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41
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Introduction
Current institution
Publications
Publications (41)
Background: Purchasing systems aim to improve resource allocation in healthcare markets. The Netherlands is characterized by four different purchasing systems: managed competition in the hospital market, a non-competitive single payer system for long-term care, municipal procurement for home care and social services, and self-procurement via person...
Study design:
An in-depth interview study including patients, general practitioners, neurologists and neurosurgeons.
Objective:
To gain insight in decision-making in sciatica care, by identifying patients' and physicians' preferences for treatment options, and the differences between and within both groups.
Summary of background data:
Sciatica...
Health systems invest in coordination and collaboration between emergency departments (ED) and after-hours primary care providers (AHPCs) to alleviate pressure on the acute care chain. There are substantial gaps in the existing evidence, limited in sample size, follow-up care, and costs. We assess whether acute care collaborations (ACCs) are associ...
Objective:
To establish a methodological approach to compare two high-need, high-cost (HNHC) patient personas internationally.
Data sources:
Linked individual-level administrative data from the inpatient and outpatient sectors compiled by the International Collaborative on Costs, Outcomes, and Needs in Care (ICCONIC) across 11 countries: Austral...
Sciatica is a common back problem with a generally positive natural course. This interview study was performed to gain increased insight into ambivalent and reluctant medicalization on the interactional level regarding the perceptions of Dutch patients and physicians about sciatica and its treatment options as a case study. While the concept of med...
Background:
Optimal care for Parkinson's disease (PD) requires coordination and collaboration between providers within a complex care network. Individual patients have personalised networks of their own providers, creating a unique informal network of providers who treat ('share') the same patient. These 'patient-sharing networks' differ in densit...
Zusammenfassung
Hintergrund
Studien aus unterschiedlichen Ländern haben gezeigt, dass eine kleine Zahl von Versicherten (Hochkostenversicherte) einen großen Teil der Leistungsausgaben im Gesundheitssektor verursacht. Gleichzeitig wird davon ausgegangen, dass ein Teil dieser Hochkosten durch besseres Management dieser Personengruppe reduziert werde...
Background:
Medicalization has been a topic of discussion and research for over four decades. It is a known concept to researchers from a broad range of disciplines. Medicalization appears to be a concept that speaks to all, suggesting a shared understanding of what it constitutes. However, conceptually, the definition of medicalization has evolve...
Aims:
This study aimed to determine the characteristics of patients with heart failure and high costs (top 1% and top 2-5% highest costs in perspective of the general population) and to explore the longitudinal health care utilization and persistency of high costs.
Methods and results:
Longitudinal observational study using claims data from 2006...
Objective: To reconstruct a sex-specific patient journey for Dutch persons with Parkinson's disease (PD) during the first 5 years after diagnosis.
Method: We analyzed a national administrative medical claims database containing data of all patients newly diagnosed with PD between 2012 and 2016 in the Netherlands. We performed time-to-event analysis...
Background
Across countries, a small group of patients accounts for the majority of health care spending. These patients are more likely than other patients to experience problems with quality and safety in their care, suggesting that efforts targeting efficiency and quality among this population might have significant payoffs for health systems. B...
In a system of managed competition, selective contracting and patient choice reward providers for quality improvements through increases in patient numbers and revenue. We research whether these mechanisms function as envisioned by investigating the relationship between quality improvements and patient numbers in assisted reproduction technology in...
Introduction:
Outcome-based payment models (OBPMs) might solve the shortcomings of fee-for-service or diagnostic-related group (DRG) models using financial incentives based on outcome indicators of the provided care. This review provides an analysis of the characteristics and effectiveness of OBPMs, to determine which models lead to favourable eff...
Unsustainable growth in healthcare expenditure demands effective cost-containment policies. We review policy effectiveness using total payer expenditure as primary outcome measure. We included all OECD member states from 1970 onward. After a rigorous quality appraisal, we included 43 original studies and 18 systematic reviews that cover 341 studies...
Introduction
In Ontario, the top 5% of high-cost users account for 66% of health care costs. The heavy use of resources combined with perceived inefficiencies offer an imperative to target strategies to redesign care to better meet patient needs and increase value.
Objectives and Approach
As part of a request submitted to the Applied Health Resear...
Objectives
To investigate the characteristics and healthcare utilisation of high-cost patients and to compare high-cost patients across payers and countries.
Design
Systematic review.
Data sources
PubMed and Embase databases were searched until 30 October 2017.
Eligibility criteria and outcomes
Our final search was built on three themes: ‘high-c...
Background:
Overuse of unnecessary care is widespread around the world. This so-called low-value care provides no benefit for the patient, wastes resources and can cause harm. The concept of low-value care is broad and there are different reasons for care to be of low-value. Hence, different strategies might be necessary to reduce it and awareness...
Onder meer door de vergrijzing en de toename van dure innovaties in de zorg zal het aandeel van de zorg in het bruto nationaal product in de toekomst verder oplopen. Hierdoor blijft er minder geld over voor andere publieke voorzieningen, zoals het onderwijs en de sociale zekerheid. Ook de koopkrachtontwikkeling komt onder druk te staan. Daarom klin...
Objective To determine medical needs, demographic characteristics and healthcare utilisation patterns of the top 1% and top 2%–5% high-cost beneficiaries in the Netherlands.
Design Cross-sectional study using 1 year claims data. We broke down high-cost beneficiaries by demographics, the most cost-incurring condition per beneficiary and expensive t...
Marktprikkels verbeteren zorg niet bij reageerbuisbevruchting GEZONDHEIDSZORG D e heilige graal voor beleidsmakers in de gezondheidszorg is betere kwaliteit van zorg en lagere kosten (Berwick et al., 2008). Dit is niet makkelijk te realiseren, want in de zorg leidt een hogere kwali-teit tot minder behandelingen: genezen patiënten komen immers niet...
Citation: van Dijk W, Faber MJ, Tanke MAC, Jeurissen PPT, Westert GP. Define and conquer: how semantics foster progress; a response to recent commentaries.
Antimicrobial stewardship is recognized as a key component to stop the current European spread of antimicrobial resistance. It has also become evident that antimicrobial resistance is a problem that cannot be tackled by single institutions or physicians. Prevention of antimicrobial resistance needs rigorous actions at ward level, institution level,...
Objective:
To determine characteristics and healthcare utilization of high-cost patients in the Netherlands.
Design:
Cross-sectional study, using claim data for 2013 from one Dutch health insurer. Analyses were limited to the curative health system (care that falls under the Health Insurance Act), including voluntary supplementary insurance.
Me...
Sustainable mental healthcare is inseparably linked to an agenda that provides value-for-money and it implies a major transition. However, in principle, it should be possible to fit these changes into the current system of governance. More attention needs to be given to the various domains, and to a reduction in administrative costs. reimbursement...
The concept of overdiagnosis is a dominant topic in medical literature and discussions. Inresearch that targets overdiagnosis, medicalisation is often presented as the societal and individual burden of unnecessary medical expansion. In this way, the focus lies on the influence of medicine on society, neglecting the possible influence of society on...
