Abstract
BackgroundIn order to address the challenges of an ageing population the Belgian government decided to allocate resources to the creation of geriatric day hospitals (GDHs). Although GDHs are meant to be a strategy to support general practitioners (GPs) caring for the frail elderly, few Belgian GPs seem to refer to a GDH. This study aims to explore the barriers and facilitating factors of GPs' referral to GDHs.MethodsA qualitative study using focus group discussions (FGDs) was conducted. Fifteen FGDs were organized in the different Belgian regions (Flanders, Wallonia, Brussels).ResultsContextual factors such as the unsatisfactory cooperation between hospital and GPs and organizational barriers such as the lack of communication on referral procedures between hospital and primary health care (PHC) were identified. Lack of basic knowledge about the concept or the local organization of GDH seemed to be a problem. Unclear task descriptions, responsibilities and activities of a GDH formed prominent points of discussion in all FGDs. Nevertheless a lot of possible advantages and disadvantages of GDHs for the patient and for the GP were mentioned.ConclusionsIn the case of poor referral to GDHs, focusing on improving overall collaboration between primary and secondary health care is essential. This can be achieved by actively delivering adequate information, permanent communication and more involvement of PHC in the organization and functioning of GDHs. The absence of a transparent health care system with delineated role definitions, seems to hinder the integration of new initiatives like GDHs in the care process. Strategies to enhance referral to GDHs should use a comprehensive approach.
Highlights
In order to address the challenges of an ageing population the Belgian government decided to allocate resources to the creation of geriatric day hospitals (GDHs)
The analysis of the data showed a broad spectrum of barriers and possible facilitators to use the GDH as a tool in the care for the frail elderly
Because of the participants' lack of knowledge and experience with GDHs, statements mentioned below are mainly based on general practitioners (GPs)' assumptions and perceptions
Summary
In order to address the challenges of an ageing population the Belgian government decided to allocate resources to the creation of geriatric day hospitals (GDHs). International research shows that geriatric day hospitals (GDHs) are a potentially interesting tool in organizing comprehensive care for the elderly [4,5,6,7,8]. In Belgium a hospital centred 'Care Program for the Geriatric Patient' was gradually introduced in 2007 and financed by the federal government [13]. This program regulates and stimulates the further development of five aspects of geriatric hospital care: the geriatric ward, the geriatric consultation, the internal liaison function, the external liaison function and the GDH. There was no parallel initiative to financially support primary care for the geriatric patient
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