
Roland D FrieleNivel – Research for better care | NIVEL
Roland D Friele
prof. dr.
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260
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Introduction
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July 2008 - present
January 1989 - present
Publications
Publications (260)
Introduction
The digitalization of healthcare poses a risk of exacerbating health inequalities. Dutch public libraries offer freely accessible e-health courses given by trainers. However, there is limited knowledge on whether these libraries successfully reach and support those in need. This study aimed to explore trainers’ perspectives on the chal...
Background
There is a growing concern that digital health care may exacerbate existing health disparities. Digital health care or eHealth encompasses the digital apps that are used in health care. Differences in access, use, and perceived benefits of digital technology among socioeconomic groups are commonly referred to as the digital divide. Curre...
Background
The involvement of patients or next of kin (P/N) after a serious adverse event (SAE) is evolving. Beyond providing mandatory information, there is growing recognition of the need to incorporate their interests. This study explores practical manifestations of P/N involvement and identifies significant considerations for hospitals.
Method...
Background
Over the last decade attention has grown to give patients and next of kin (P/N) more substantial roles in adverse event investigations. Adverse event investigations occur after adverse events that resulted in death or severe injury. Few studies have focused on patient perspectives on their involvement in such investigations. The present...
BACKGROUND
Digitalization of health care services drives people to seek support in utilizing e-health. In the Dutch context, support is offered by public libraries through an e-health course. There is limited insight into the motivation of citizens to seek formal support in e-health use.
OBJECTIVE
This is a qualitative study on motivations of citi...
The Defendant as the Reluctant Player in the Adversarial Setting of Medical Disputes Committees
Medical dispute committees in the Netherlands were formalised in 2017. They offer hybrid procedures, combining complaints handling with the processing of a potential claim in cases where a complaint could not be resolved at the health care organisation....
Background
Recent studies on the impact of ex-post legislative evaluations show that there are different types of impact and different factors that can influence it. These include the context of a legislative evaluation, research quality, and interactions between researchers and other actors within the evaluation process. However, thorough empirica...
BACKGROUND
Background: There is a growing concern that digital healthcare may exacerbate existing differences in health. Digital healthcare or e-health is defined as the digital applications that are used in healthcare. Differences in access to and perceived benefits of digital technology among socio-economic groups are commonly referred to as the...
In various countries, laws are increasingly being evaluated by examining the effects in practice once a law enters into force. No systematic overview currently exists on the impact of these ex-post legislative evaluations. Therefore, this scoping review systematically examines the various types of impact of ex-post legislative evaluations. The stud...
Background
Health care incidents, such as medical errors, cause tragedies all over the world. Recent legislation in the Netherlands has established medical dispute committees to provide for an appeals procedure offering an alternative to civil litigation and to meet the needs of clients. Dispute committees incorporate a hybrid procedure where one c...
Objective
This study aimed to provide an overview of the strategies adopted by hospitals that target effective communication and nonmaterial restoration (i.e., without a financial or material focus) after health care incidents, and to formulate elements in hospital strategies that patients consider essential by analysing how patients have evaluated...
Before you know it, you are on opposite sides of the fence: doctor and patient. That is how it feels when you hear that a disciplinary complaint has been made against you. But most complainants are not interested in this: they mainly want to be heard and, often, to see their complaint acted upon. Two mechanisms can explain why, as a doctor, it stil...
Background
Telemonitoring could offer solutions to the mounting challenges for health care and could improve patient self-management. Studies have addressed the benefits and challenges of telemonitoring for certain patient groups.
Objective
This paper will examine the nationwide uptake of telemonitoring in chronic care in the Netherlands from 2014...
Raising a minimum legal drinking age (MLDA) has generated interest and debate in research and politics, but opposition persists. Up to now, the presentation of impacts focussed on effectiveness (i.e., intended impact); to our knowledge, no literature syntheses focussed on both intended and unintended impacts. A systematic scoping review was conduct...
De Wet kwaliteit, klachten en geschillen zorg (Wkkgz) is per 1 januari 2016 van kracht geworden, met als hoofddoelen het versterken van de positie van cliënten en het bevorderen van de kwaliteit van zorg. Volgens artikel 31 Wkkgz zendt de minister binnen vijf jaar na de inwerkingtreding van de wet een verslag over de doeltreffendheid en de effecten...
