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Reallocations in acne healthcare: exploring the possible roles and added value of non-physicians by a mixed-methods study design

Authors
  • de Vries, Femke1, 2
  • Welbie, Marlies3
  • Tjin, Esther1
  • Driessen, Rieke2
  • van de Kerkhof, Peter2
  • 1 HU University of Applied Sciences, Heidelberglaan 7, Utrecht, 3584 CS, The Netherlands , Utrecht (Netherlands)
  • 2 Radboud university medical centre, Nijmegen, The Netherlands , Nijmegen (Netherlands)
  • 3 HU University of Applied Sciences, Utrecht, The Netherlands , Utrecht (Netherlands)
Type
Published Article
Journal
BMC Health Services Research
Publisher
Springer (Biomed Central Ltd.)
Publication Date
Jul 27, 2021
Volume
21
Issue
1
Identifiers
DOI: 10.1186/s12913-021-06744-2
Source
Springer Nature
Keywords
Disciplines
  • Research
License
Green

Abstract

BackgroundA highly promoted opportunity for optimizing healthcare services is to expand the role of non-physician care providers by care reallocation. Reallocating care from physicians to non-physicians can play an important role in solving systemic healthcare problems such as care delays, hospital overcrowding, long waiting lists, high work pressure and expanding healthcare costs. Dermatological healthcare services, such as the acne care provision, are well suited for exploring the opportunities for care reallocation as many different types of care professionals are involved in the care process. In the Netherlands, acne care is mainly delivered by general practitioners and dermatologists. The Dutch healthcare system also recognizes non-physician care providers, among which dermal therapists and beauticians are the most common professions. However, the role and added value of non-physicians is still unclear. The present study aimed to explore the possibilities for reallocating care to non-physicians and identify drivers for and barriers to reallocation.MethodsA mixed-method design was used collecting quantitative and qualitative data from representatives of the main 4 Dutch professions providing acne care: dermatologists, GP’s, Dermal therapists and beauticians.ResultsA total of 560 questionnaires were completed and 24 semi-structured interviews were conducted. A broad spectrum of non-physician tasks and responsibilities were delineated. Interviewed physicians considered acne as a low-complexity skin condition which made them willing to explore the possibilities for reallocating. A majority of all interviewees saw a key role for non-physicians in counselling and supporting patients during treatment, which they considered an important role for increasing patients’ adherence to proposed treatment regimes, contributing to successful clinical outcome. Also, the amount of time non-physicians spend on patients was experienced as driver for reallocation. Legislation and regulations, uncertainties about the extent of scientific evidence and proper protocols use within the non-physician clinical practice were experienced as barriers influencing the possibilities for reallocation.ConclusionsDelineated roles and drivers demonstrate there is room and potential for reallocation between physicians and non-physicians within acne healthcare, when barriers are adequately addressed.

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