Integrated Care for Elderly in Walcheren

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The complex care required for vulnerable elderly people calls for a new care model which focuses on bridging the gap between care providers and centres on the client. The goal of the experiment is to compare a fully integrated care model for vulnerable elderly people with the current provision of care in terms of costs and effects for the elderly (quality of life, satisfaction, mental, physical and psychological impairment), caregivers (burden and quality of life), professionals (burden and satisfaction) and organisation of care (cohesion, continuity, power, interests). The fully integrated model will incorporate timely fully integrated detection and diagnosis (GFI and Easycare) and individualised care, based on the client’s needs, directed from primary care in cooperation with the partners in the supply chain. The provision of primary care will become a one-stop function connecting care providers through a multidisciplinary approach, protocols and consultation. A nurse practitioner will act as both care coordinator and liaison officer. A quasi-experimental design was chosen for the evaluation in which the effects will be measured by means of a before-and-after study with a control group.


January 2010 - December 2012



  • Netherlands Organisation for Health Research and Development (ZonMw)


  • Walcheren General Practitioners’ Cooperative
  • Walcheren Care Group
  • Stichting voor Regionale Zorgverlening (Foundation for Regional Health care)
  • Zorgstroom
  • Walcheren Hospital
  • Stichting Werkt voor Ouderen (foundation providing care for the elderly)
  • Klaverblad patients’ platform