Patrick Paulus Theodoor Jeurissen

Radboud University Medical Centre (Radboudumc) · Department of IQ Healthcare

The market-oriented reform in the Dutch health care system is now in its 10th year. This article offers a concise overview of some of its effects thus far on health insurance, healthcare purchasing and healthcare provision. Furthermore, attention is given to its impact on healthcare expenditures, power and trust relationships as well as the relatio...

A few studies have noted the outsize administrative costs of US hospitals, but no research has compared these costs across multiple nations with various types of health care systems. We assembled a team of international health policy experts to conduct just such a challenging analysis of hospital administrative costs across eight nations: Canada, E...

Importance A higher out-of-pocket price for mental health care may lead not only to cost savings but also to negative downstream consequences. Objective To examine the association of higher patient cost sharing with mental health care use and downstream effects, such as involuntary commitment and acute mental health care use. Design, Setting, and...

Background: Publicly funded healthcare forms an intricate part of government spending in most Organisation for Economic Co-operation and Development (OECD) countries, because of its reliance on entitlements and dedicated revenue streams. The impact of budgetary rules and procedures on publicly funded health care might thus be different from other...

Het kabinet-Rutte IV wil de regeldruk voor zorgprofessionals aanpakken. Tegelijkertijd staat er beleid in de steigers, zoals passende zorg, dat gemakkelijk tot hogere administratieve kosten kan leiden. Het is de vraag in hoeverre de baten van het zorgbeleid opwegen tegen de extra administratieve kosten ervan. IN HET KORT ● Administratieve kosten i...

The Rutte IV administration can and will spend much less on healthcare than its predecessor. A difficult task. Providing less low-value care, that is healthcare with no or little benefit for the patient given the alternatives, by physicians is one way to improve quality and reduce costs. Less low-value care will therefore play a crucial role in the...

We provide an explorative and international comparison of the governance models of academic medical centres (AMCs). These centres face significant challenges, including disruptive external pressures and enduring financial conflicts pertaining to patient treatment, research and education. Therefore, we covered 10 European countries (Cyprus, Czechia,...

Inadequate treatment of multimorbidity is recognised as a major determinant of the effectiveness of healthcare and also of its inappropriate expenditures. However, current payment systems target, primarily, the treatment of single diseases, thus hindering integrated delivery of care for patients with multimorbidity (PwM). This review aims to assess...

Het Kabinet heeft grote ambities op het vlak van betaalbare zorg en sociaaleconomische gezondheidsverschillen. Daarvoor kiest het niet voor een stelselwijziging in de zorg, maar voor meer sturing op doelmatigheid om de budgettaire opgave te realiseren. Dit staat in contrast met voorgaande jaren en ook met de uitgangspunten van het curatieve zorgste...

The books Vijftig jaar kostenbeheersing in de zorg. Deel I: 1966-1995 en Deel II: 1995 are a twin-panel on cost control and cost control policy for healthcare.

Background: A lack of knowledge exists on real world hospital strategies that seek to improve quality, while reducing or containing costs. The aim of this study is to identify hospitals that have implemented such strategies and determine factors influencing the implementation. Methods: We searched PubMed, EMBASE, Web of Science, Cochrane Library...

In 2006, The Netherlands embarked upon an ambitious reform of the Dutch health care system based upon the principles of regulated competition. Fiscal sustainability go the system has improved. In many places diversity has increased among providers, insurance policies etc. High levels of universal access are still paramount for the system. However,...

Background Academic Medical Centers (AMCs) are organizations that link three functions: providing highly specialized medical services, teaching activities and conducting research. The aim of the study was to provide an international comparison of the governance and organization models of AMCs. The analysis covered 10 European countries (Cyprus, Cze...

Context: Practitioners and politicians alike emphasise the wish to reduce administrative costs (AC) in Dutch LTC, but a robust empirical body of evidence on the components, determinants and value of AC in LTC is absent. Neither has the expert consensus of ways to track and trace AC in LTC been sought. Objective(s): We investigated whether it is pos...

Background Chronic heart failure accounts for approximately 1%-2% of health care expenditures in most developed countries. These costs are primarily driven by hospitalizations and comorbidities. Telemonitoring has been proposed to reduce the number of hospitalizations and decrease the cost of treatment for patients with heart failure. However, the...

