gms | German Medical Science

G-I-N Conference 2012

Guidelines International Network

22.08 - 25.08.2012, Berlin

Similarities and differences between national evidence based guidelines and regional agreements

Meeting Abstract

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  • L. Meijer - NIVEL (Netherlands Institute for Health Services Research), Utrecht, The Netherlands; MCCE Medical Coordinating Center Eemland, Amersfoort, The Netherlands
  • F. Schellevis - NIVEL (Netherlands Institute for Health Services Research), Utrecht, The Netherlands; VU University Medical Centre Dept. General Practice / EMGO+ Institute, Amsterdam, The Netherlands

Guidelines International Network. G-I-N Conference 2012. Berlin, 22.-25.08.2012. Düsseldorf: German Medical Science GMS Publishing House; 2012. DocP178

doi: 10.3205/12gin290, urn:nbn:de:0183-12gin2905

Published: July 10, 2012

© 2012 Meijer et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.



Background: In the Netherlands many evidence based practice guidelines include recommendations for the cooperation between GPs and medical specialists. Regionally, GPs and medical specialists develop regional agreements (RA) for their collaboration using these national guidelines.

Objective: To compare the subjects of national guidelines and the RA.

Methods: National guidelines including recommendations about the cooperation of GPs and medical specialists and RAs were collected in 2009. The subjects of the national and regional documents were compared.

Results: 150 national guidelines including recommendations for collaboration and 361 RAs were found. For one third of the national guidelines at least one RA was developed. Half of the RAs had the same subject as a national guideline. The 188 RAs without a link to a national guideline regarded diagnostic examinations (53), different topics related to one specific speciality for example orthopaedics or ophthalmology (52) and a specific illness or complaint (52). RAs about collaboration in mental health care and oncology were rare.

Discussion (Conclusion): The subjects of RAs are partly consistent with the subjects of national guidelines. There is too little attention for regional agreements about cooperation in mental health care and oncology. There is a need for national guidelines about diagnostic research.

Implications for guideline developers/users: The subjects which are less covered by RAs might need support of guideline developers to implement these in regional care. Regional organizations can play a role in prioritizing the subjects for developing national guidelines.