Interprofessional Collaborative Practice in Primary Care: Potentially Avoidable Hospitalization (SCOPE HPE)

Collaborative Practice in Primary Care: a Comparison of the Global Rate of Potentially Avoidable Hospitalization, Depending on Whether Their General Practitioner is Part of a Primary Care Team. A Cohort Study With a 36-month Follow-up.

The World Health Organization supports collaborative practice in primary care, defining it as "when multiple health professionals from different professional backgrounds work together with patients, families, carers and communities to deliver the highest quality of care across settings" (1). Previous research have shown that collaborative practice in primary care improves care pathways, efficiency of care (2,3), job satisfaction among health professionals (4-6), and economic efficiency (3,7). Riverin et al. found a reduction in post-hospitalization mortality with collaborative practice (8).

In France, the establishment of primary care teams following the American model of Centered Medical Homes is encouraged. In the Pays de la Loire region, two models exist: A national and a regional model.

A major issue for patient care team is the care of seniors (9,10).Hospitalizations can have adverse health effects for this population (11,12). 45% of emergency admissions follow by a hospitalization concern them (13).

The hypothesis of the study is that collaborative practice could reduce the global rate of potential avoidable hospitalizations among seniors.

Study Overview

• Status: Not yet recruiting
• Conditions: Aged; Hospitalization; Primary Health Care
• Intervention / Treatment: Other: Primary care team

• Study Type: Observational
• Enrollment (Estimated): 500000

Contacts and Locations

• Study Contact: Name: Cédric RAT, Doctor; Phone Number: 02.40.41.28.28; Email: cedric.rat@univ-nantes.fr

Study Locations

• France
  • Nantes, France, 44093
    • University Hospital
    • Contact: Cédric RAT, Doctor; Phone Number: 02.40.41.28.28; Email: cedric.rat@univ-nantes.fr

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Older Adult
• Accepts Healthy Volunteers: N/A

• Sampling Method: Non-Probability Sample

Study Population

Seniors

Description

Inclusion Criteria:

• Patients over 75 years old and over 65 years old with chronic disease(s), with a general practitioner in Pays de la Loire, affiliated with the general health insurance system and have had at least one healthcare encounter, and residing in the Pays de la Loire region.

Exclusion Criteria:

• Patients whose general practitioner has ceased their practice or changed their affiliation, as well as patients who have switched to a new general practitioner.

Study Plan

How is the study designed?

Number of groups / cohorts

2

Cohorts and Interventions

Group / Cohort	Intervention / Treatment
Primary care team; Patients whose general practitioner is a member of a primary care team since at least 12 months	Other: Primary care team; Patients whose general practitioner is a member of a primary care team since at least 12 months
Traditional; Patients whose general practitioner is not part of a primary care team

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Comparison of Global rate of potentially avoidable hospitalization	Comparison of the global rate of potentially avoidable hospitalization of seniors, depending on whether their general practitioner is a member of a primary care team. Use of reimbursement data of Health Insurance System.	36 months

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Comparison of criterion of quality	Comparison of criterion of quality (rate of potentially avoidable hospitalization with emergency enter, rate of potentially avoidable hospitalization for patients with chronic disease(s), rate of rehospitalization at one month, mortality in post-hospitalization and rate of emergency admission), depending on whether their general practitioner is a member of a primary care team. Use of reimbursement data of Health Insurance System.	36 months
Comparison of Global rate of potentially avoidable hospitalization depending the model of primary care team	Comparison of Global rate of potentially avoidable hospitalization depending the model of primary care team Description: comparison of global rate of potentially avoidable hospitalization depending general practitioner is a member of a national model of primary care team or a regional model of primary care team. Use of reimbursement data of Health Insurance System.	36 months
Medico-economic evaluation	To determine health expenditures per patient, annual and total. Use of reimbursement data of Health Insurance System.	36 months

Collaborators and Investigators

• Sponsor: Nantes University Hospital

Study record dates

Study Major Dates

• Study Start (Estimated): June 1, 2024
• Primary Completion (Estimated): December 1, 2024
• Study Completion (Estimated): December 1, 2024

Study Registration Dates

• First Submitted: May 3, 2024
• First Submitted That Met QC Criteria: May 16, 2024
• First Posted (Actual): May 17, 2024

Study Record Updates

• Last Update Posted (Actual): May 17, 2024
• Last Update Submitted That Met QC Criteria: May 16, 2024
• Last Verified: May 1, 2024

More Information

Terms related to this study

• Keywords: Seniors; Collaborative practice; Potentially avoidable hospitalization; Primary Care Team
• Other Study ID Numbers: RC21_0307

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No