Introduction: Governments, purchasers and healthcare organizations see task reallocation as part of the solution for the increasing demand for care, increasing healthcare costs, and workforce shortages. Internationally, many governments are implementing policies regarding deployment of nurse practitioners (NPs) and physician assistants (PAs). Thus...

Context: Some nursing homes fared better than others to protect themselves against the 2019 coronavirus disease (COVID-19). Organisational characteristics may mediate the effect of the COVID-19 pandemic. Previous reviews have suggested for-profit providers provide worse quality of care. Does ownership also matter in the response to the COVID-19 pan...

Sugar consumption is on the rise globally with detrimental (oral) health effects. There is ample evidence that sugar-sweetened beverage (SSB) taxes can efficiently reduce sugar consumption. However, evidence alone is seldom enough to implement a policy. In this article, we present a narrative synthesis of evidence, based on real-world SSB tax evalu...

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...

The Covid-19 pandemic has put policy systems to the test. In this paper, we unmask the institutionalized resilience of the Dutch health care system to pandemic crisis. Building on logics of crisis decision-making and on the notion of ‘tact’, we reveal how the Dutch government initially succeeded in orchestrating collective action through aligning p...

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 density...

s Developing and distributing a safe and effective SARS-CoV-2 (COVID-19) vaccine has garnered immense global interest. Less than a year after COVID-19 was declared a pandemic, several vaccine candidates had received emergency use authorization across a range of countries. Despite this scientific breakthrough, the journey from vaccine discovery to g...

BACKGROUND Chronic heart failure accounts for approximately 1%-2% of health care expenditures in most developed countries. These costs are primarily driven by hospitalizations and comorbidities. Telemonitoring has been proposed to reduce the number of hospitalizations and decrease the cost of treatment for patients with heart failure. However, the...

Background In the Netherlands, the for-profit sector has gained a substantial share of nursing home care within just a few years. The ethical question that arises from the growth of for-profit care is whether the market logic can be reconciled with the provision of healthcare. This question relates to the debate on the Moral Limits of Markets (MLM)...

For-profit hospitals’ market share has increased in many nations over recent decades. Previous studies suggest that their growth is not attributable to superior performance on access, quality of care, or efficiency. We analyzed other factors that we hypothesized may contribute to the increasing role of for-profit hospitals. We studied the historica...

Sweetened beverage (SB) taxes have recently been introduced to prevent obesity by several governments, but limited information on related policy adoption processes hampers further diffusion. We investigated the agenda-setting and decision-making phases of SB tax reforms in Berkeley and Philadelphia (where it was successfully adopted), and Cook Coun...

Begrotingsregels dempen collectieve zorguitgaven H et kabinet neemt in de coronacrisis verregaan-de maatregelen om zorgaanbieders financiële zekerheid te verschaffen. Budgettaire kaders worden feitelijk tijdelijk buiten spel gezet, ook in de zorg. Normaal zijn de Nederlandse zorguitgaven ech-ter strikt onderdeel van de begrotingsregels van het kabi...

The current coronavirus disease 2019 (COVID-19) pandemic is testing healthcare systems like never before and all efforts are now being put into controlling the COVID-19 crisis. We witness increasing morbidity, delivery systems that sometimes are on the brink of collapse, and some shameless rent seeking. However, besides all the challenges, there ar...

This perspective argues that for-profit hospitals will be heavily affected by epidemic crises, including the current coronavirus disease 2019 (COVID-19) outbreak. Policy-makers should be aware that for-profit hospitals in particular are likely to face financial distress. The suspension of all non-urgent elective surgery and the relegation of market...

This exploratory, mixed-methods study analyzes characteristics of the emerging for-profit nursing home industry in the Netherlands and identifies the interrelated set of factors (context, trends, and sector conditions) that contribute to its growth. Until recently, the Dutch nursing home sector relied almost exclusively on nonprofit providers. Even...

