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Introduction
Skills and Expertise
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January 2007 - present
September 2002 - present
January 1994 - September 2002
Publications
Publications (204)
Objectives
In many Western societies, the state pension age is being raised to stimulate prolonged working. In the Netherlands, the raise of the state pension age is linked to the remaining life expectancy at age 65 with a factor of 2/3rd, and is expected to be 68 years in 2040. It is not yet well understood whether health of the 60+ permits this i...
Samenvatting
Inleiding
We hebben berekend hoeveel er in 2015 aan preventie is uitgegeven. We maakten onderscheid tussen gezondheidsbescherming, gezondheidsbevordering en ziektepreventie. Bij de berekening van de uitgaven beperkten we ons tot universele, selectieve en geïndiceerde preventie. Zorggerelateerde preventie kan nauwelijks onderscheiden w...
Background:
Traumatic brain injury (TBI) is the main cause of mortality and severe morbidity in cyclists admitted to Dutch emergency departments (EDs). Although the use of bicycle helmets is an effective way of preventing TBI, this is uncommon in the Netherlands. An option to increase its use is through a legal enforcement. However, little is know...
It is widely acknowledged that in order to promote public health and prevent diseases, a wide range of scientific disciplines and sectors beyond the health sector need to be involved. Evidence-based interventions, beyond preventive health interventions targeting disease risk factors and interventions from other sectors, should be developed and impl...
Introduction
In 2015, Dutch healthcare expenditure exceeded 85 billion euros. But what about prevention? In this study we estimated national expenditure on prevention. A distinction was made between health protection, health promotion and disease prevention. In the estimation of prevention expenditures, this study is limited to universal, selective...
Introduction
In November 2018, the Ministry of Health, Welfare and Sports presented the National Prevention Agreement (NPA). Within this NPA, interventions targeting smoking, being overweight and problematic alcohol use were proposed to induce lifestyle changes. In addition to measures aimed at these three themes, there is also a range of intervent...
Background
In the Netherlands, toxoplasmosis ranks third in disease burden among foodborne pathogens, with an estimated health loss of 1,900 Disability Adjusted Life Years and a cost-of-illness estimated at €44 million annually. We performed a Social Cost-Benefit Analysis (SCBA) to evaluate the net value of two potential interventions, freezing mea...
Background:
Aggregated claims data on medication are often used as a proxy for the prevalence of diseases, especially chronic diseases. However, linkage between medication and diagnosis tend to be theory based and not very precise. Modelling disease probability at an individual level using individual level data may yield more accurate results.
Me...
In the Netherlands, toxoplasmosis ranks second in disease burden among foodborne pathogens with an estimated health loss of 1,900 Disability Adjusted Life Years and a cost-of-illness estimated at €45 million annually. Therefore, effective and preferably cost-effective preventive interventions are warranted. Freezing meat intended for raw or underco...
Attribution of toxoplasmosis to main pathways.
(DOCX)
Annual average costs for patients, healthcare, special education, and productivity losses due to T. gondii infection in the Netherlands, 2016.
(DOCX)
Incidences, Burden of disease (BoD) and cost-of-illness (COI).
(DOCX)
Quantitative Microbial Risk Assessment (QMRA).
(DOCX)
Assumptions regarding the interventions.
(DOCX)
Assuming effectiveness 1%, lasting for 5 years in the minimum scenario.
(PDF)
Assuming effectiveness 1%, lasting for 5 years in the maximum scenario.
(PDF)
Assuming effectiveness 1%, lasting for 10 years in the maximum scenario.
(PDF)
Assuming effectiveness 10%, lasting for 10 years in the minimum scenario.
(PDF)
Assuming effectiveness 1%, lasting for 10 years in the minimum scenario.
(PDF)
Assuming effectiveness 10%, lasting for 10 years in the maximum scenario.
(PDF)
To overcome self-control difficulties, people can commit to their health goals by voluntarily accepting deadlines with consequences. In a commitment lottery, the winners are drawn from all participants, but can only claim their prize if they also attained their gym-attendance goals. In a 52-week, three-arm trial across six company gyms, we tested i...
Many people aim to change their lifestyle, but have trouble acting on their intentions. Behavioral economic incentives and related emotions can support commitment to personal health goals, but the related emotions remain unexplored. In a regret lottery, winners who do not attain their health goals do not get their prize but receive feedback on what...
Background
The World Health Organization has identified physical inactivity as the fourth leading risk factor for global mortality. People often intend to engage in physical activity on a regular basis, but have trouble doing so. To realize their health goals, people can voluntarily accept deadlines with consequences that restrict undesired future...