Introduction
Disciplinary procedures can have a negative impact on the professional functioning of medical doctors. In this questionnaire study, doctors’ experience with open culture and support during a disciplinary procedure is studied to determine whether open culture and support are associated with perceived changes in the professional practice...
Background
Primary health care data have shown that most patients who were treated for overweight or obesity by a dietitian did not accomplish the recommended treatment period. It is hypothesised that a slow rate of weight loss might discourage patients from continuing dietetic treatment. This study evaluated intermediate weight changes during regu...
Objective:
In the Netherlands, enforcement of the alcohol age limit is low and inconsistent because of limited resources. A solution is to optimize the efforts of enforcement officers by prioritizing ways in which they regulate commercial alcohol availability. This could increase compliance by sellers, curbing commercial availability. The objectiv...
Er bestaat ongemak over het Wmo-beleid bij gespreksvoerders die namens de gemeente de keukentafelgesprekken voeren met inwoners die maatschappelijke ondersteuning aanvragen via de Wmo 2015. De dominante beleidsdoelstelling van het bevorderen van zelfredzaamheid biedt gespreksvoerders onvoldoende houvast bij het bespreken en afwegen van moeilijke ke...
BACKGROUND
Telemonitoring could offer solutions to the mounting challenges for health care and could improve patient self-management. Studies have addressed the benefits and challenges of telemonitoring for certain patient groups.
OBJECTIVE
This paper will examine the nationwide uptake of telemonitoring in chronic care in the Netherlands from 2014...
Introduction
On 23 November 2018 in the Netherlands more than 70 organizations signed the National Prevention Agreement. This document had been set up by the Dutch government aiming to create a healthy generation in 2040. It focuses on alcohol, next to overweight and tobacco control. Participants are a.o. NGO's, the sports sector, insurance compani...
Het is soms lastig om als direct betrokkene op een klacht te moeten reageren. Een klachtenfunctionaris of het organiseren van peer support kan dan een oplossing zijn. Bij de start van een geschillenprocedure zouden klagers beter geïnformeerd moeten worden over wat die procedure inhoudt.
Introduction
Dietitians are the preferred primary health care professionals for nutritional care in overweight patients. Guidelines for dietitians recommend a weight reduction of ≥ 5% of initial body weight after one year of treatment. The purpose of this study was to evaluate weight change in patients with overweight who were treated by dietitians...
In Europe, the rules for surveillance on the manufacturing process of drugs is regulated within the Good Manufacturing Process (GMP) protocol. Every European country has its own regulatory body that is responsible for the surveillance on the compliance of this protocol by pharmaceutical companies. In the Netherlands, the Health and Youth Care Inspe...
Introduction
Disciplinary procedures can have serious consequences for the health, personal life and professional functioning of doctors. Until recently, specific disciplinary measures (reprimands) were publicly disclosed in the Netherlands. The perceived additional impact of disclosing reprimands on the professional and personal life of doctors is...
Background
Routine weight recording in electronic health records (EHRs) could assist general practitioners (GPs) in the identification, prevention, and management of overweight patients. However, the extent to which weight management is embedded in general practice in the Netherlands has not been investigated. The purpose of this study was to evalu...
Involving patients and families in mental healthcare is becoming more commonplace, but little is known about how they are involved in the aftermath of serious adverse events related to quality of care (sentinel events, including suicides). This study explores the role patients and families have in formal processes after sentinel events in Dutch men...
Background:
Electronic health (eHealth) solutions are considered to relieve current and future pressure on the sustainability of primary health care systems. However, evidence of the effectiveness of eHealth in daily practice is missing. Furthermore, eHealth solutions are often not implemented structurally after a pilot phase, even if successful d...
Objectives
It is unclear why the use of email consultation is not more widespread in Dutch general practice, particularly because, since 2006, its costs can be reimbursed. To encourage further implementation, it is needed to understand the current use of email consultations. This study aims to understand the use of email consultation by different p...
The Netherlands Health and Youth Care Inspectorate (IGJ) wants to take the patient's perspective into account more often in its supervision of quality of care. The inspectorate already has some insight into this perspective via patients' reports; patients report complaints with the aim of preventing recurrence of the problem. However, the inspector...
https://www.nictiz.nl/ehealth/ehealth-monitor/ehealth-monitor-2017
Objectives:
Internationally, healthcare quality regulators are criticized for failing to respond to patients' complaints. Patient involvement is, therefore, an important item on the policy agenda. However, it can be argued that there is a discrepancy between the patients' perspective and current regulatory approaches.This study examines whether a...