Coronavirus kan de zorg structureel veranderen A lle aandacht gaat momenteel uit naar het indam-men van het COVID-19-virus. De uitbraak van het virus heeft op de korte termijn twee verschil-lende effecten op de zorg: aan de ene kant is er in de acute keten meer capaciteit nodig. Aan de andere kant valt de zorg die even kan wachten massaal weg. Meer...

Background: Under a constrained health care budget, cost-increasing technologies may displace funds from existing health services. However, it is unknown what services are displaced and how such displacement takes place in practice. The aim of our study was to investigate how the Dutch hospital sector has dealt with the introduction of cost-increa...

Background: Independent treatment centres (ITCs) are a growing phenomenon in many healthcare systems. Focus factory theory predicts that ITCs provide high quality healthcare with low prices, through specialisation, high-volume and routine. This study examines if ITC care outperforms general hospital (GH) care within a regulated competition system...

Payment systems (PS) are at the core of the intermediation function between payers and recipients of care, which is complex because of the lack of functioning true markets in healthcare, and where the final outcome is significantly disconnected from what is paid for. There is a major distinction between retrospective and prospective PS. Incentives...

The context for health and hospital care will continue to change greatly. One area of change is ownership, between public, public-private partnership, private not-for-profit, and private for-profit. There are differences between formal and effective control, given that almost everywhere the state has a major role. Pseudo-markets can be created by a...

The determinants of health status depend on public health measures and curative and care services. “Hospitals” as organizations concentrate resources—physical capital and human capital, and technology—and thereby do things which other settings simply cannot. Yet, somehow, they mean different things to different people at different times and differe...

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...

Background: The number of independent treatment centres (ITCs) has grown substantially. However, little is known as to whether the volume-quality relationship exists within this sector and whether other possible organisational factors mediate this relationship. The aim of this study is to gain a better understanding of such possible relationships....

New technologies may displace existing, higher‐value care under a fixed budget. Countries aim to curtail adoption of low‐value technologies, for example, by installing cost‐effectiveness thresholds. Our objective is to estimate the opportunity cost of hospital care to identify a threshold value for the Netherlands. To this aim, we combine claims da...

Background: For older adults, a good transition from hospital to the primary or long-term care setting can decrease readmissions. This paper presents the 6-month post-discharge healthcare utilization of older adults and describes the numbers of readmissions and deaths for the most frequently occurring aftercare arrangements as a starting point in...

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 identify differences between independent treatment centers (ITCs) and general hospitals (GHs) regarding costs, quality of care, and efficiency. Data sources: Anonymous claims data (2013-2015) were used. We also obtained quality indicators from a semipublic platform. Study design: This study uses a comparative multilevel analysis,...

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...

A central element of the 2006 health insurance reform in the Netherlands is strategic purchasing by health insurers. After a brief elaboration of the concept of trust this article discusses the trust of insured in the new purchasing role of health insurers. There are various indications of a trust problem or credible commitment problem in Dutch hea...

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...

Onderzoek naar invloed zorgverzekeraars op voorschrijf-en afleverbeleid Actieve inkoop door zorgverzekeraars wordt met een zeker wantrouwen bekeken door het werkveld. Nergens wordt meer actief ingekocht dan bij geneesmiddelen. Als dus ergens de professionele autonomie onder druk komt te staan is het wel op dit terrein. De vraag is of hierdoor het a...

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...

In the final issue of Public Health Nutrition in 2017, Kathryn Backholer and colleagues provide a clear overview of the spread of taxes on sugar-sweetened beverages (SSB) in 2017, and a useful overview of opposing arguments and their counterpoints. Backholer et al . argue that much of the action was concentrated in the USA, but in the present comme...

De algemene toegankelijkheid tot sociale zekerheid en zorg werd in 1968 voltooid met de Algemene Wet Bijzondere Ziektekosten. De overheid was zich toen, en nu nog steeds, bewust van de noodzaak dat de kosten van zorg en zekerheid dienden te worden beheerst: door te sterke groei ten opzichte van het nationaal inkomen zou de ruimte voor andere publie...

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...

European countries have enhanced the scope of private provision within their health care systems. Privatizing services have been suggested as a means to improve access, quality, and efficiency in health care. This raises questions about the relative performance of private hospitals compared with public hospitals. Most systematic reviews that scruti...