Background
Since in an ageing society more long-term care (LTC) facilities are needed, it is important to understand the main determinants of first-time utilization of (LTC) services.
Methods
The Andersen service model, which distinguishes predisposing, enabling and need factors, was used to develop a model for first-time utilization of LTC servic...
- Two recent societal cost-benefit analyses have documented the costs of smoking and the cost-effectiveness of preventing smoking.- Smoking costs the Netherlands society EUR 33 billion per year.- The majority of this is the monetary value of health loss; these are "soft" euros that cannot be re-spent.- There is not a great deal of difference betwee...
We worden allemaal steeds ouder en we zetten alles in op het zolang mogelijk vitaal en zelfstandig blijven. Dat geldt evenzeer voor het Tijdschrift voor Sociale Geneeskunde dat nu als TSG Tijdschrift voor Gezondheidswetenschappen door het leven gaat. De jaren hebben dit tijdschrift niet onberoerd gelaten. TSG heeft in de loop der jaren wel ‘een jas...
The rise in healthcare expenditures has raised doubts about the sustainability of health systems and instigated a discussion on their design. Policy making in this field requires a proper understanding of how healthcare expenditures evolve throughout an individual's lifetime, and of how they vary between individuals. Given the lack of data on healt...
The effect of population aging on future health services use depends on the relationship between longevity gains and health. Whether further gains in life expectancy will be paired by improvements in health is uncertain. We therefore analyze the effect of population ageing on health services use under different health scenarios. We focus on the pos...
Dit onderzoek is deel van NETSPAR small vision grants “Woonvermogen en langdurige zorg”. Onderzoeksvragen zijn: - Hoe verhouden zich vermogen (uit eigen huis) tegen het gebruik van LDZ onder de ouderen? - Wat is de simultane verdeling van LDZ kosten en eigen bijdragen aan zorg onder de ouderen aan de ene kant EN hun vermogen aan de andere kant?
This paper addresses two important questions. First, how does (housing) wealth relate to the need and use of long term care (LTC) among the elderly? And second, what is the simultaneous distribution of LTC costs and out-of-pocket-payments on the one hand, and (housing) wealth among the elderly on the other hand? Our findings reveal that mean LTC co...
Topdrukte werd er verwacht, een jaar of drie geleden, op de Oudlaan in Utrecht waar het hoofdkantoor van Actiz is gevestigd. Lange files met durfkapitalisten, banken, private equity financiers en alle anderen die wat meer rendement uit hun euro’s willen halen dan de schamele percentages die de banken bieden.
De Betuwelijn, de Hogesnelheidslijn-Zuid, de aanleg van de Tweede Maasvlakte, het zijn zomaar een paar voorbeelden van grote infrastructurele projecten waartoe besloten is na een uitgebreide afweging van de kosten en de opbrengsten. Dit vanuit een perspectief van de maatschappij als geheel.
Health care costs have increased due to population ageing. It is often said that the majority of health care spending occurs in the last year of life and that, as a result, the total costs of population ageing are considerably lower than is usually predicted. With the Netherlands facing a rapidly ageing population, such statements are well-received...
Ook op het terrein van volksgezondheid en zorg kunnen MKBA’s een nuttige rol spelen bij de beleidsvoorbereiding. Daarbij kan worden aangesloten bij de bestaande richtlijnen voor kosteneffectiviteitsonderzoek in de zorg. Deze richtlijnen komen echter niet altijd overeen met de
Algemene leidraad MKBA. Een aanzet tot een praktische MKBA-werkwijzer voo...
Een maatschappelijke kosten-batenanalyse (MKBA) biedt een overzicht van de voor- en nadelen van een maatregel, zoals de aanleg van een weg of woonwijk. Door deze voor- en nadelen zoveel mogelijk te kwantificeren en in euro's uit te drukken, geeft een MKBA inzicht in het effect van de maatregel op de welvaart in Nederland. Met die informatie kan een...
Within the Netherlands, there are substantial social inequalities in care consumption and health care costs. People differ in terms of their use of care facilities. This is influenced by factors such as their socio-economic position, mode of cohabitation and country of origin. The present study reveals that this effect is even more pronounced than...
We study long-term care demand in the Netherlands for a sample of elderly Dutch households using detailed administrative data. Long-term care in the Netherlands is provided by a public health care system that is generous in comparison to that in many other countries, but offers few possibilities for differentiation. Moving to a nursing home is gene...
Although the consequences of population aging for growth in health expenditures have been widely investigated, research on this topic is rather fragmented. Therefore, these consequences are not fully understood. This paper reviews the consequences of population aging for health expenditure growth in Western countries by combining insights from epid...
