Decreased health care utilization after release GP@Home website10 November 2016• PRESSRELEASE
Research from the Leiden University Medical Center and the Dutch College of General Practitioners shows that the number of general practitioner consultations decreased with 12% after the release of the evidence-based website GP@Home (www.thuisarts.nl). On a national level this means a reduction of 675.000 general practitioner visits each month.
Many patients seek online for health information and use this information to decide whether or not to visit a doctor. Still, many patients need reliable information and visit their general practitioner (GP) for this reason. In the study, researchers tested the hypothesis that providing evidence-based online health information reduces health care utilization. The results were published in BMJ open at November 10, 2016.
The website GP@Home, launched in march 2012 by the Dutch College of General Practitioners, currently has 2.9 million unique page views per month. The online information is evidence-based, created by GPs and in line with most recent nationwide primary care guidelines. It is easy accessible and uses understandable plain language. In the Netherlands, 90% of the GPs use www.thuisarts.nl as a supportive tool during their consultations and patients subsequently look up the provided information online.
Trend in health care usage before and after GP@Home
For this study, researchers from the Department of Public Health & Primary Care of the LUMC used data from the NIVEL Primary Care Database from 2009 to 2014 of nearly 1 million Dutch inhabitants. They visited their GP 18.1 million times during this time period. By comparing the trend in GP visits before and after the release of the website, researchers could estimate its effect on health care utilization. They accounted for seasonal fluctuations. To make sure as much as possible that the decrease in trend was indeed caused by the launch of the GP@Home website, they performed three extra analyses:
- They looked at the trend of topics which were not on the website during the study period, a so called control group. Health care utilization did not decrease in this control group.
- Chronic- and non-chronic care was analysed separately. Changes in the health care system for chronic care in the Netherlands could have affected the observed decline. However, this was not the case.
- They analysed the decrease separately after 12 and 24 months, because it could be expected that the decrease in health care utilization would be more visible over time, as page views on the website were increasing. It showed that the decrease was robust as page views grew.
Less telephone calls, longer consultations
The results of the study showed that the decrease was most prominent for telephone calls by patients. The number of long consultations (more than 20 minutes) actually increased. This probably means that, often less-complex, telephone consultations decreased after the launch of the website. Importantly, the decrease of health care utilization was also visible for the elderly and people with a low socioeconomic status. So, the website also reached these populations.
This study shows that eHealth can be a powerful tool to increase self-management of disease and change health care utilization. The clear, independent character of the website Thuisarts.nl and the integration of the website in the consultations of GPs seem the key to success.