Background
Although many web-based mental health interventions are being released, the actual uptake by end users is limited. The marginal level of engagement of end users when developing these interventions is recognized as an important cause for uptake problems. In this paper, we offer our perceptive on how to improve user engagement. By doing so...
Background
There is a growing emphasis on self-monitoring applications that allow patients to measure their own physical health parameters. A prerequisite for achieving positive effects is patients’ willingness to self-monitor. The controllability of disease types, patients’ perceived self-efficacy and health problems could play an essential role i...
In health care policies, the right to complain is presented as a key patient right. Complaints are also seen as a potential vehicle for quality improvement. However, in long-term care facilities for older persons in the Netherlands, relatively few complaints are registered. An explorative qualitative study was performed at three long-term care faci...
Objectives:
It is assumed that classifying and aggregated reporting of patients' complaints by regulators helps to identify problem areas, to respond better to patients and increase public accountability. This pilot study addresses what a classification of complaints in a regulatory setting contributes to the various goals.
Methods:
A taxonomy w...
"Gemakkelijk je zorg regelen, dat kan met eHealth-diensten zoals online consulten. Veel mensen weten niet dat dit mogelijk is, terwijl dit wel al bij veel artsen kan. Zorgverleners moeten patiënten actief stimuleren om hun online diensten te gebruiken. Dit is een van de aanbevelingen uit de eHealth-monitor 2016 van Nictiz en het NIVEL." https://www...
Rapportage eHealth-doelstellingen 2016.
The report describes the results of research among several types of health care workers (doctors, nurses) and patients with chronic conditions and/or fragile elderly. It regards there experiences with and use of eHealth.
Background:
Self-management is considered as an essential component of chronic care by primary care professionals. eHealth is expected to play an important role in supporting patients in their self-management. For effective implementation of eHealth it is important to investigate patients' expectations and needs regarding self-management and eHeal...
Background: Self-management is considered as an essential component of chronic care by primary care professionals. eHealth is expected to play an important role in supporting patients in their self-management. For effective implementation of eHealth it is important to investigate patients’ expectations and needs regarding self-management and eHealt...
In the wake of various high-profile incidents in a number of countries, regulators of healthcare quality have been criticised for their 'soft' approach. In politics, concerns were expressed about public confidence. It was claimed that there are discrepancies between public opinions related to values and the values guiding regulation policies. Altho...
Background:
The Netherlands is one of the frontrunners of eHealth in Europe. Many general practices offer Internet services, which can be used by patients to communicate with their general practice. In promoting and implementing such services, it is important to gain insight into patients' actual use and intention toward using.
Objective:
The ob...
Background
Patients who submit complaints about the healthcare they have received are often dissatisfied with the response to their complaints. This is usually attributed to the failure of physicians to respond adequately to what complainants want, e.g. an apology or an explanation. However, expectations of complaint handling among the public may c...
- Recent broadly-supported guidelines stipulate that physicians and other care providers should be open and honest about incidents, i.e. medical errors.- This standard has been reinforced by recent statements from the medical disciplinary board and is shortly expected to be incorporated into Dutch law. - In daily practice many personal and institut...
Introduction: In the last years a large number of telecare and eHealth technologies have been developed which can be used in primary care to support patients with a chronic condition with self-management. However, these technologies are not yet frequently implemented and routinely used in the healthcare process. One of the reasons is that there is...
Governments in several countries are facing problems concerning the accountability of regulators in health care. Questions have been raised about how patients' complaints should be valued in the regulatory process. However, it is not known what patients who made complaints expect to achieve in the process of health-care quality regulation.
To asses...
Bij het toezicht op de kinderopvang gebruiken de GGD’en een risicomodel. Dit risicomodel moet ervoor zorgen dat inspecteurs op uniforme wijze de inspectieactiviteit kunnen bepalen en dat meer tijd wordt besteed aan de inspectie van zwakkere kinderopvanglocaties.
Toezicht op de kinderopvang in Nederland is de wettelijke taak van de gemeenten. Zij g...