- Increasing healthcare costs force policy makers to make difficult choices in the insurance package.- In order to make rational choices, there must be an understanding of the healthcare costs as well as the value of the health that the care provides.- Health economists have in recent years carried out extensive research into the value that people...
We investigate the dynamic relationship between several dimensions of health and health care expenditures for older individuals. Health data from the Longitudinal Aging Survey Amsterdam is combined with data on hospital and long term care use. We estimate a latent variable based jointly on observed health indicators and expenditures. Annual transit...
Spectrum biedt ruimte voor beschouwingen, discussies en opiniërende artikelen over onderwerpen op het terrein van de volksgezondheid en de gezondheidszorg. Bijdragen dienen te worden aangeboden conform de aanwijzingen voor de auteurs. Voor overleg over het thema kan contact worden opgenomen met de rubrieksredacteuren van Spectrum: prof. dr. J.A.M....
To investigate the reasons behind the sharp upturn of life expectancy in the Netherlands around 2002.
Descriptive, trend analysis.
Mortality data were categorised by age, sex and cause of death and analysed using life-table methods. Trends in determinants of mortality (including healthcare delivery) were compared with trends in mortality.
Two-third...
Background:
In The Netherlands, 1168 Q-fever patients were notified in 2007 and 2008. Patients and general practitioners (GPs) regularly reported persisting symptoms after acute Q-fever, especially fatigue and long periods of sick leave, to the public health authorities. International studies on smaller Q-fever outbreaks demonstrate that symptoms...
In deze notitie staan de zorgkosten van ongezond gedrag centraal, en hierbij ligt de nadruk op roken, overgewicht en lichamelijke activiteit. Er wordt niet alleen naar de huidige zorgkosten gekeken, maar ook naar de invloed van ongezond gedrag op de zorgkosten op lange termijn. De berekeningen in deze notitie zijn uitgevoerd met behulp van het RIVM...
Health care utilization is expected to rise in the coming decades. Not only will the aggregate need for health care grow by changing demographics, so too will per capita utilization. It has been suggested that trends in health care utilization may be age-specific. In this paper, age-specific trends in health care utilization are presented for diffe...
During the 1980s and 1990s life expectancy at birth has risen only slowly in the Netherlands. In 2002, however, the rise in life expectancy suddenly accelerated. We studied the possible causes of this remarkable development. Mortality data by age, gender and cause of death were analyzed using life table methods and age-period-cohort modeling. Trend...
In this paper, we investigate the relationship between baseline health and costs of hospital use over a period of eight years. We combine cross-sectional survey data with information from the Dutch national hospital register. Four different indicators of health (self-perceived health, long-term impairments, ADL limitations and comorbidity) are cons...
It has been demonstrated repeatedly that time to death is a much better predictor of health care expenditures than age. This is known as the 'red herring' hypothesis. In this article, we investigate whether this is also the case regarding disease-specific hospital expenditures. Longitudinal data samples from the Dutch hospital register (n=11 253 45...
The inclusion of medical costs in life years gained in economic evaluations of health care technologies has long been controversial. Arguments in favour of the inclusion of such costs are gaining support, which shifts the question from whether to how to include these costs. This paper elaborates on the issue how to include cost in life years gained...
A shortcoming of many economic evaluations is that they do not include all medical costs in life-years gained (also termed indirect medical costs). One of the reasons for this is the practical difficulties in the estimation of these costs. While some methods have been proposed to estimate indirect medical costs in a standardized manner, these metho...
This article presents methods for using administrative data to study multimorbidity in hospitalized individuals and indicates how the findings can be used to gain a deeper understanding of hospital multimorbidity.
A Dutch nationwide hospital register (n=4,521,856) was used to calculate age- and sex-standardized observed/expected ratios of disease-p...
The cost-effectiveness of passive immunisation against respiratory syncytial virus (RSV) in the Netherlands was studied by assessing incremental costs to prevent one hospitalisation in high-risk children using a novel individualised monthly approach.
Cost-effectiveness analysis was performed by combining estimates of individual hospitalisation cost...
Long-term care in the Netherlands. Background information on the long-term care system in the Netherlands.
Long-term care is often associated with high health care expenditures. In the Netherlands, an ageing population will likely increase the demand for long-term care within the near future. The development of risk profiles will not only be useful for projecting future demand, but also for providing clues that may prevent or delay long-term care utiliz...
Met de volksgezondheid in Nederland gaat het redelijk goed. Maar dat is geen pleidooi om in het volksgezondheidbeleid gas
terug te nemen. Integendeel. Nederland kan en moet blijven investeren in de volksgezondheid. Omdat gezondheid een groot goed
is, maar ook omdat een vergrijzende economie gezonde burgers broodnodig heeft.
