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Sample records for dutch health care

  1. Dutch health care performance report 2008.

    NARCIS (Netherlands)

    Westert, G.P.; Berg, M.J. van den; Koolman, X.; Verkleij, H.

    2008-01-01

    This is the second national report on the performance of the Dutch health care system. Its focus is on quality, access and costs in 2006/7. The Dutch Health Care Performance Report presents a broad picture based on 110 indicators. Where possible, comparisons in time and between countries are

  2. Quality systems in Dutch health care institutions.

    NARCIS (Netherlands)

    Casparie, A.F.; Sluijs, E.M.; Wagner, C.; Bakker, D.H. de

    1997-01-01

    The implementation of quality systems in Dutch health care was supervised by a national committee during 1990-1995. To monitor the progress of implementation a large survey was conducted in the beginning of 1995. The survey enclosed all subsectors in health care. A postal questionnaire-derived fr

  3. Public trust in Dutch health care

    NARCIS (Netherlands)

    Straten, G.F.M.; Friele, R.D.; Groenewegen, P.P.

    2002-01-01

    This article describes the development of a valid and reliable instrument to measure different dimensions of public trust in health care in the Netherlands. This instrument is needed because the concept was not well developed,or operationalized in earlier research. The new instrument will be used in

  4. Public trust in Dutch health care.

    NARCIS (Netherlands)

    Straten, G.F.M.; Friele, R.D.; Groenewegen, P.P.

    2002-01-01

    This article describes the development of a valid and reliable instrument to measure different dimensions of public trust in health care in the Netherlands. This instrument is needed because the concept was not well developed, or operationalized in earlier research. The new instrument will be used i

  5. The use of therapeutic ultrasound by physical therapists in Dutch primary health care.

    NARCIS (Netherlands)

    Roebroeck, M.E.; Dekker, J.; Oostendorp, R.A.B.

    1998-01-01

    Background and purpose: the purpose of this study were to describe the use of ultrasound by Dutch physical therapists and to address the question of whether this use is what would be considered correct. Subjects and methods: physical therapists in the Dutch primary health care system gathered data

  6. The use of therapeutic ultrasound by physical therapists in Dutch primary health care.

    NARCIS (Netherlands)

    Roebroeck, M.E.; Dekker, J.; Oostendorp, R.A.B.

    1998-01-01

    Background and purpose: the purpose of this study were to describe the use of ultrasound by Dutch physical therapists and to address the question of whether this use is what would be considered correct. Subjects and methods: physical therapists in the Dutch primary health care system gathered data o

  7. Regulated competition in health care: switching and barriers to switching in the Dutch health insurance system.

    NARCIS (Netherlands)

    Reitsma-van Rooijen, M.; Jong, J.D. de; Rijken, M.

    2011-01-01

    Background: In 2006, a number of changes in the Dutch health insurance system came into effect. In this new system mobility of insured is important. The idea is that insured switch insurers because they are not satisfied with quality of care and the premium of their insurance. As a result, insurers

  8. Spending on Health Care in the Netherlands: Not Going so Dutch

    NARCIS (Netherlands)

    P.L.H. Bakx (Pieter); O.A. O'Donnell (Owen); E.K.A. van Doorslaer (Eddy)

    2016-01-01

    textabstractThe Netherlands is among the top spenders on health in the OECD. We document the life-cycle profile, concentration and persistence of this expenditure using claims data covering both curative and long-term care expenses for the full Dutch population. Spending on health care is strongly c

  9. Spending on Health Care in the Netherlands: Not Going So Dutch

    NARCIS (Netherlands)

    P. Bakx (Pieter); O.A. O'Donnell (Owen); E.K.A. van Doorslaer (Eddy)

    2016-01-01

    textabstractThe Netherlands is among the top spenders on health in the OECD. We document the life-cycle profile, concentration and persistence of this expenditure using claims data covering both curative and long-term care expenses for the full Dutch population. Spending on health care is strongly c

  10. Participation and coordination in Dutch health care policy-making. A network analysis of the system of intermediate organizations in Dutch health care.

    Science.gov (United States)

    Lamping, Antonie J; Raab, Jörg; Kenis, Patrick

    2013-06-01

    This study explores the system of intermediate organizations in Dutch health care as the crucial system to understand health care policy-making in the Netherlands. We argue that the Dutch health care system can be understood as a system consisting of distinct but inter-related policy domains. In this study, we analyze four such policy domains: Finances, quality of care, manpower planning and pharmaceuticals. With the help of network analytic techniques, we describe how this highly differentiated system of >200 intermediate organizations is structured and coordinated and what (policy) consequences can be observed with regard to its particular structure and coordination mechanisms. We further analyze the extent to which this system of intermediate organizations enables participation of stakeholders in policy-making using network visualization tools. The results indicate that coordination between the different policy domains within the health care sector takes place not as one would expect through governmental agencies, but through representative organizations such as the representative organizations of the (general) hospitals, the health care consumers and the employers' association. We further conclude that the system allows as well as denies a large number of potential participants access to the policy-making process. As a consequence, the representation of interests is not necessarily balanced, which in turn affects health care policy. We find that the interests of the Dutch health care consumers are well accommodated with the national umbrella organization NPCF in the lead. However, this is no safeguard for the overall community values of good health care since, for example, the interests of the public health sector are likely to be marginalized.

  11. Child and adolescent mental health care in Dutch general practice: time trend analyses.

    NARCIS (Netherlands)

    Zwaanswijk, M.; Dijk, C.E. van; Verheij, R.A.

