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01.12.2018 | Research article | Ausgabe 1/2018 Open Access

BMC Family Practice 1/2018

Substitution of care for chronic heart failure from the hospital to the general practice: patients’ perspectives

Zeitschrift:
BMC Family Practice > Ausgabe 1/2018
Autoren:
J. A. Wildeboer, A. R. T. van de Ven, D. de Boer
Wichtige Hinweise

Electronic supplementary material

The online version of this article (https://​doi.​org/​10.​1186/​s12875-017-0688-z) contains supplementary material, which is available to authorized users.

Abstract

Background

Shifting care from the secondary to the primary system may present an opportunity to ensure that the increasing number of patients with chronic heart failure (CHF) receive high-quality care while containing costs. However, shifting from secondary to primary care might seem radical to patients. A qualitative insight into patients’ issues, preferences, expectations and needs may help arrange a smooth transition from secondary to primary care for CHF patients. The aim of this exploratory study is therefore to gain insights into the way CHF patients in secondary care perceive the possibility of substitution of CHF care from secondary to primary care.

Methods

In total, fifteen semi-structured interviews were conducted with CHF patients. Topics discussed during the interviews were the advantages and disadvantages, attitudes of patients, preferences regarding the substitution and trust in the GP and cardiologist. A thematic analysis was performed.

Results

The minority of the patients welcomed the idea of substitution. Against that, the majority of the patients had various concerns. This attitude was mainly influenced by two main themes, confidence and security and accessibility. Most patients had more confidence in secondary than in primary care because of the greater level of knowledge and more possibilities for examination in secondary care and because of good relationships and positive previous experiences in secondary care. Patients also indicated that the general practice is geographically more easily accessible than the hospital.

Conclusion

Patients had various concerns regarding the substitution of care for chronic heart failure. Addressing these concerns by informing them appropriately may contribute to a smooth and patient-friendly substitution from secondary to primary care. The fears and needs of patients could also be taken into account by policymakers when optimising the way substitution is organised, or when substitution is introduced.
Zusatzmaterial
Additional file 1: Topic list that was used during the semi-structured interviews. (DOCX 14 kb)
12875_2017_688_MOESM1_ESM.docx
Literatur
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