Effects of transmural care on coordination and continuity of care

Although health care in The Netherlands is of a high quality with strong em phasis on primary care and high accessibility to hospital cart, care defici ts may arise in patients with chronic complex health problems who need the attention of several caregivers. Because no regular coordinating centre or person exists, coordination of care may be deficient leading to a poor cont inuity of care. This may be particularly true for those patients being care d fur by both primary and hospital carl reams, as is the case for most term inal cancer patients. Therefore, a transmural home care intervention progra mme for terminal cancer patients was introduced which intended to optimize coordination of care and thereby improve continuity of care. This quasi-exp erimental study investigated the effects of this intervention (intervention group 79 patients) on indicators of coordination and continuity of care. W hen compared to standard care (control group 37 patients) moderate positive effects (mainly for the nursing disciplines) on the various indicators of coordination and continuity of care by the transmural home care interventio n programme were found. Future prospective studies are needed to further el ucidate the effects of transmural care on these aspects of care. (C) 2000 E lsevier Science lreland Ltd. All rights reserved.