BACKGROUND: General Practitioners (GPs) play a key role in the healthcare trajectory of patients. If the patient experiences problems that are typically non-life-threatening, such as the symptoms of post-intensive-care syndrome, the GP will be the first healthcare professional they consult. The primary aim of this study is to gain insight in the frequency of GP consultations during the year before hospital admission and the year after discharge for ICU survivors and a matched control group from the general population. The secondary aim of this study is to gain insight into differences between subgroups of the ICU population with respect to the frequency of GP consultations.METHODS: We conducted a retrospective cohort study, combining a national health insurance claims database and a national quality registry for ICUs. Clinical data of patients admitted to an ICU in 2013 were enriched with claims data from the years 2012, 2013 and 2014. Poisson regression was used to assess the differences in frequency of GP consultations between the ICU population and the control group.RESULTS: ICU patients have more consultations with GPs during the year before and after admission than individuals in the control group. In the last four weeks before admission, ICU patients have 3.58 (CI 3.37; 3.80) times more GP consultations than the control group, and during the first four weeks after discharge they have 4.98 (CI 4.74; 5.23) times more GP consultations. In the year after hospital discharge ICU survivors have an increased GP consultation rate compared to the year before their hospital admission.CONCLUSIONS: Close to hospital admission and shortly after hospital discharge, the frequency of GP consultations substantially increases in the population of ICU survivors. Even a year after hospital discharge, ICU survivors have increased GP consultation rates. Therefore, GPs should be well informed about the problems ICU patients suffer after discharge, in order to provide suitable follow-up care.
The purpose of this article is to explore innovative and adaptive ways of matching people with jobs in the context of a Dutch policy initiative aimed at the skills mismatch in the region of Amsterdam. This is an important and urgent issue because of the challenges of the future labor market, in which technological disruption and socio-economic forces affect the content and conditions of jobs and occupations. Powered by digital technology and data-driven approaches it is possible to design ‘?ne-grained’ matching systems based on skills or competences. The article combines an exploration of occupational taxonomies, skills frameworks and good practices of these skills-based applications with a theoretical discussion on the relevance and adaptations of Person-Environment Fit and matching theories. The article shows that these new forms of innovative, adaptive and ?uid matching have bene?ts for policy-makers, employers and jobseekers alike. In the discussion section some critical remarks are made on the matching theory and its application in contemporary instruments and tools. https://www.ojs.tnkul.pl/index.php/jpepsi/article/view/9624
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