The perceptions of Dutch general practitioners on the implementation of a proactive integrated care approach for patients with complex needs: a pilot survey.

Abstract

BACKGROUND: For a subgroup of patients with complex health needs on multiple domains (somatic, mental and/or social) often accompanied with disproportional healthcare use, a new proactive and integrated care (PIC) approach is being developed in the primary care setting to stimulate health improvement among these patients. To ensure sustainable implementation of the PIC approach it is important to study factors influencing the initial uptake of the intervention prior to actual implementation. This Pilot survey explores whether general practitioners (GPs) recognize patients with complex needs, understand their needs, and how they perceive the acceptability, appropriateness, and feasibility of the PIC approach. METHODS: For this pilot survey, a convenience sample of GPs was recruited in the regions of Utrecht and The Hague in the Netherlands. They completed a questionnaire assessing their recognition and awareness of these patients’ needs, and their views on the acceptability, appropriateness, and feasibility of the PIC approach. RESULTS: In total 22 GP filled in the survey. Most GPs (90.90%) recognize patients with complex needs as a patient group, yet only 42.90% report awareness of their needs. Furthermore, 80.90% agree that care change is needed. While only 4.50% of GPs find the PIC approach to be unacceptable, a larger portion express doubts about its appropriateness (22.70%) and feasibility (22.70%). CONCLUSIONS: As an exploratory pilot survey, these findings offer initial indicators that while GPs acknowledge patients with complex needs and support care change, further research is needed to confirm the appropriateness and feasibility of the PIC approach.