Background: Various European healthcare systems encourage patients to make an active choice of healthcare provider, both as a worthwhile effort for patients and an instrument to encourage competition between providers. In previous research, patient groups were distinguished regarding patients’ hospital selection process: patients without choice opp...
Background
Various north-western European health-care systems encourage patients to make an active choice of health-care provider. This study explores, qualitatively, patients' hospital selection processes and provides insight into the reasons why patients do or do not make active choices.Methods
Semi-structured individual interviews were conducted...
This article deals with the questions what the benefits and limitations are of the instruments and strategies that patient organisations use to influence quality of care. The advocacy of patients' interests has become more important for patient organisations in recent years, which is partly due to Dutch health care policy reform. Thirty state funde...
De afgelopen jaren zijn verschillende malen voorstellen gedaan om een algemene Toezichtwet op het terrein van de zorg te maken. Deze voorstellen behelsden vaak niet meer dan een globaal idee. Tot nu toe is nimmer onderzoek verricht naar de mogelijke opzet en meerwaarde van een dergelijke Toezichtwet. In het kader van de onlangs door ons afgeronde t...
Today, in several north-western European countries, patients are encouraged to choose, actively, a healthcare provider. However, patients often visit the provider that is recommended by their general practitioner (GP). The introduction of patient choice requires GPs to support patients to be involved, actively, in the choice of a healthcare provide...
Providing information to citizens is an important first step in the implementation of new policy. In this study we explain differences in the knowledge of citizens between municipalities of a newly introduced law in the Netherlands, the Social Support Act, 10 months after it became into force. This law is especially important for older people that...
The use of technology in care at home has potential benefits such as improved quality of care. This includes greater focus on the patients' role in managing their health and increased patient involvement in the care process. The objective of this scoping review is to analyse the existing evidence for effects of technology in home-based care on pati...
An increasing number of patients become eligible for organ transplants. In the Netherlands, at the level of policy discourse, growing waiting lists are often referred to as a persistent "shortage" of organs, producing a "public health crisis." In this way, organ donation is presented as an ethical, social, and medical necessity. Likewise, policy di...
In several countries, patients are encouraged to choose health care providers. Simultaneously, there is a tendency towards the concentration of health care, which might lessen the choice. Our aim was to assess the impact of patients' distances from their providers on their information-seeking, which is one element of choice.
Two thousand members of...
To assess differences in patient satisfaction between a complaints procedure designed towards the needs of complainants (referred to here as the 'Committee') and a procedure that primarily aims at improving the professional quality of health care (referred to here as the 'Board').
Patients' experiences and satisfaction were assessed through a quest...
Several countries are implementing a national electronic patient record (n-EPR). Despite the assumed positive effects of n-EPRs on the efficiency, continuity, safety and quality of care, their overall adoption remains low and meets resistance from involved parties. The implementation of the Dutch n-EPR also raised considerable controversy, which ev...
Background
In the Netherlands in 2006, a health insurance system reform took place in which regulated competition between insurers and providers is key. In this context, the government placed greater emphasis on patients being able to choose health insurers and providers as a precondition for competition. Patient choice became an instrument instead...
Background
In several northwest European countries, a demand-driven healthcare system has been implemented that stresses the importance of patient healthcare provider choice. In this study, we are conducting a scoping review aiming to map out what is known about the determinants of patient choice of a wide range of healthcare providers. As far as w...
Participation of disabled or chronically ill persons into the society may require support in the sense of human or technical aid. In this study we look into the decision making power of governments and the way citizens are involved in these processes. Decision making power can be political, financial and administrative and may be organized at natio...
The introduction of home telecare in healthcare organizations has shown mixed results in practice. The aim of this study is to arrive at a set of key factors that can be used in further implementation of video communication. We argue that key factors are mainly found in the organizational climate for home telecare implementation, the characteristic...
In this contribution we discuss some pertinent issues regarding knowledge implementation in the Netherlands, focusing on the largest public funding agency for health research in the Netherlands (ZonMw). The commentary is based on a report, which includes a structured analysis of 79 projects funded by ZonMW, a survey of published implementation rese...
Various countries are currently implementing a national electronic patient record (n-EPR). Despite the assumed positive effects of n-EPRs, their overall adoption remains low and meets resistance from health care providers. This study aims to increase our understanding of health care providers' attitude towards the n-EPR, by investigating their perc...