Achterstandswijken zijn impopulair bij huisartsen

Hingstman, L.; Kenens, Raymond

doi:10.1007/bf03085773

Cited by 19 publications

(21 citation statements)

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“…To minimize this possible bias, we offered accreditation points for completing the questionnaire, creating an incentive to participate for all GPs. In addition, although GPs in the in the age group of 55-64 years were somewhat overrepresented, overall, our sample corresponded quite well with the total population of Dutch GPs in terms of basic characteristics [20]. Secondly, perceived barriers depend on GPs perceptions' of the situation and may not accurately reflect the (whole spectrum of) barriers.…”

Section: Discussionmentioning

confidence: 85%

Perceived barriers to guideline adherence: A survey among general practitioners

et al. 2011

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BackgroundDespite considerable efforts to promote and support guideline use, adherence is often suboptimal. Barriers to adherence vary not only across guidelines but also across recommendations within guidelines. The aim of this study was to assess the perceived barriers to guideline adherence among GPs by focusing on key recommendations within guidelines.MethodsWe conducted a cross-sectional electronic survey among 703 GPs in the Netherlands. Sixteen key recommendations were derived from four national guidelines. Six statements were included to address the attitudes towards guidelines in general. In addition, GPs were asked to rate their perceived adherence (one statement) and the perceived barriers (fourteen statements) for each of the key recommendations, based on an existing framework.Results264 GPs (38%) completed the questionnaire. Although 35% of the GPs reported difficulties in changing routines and habits to follow guidelines, 89% believed that following guidelines leads to improved patient care. Perceived adherence varied between 52 and 95% across recommendations (mean: 77%). The most perceived barriers were related to external factors, in particular patient ability and behaviour (mean: 30%) and patient preferences (mean: 23%). Lack of applicability of recommendations in general (mean: 22%) and more specifically to individual patients (mean: 25%) were also frequently perceived as barriers. The scores on perceived barriers differed largely between recommendations [minimum range 14%; maximum range 67%].ConclusionsDutch GPs have a positive attitude towards the NHG guidelines, report high adherence rates and low levels of perceived barriers. However, the perceived adherence and perceived barriers varied largely across recommendations. The most perceived barriers across recommendations are patient related, suggesting that current guidelines do not always adequately incorporate patient preferences, needs and abilities. It may be useful to provide tools such as decision aids, supporting the flexible use of guidelines to individual patients in practice.

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Section: Discussionmentioning

confidence: 85%

Perceived barriers to guideline adherence: A survey among general practitioners

et al. 2011

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“…Compared to the Dutch population of GPs [29], GPs working in group practices and in practices located in a rural area or small town were slightly overrepresented.…”

Section: Resultsmentioning

confidence: 99%

Guidelines on uncomplicated urinary tract infections are difficult to follow: perceived barriers and suggested interventions

et al. 2010

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BackgroundUrinary tract infections (UTI) are among the most common health problems seen in general practice. Evidence-based guidelines on UTI are available, but adherence to these guidelines varies widely among practitioners for reasons not well understood. The aim of this study was to identify the barriers to the implementation of a guideline on UTI perceived by Dutch general practitioners (GPs) and to explore interventions to overcome these barriers.MethodsA focus group study, including 13 GPs working in general practices in the Netherlands, was conducted. Key recommendations on diagnosis and treatment of uncomplicated UTI were selected from the guideline. Barriers to guideline adherence and possible interventions to address these barriers were discussed. The focus group session was audio-taped and transcribed verbatim. Barriers were classified according to an existing framework.ResultsLack of agreement with the recommendations, unavailable and inconvenient materials (i.e. dipslides), and organisational constraints were perceived as barriers for the diagnostic recommendations. Barriers to implementing the treatment recommendations were lack of applicability and organisational constraints related to the availability of drugs in pharmacies. Suggested interventions were to provide small group education to GPs and practice staff members, to improve organisation and coordination of care in out of hour services, to improve the availability of preferred dosages of drugs, and to pilot-test guidelines regionally.ConclusionsDespite sufficient knowledge of the recommendations on UTI, attitudinal and external barriers made it difficult to follow them in practice. The care concerning UTI could be optimized if these barriers are adequately addressed in implementation strategies. The feasibility and success of these strategies could be improved by involving the target group of the guideline in selecting useful interventions to address the barriers to implementation.

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“…Information on GP supply in the Netherlands was obtained from the national GP registry for the year 2009 [ 24 ]. The GP registry contains characteristics for every GP and GP practice in the Netherlands.…”

Section: Methodsmentioning

confidence: 99%

The construction of a decision tool to analyse local demand and local supply for GP care using a synthetic estimation model

Graaf-Ruizendaal

Bakker

2013

Hum Resour Health

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BackgroundThis study addresses the growing academic and policy interest in the appropriate provision of local healthcare services to the healthcare needs of local populations to increase health status and decrease healthcare costs. However, for most local areas information on the demand for primary care and supply is missing. The research goal is to examine the construction of a decision tool which enables healthcare planners to analyse local supply and demand in order to arrive at a better match.MethodsNational sample-based medical record data of general practitioners (GPs) were used to predict the local demand for GP care based on local populations using a synthetic estimation technique. Next, the surplus or deficit in local GP supply were calculated using the national GP registry. Subsequently, a dynamic internet tool was built to present demand, supply and the confrontation between supply and demand regarding GP care for local areas and their surroundings in the Netherlands.ResultsRegression analysis showed a significant relationship between sociodemographic predictors of postcode areas and GP consultation time (F [14, 269,467] = 2,852.24; P <0.001). The statistical model could estimate GP consultation time for every postcode area with >1,000 inhabitants in the Netherlands covering 97% of the total population. Confronting these estimated demand figures with the actual GP supply resulted in the average GP workload and the number of full-time equivalent (FTE) GP too much/too few for local areas to cover the demand for GP care. An estimated shortage of one FTE GP or more was prevalent in about 19% of the postcode areas with >1,000 inhabitants if the surrounding postcode areas were taken into consideration. Underserved areas were mainly found in rural regions.ConclusionsThe constructed decision tool is freely accessible on the Internet and can be used as a starting point in the discussion on primary care service provision in local communities and it can make a considerable contribution to a primary care system which provides care when and where people need it.

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Achterstandswijken zijn impopulair bij huisartsen

Cited by 19 publications

References 0 publications

Perceived barriers to guideline adherence: A survey among general practitioners

Perceived barriers to guideline adherence: A survey among general practitioners

Guidelines on uncomplicated urinary tract infections are difficult to follow: perceived barriers and suggested interventions

The construction of a decision tool to analyse local demand and local supply for GP care using a synthetic estimation model

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