    2011-01-01

    Background: Because most children and adolescents visit their general practitioner (GP) regularly, general practice is a useful setting in which child and adolescent mental health problems can be identified, treated or referred to specialised care. Measures to strengthen Dutch primary mental health

  12. The Dutch health care system: how are we organised?

    NARCIS (Netherlands)

    Jabaaij, L.

    2006-01-01

    The Netherlands has a unique and complex healthcare organisation and financing system. Insight into the peculiarities of the Dutch system helps one to understand the position of general practice. This chapter opens with a short outline of Dutch demographics: who are we and how many are we? Subsequen

  13. [Dutch Institute for Health Care Improvement revised guideline, 'Sexually transmitted diseases and neonatal herpes'

    NARCIS (Netherlands)

    Bleker, O.P.; Meijden, W.I. van der; Wittenberg, J.; Bergen, J.E. van; Boeke, A.J.; Doornum, G.J.J. van; Henquet, C.J.; Galama, J.M.D.; Postma, M.J.; Prins, J.M.; Voorst Vader, P.C. van

    2003-01-01

    The Dutch Institute for Health Care Improvement revised guideline, 'Sexually transmitted diseases and neonatal herpes' summarises the current scientific position on the diagnosis and treatment of a great number of sexually transmitted diseases (STD) and neonatal herpes. Symptomatic treatment of susp

  14. [Dutch Institute for Health Care Improvement revised guideline, 'Sexually transmitted diseases and neonatal herpes'

    NARCIS (Netherlands)

    Bleker, O.P.; Meijden, W.I. van der; Wittenberg, J.; Bergen, J.E. van; Boeke, A.J.; Doornum, G.J.J. van; Henquet, C.J.; Galama, J.M.D.; Postma, M.J.; Prins, J.M.; Voorst Vader, P.C. van

    2003-01-01

    The Dutch Institute for Health Care Improvement revised guideline, 'Sexually transmitted diseases and neonatal herpes' summarises the current scientific position on the diagnosis and treatment of a great number of sexually transmitted diseases (STD) and neonatal herpes. Symptomatic treatment of susp

  15. The availability of allied health care in Dutch nursing homes.

    NARCIS (Netherlands)

    Boer, M.E. de; Leemrijse, C.J.; Ende, C.H.M. van den; Ribbe, M.W.; Dekker, J.

    2007-01-01

    Purpose. To determine the availability of allied health care in nursing homes in the Netherlands, and its dependency on characteristics of the nursing home. Methods. Structured surveys by telephone were carried out in a sample of 100 from a country total of 286 somatic (for somatic patients only) an

  16. The availability of allied health care in Dutch nursing homes.

    NARCIS (Netherlands)

    Boer, M.E. de; Leemrijse, C.J.; Ende, C.H.M. van den; Ribbe, M.W.; Dekker, J.

    2007-01-01

    Purpose. To determine the availability of allied health care in nursing homes in the Netherlands, and its dependency on characteristics of the nursing home. Methods. Structured surveys by telephone were carried out in a sample of 100 from a country total of 286 somatic (for somatic patients only) an

  17. Regulated competition in health care: Switching and barriers to switching in the Dutch health insurance system

    Directory of Open Access Journals (Sweden)

    Rijken Mieke

    2011-05-01

    Full Text Available Abstract Background In 2006, a number of changes in the Dutch health insurance system came into effect. In this new system mobility of insured is important. The idea is that insured switch insurers because they are not satisfied with quality of care and the premium of their insurance. As a result, insurers will in theory strive for a better balance between price and quality. The Dutch changes have caught the attention, internationally, of both policy makers and researchers. In our study we examined switching behaviour over three years (2007-2009. We tested if there are differences in the numbers of switchers between groups defined by socio-demographic and health characteristics and between the general population and people with chronic illness or disability. We also looked at reasons for (not-switching and at perceived barriers to switching. Methods Switching behaviour and reasons for (not-switching were measured over three years (2007-2009 by sending postal questionnaires to members of the Dutch Health Care Consumer Panel and of the National Panel of people with Chronic illness or Disability. Data were available for each year and for each panel for at least 1896 respondents - a response of between 71% and 88%. Results The percentages of switchers are low; 6% in 2007, 4% in 2008 and 3% in 2009. Younger and higher educated people switch more often than older and lower educated people and women switch more often than men. There is no difference in the percentage of switchers between the general population and people with chronic illness or disability. People with a bad self-perceived health, and chronically ill and disabled, perceive more barriers to switching than others. Conclusion The percentages of switchers are comparable to the old system. Switching is not based on quality of care and thus it can be questioned whether it will lead to a better balance between price and quality. Although there is no difference in the frequency of switching

  18. Internet and social media for health-related information and communication in health care: preferences of the Dutch general population.

    Science.gov (United States)

    Van de Belt, Tom H; Engelen, Lucien J L P G; Berben, Sivera A A; Teerenstra, Steven; Samsom, Melvin; Schoonhoven, Lisette

    2013-10-02

    Health care is increasingly featured by the use of Web 2.0 communication and collaborative technologies that are reshaping the way patients and professionals interact. These technologies or tools can be used for a variety of purposes: to instantly debate issues, discover news, analyze research, network with peers, crowd-source information, seek support, and provide advice. Not all tools are implemented successfully; in many cases, the nonusage attrition rates are high. Little is known about the preferences of the Dutch general population regarding the use of the Internet and social media in health care. To determine the preferences of the general population in the Netherlands regarding the use of the Internet and social media in health care. A cross-sectional survey was disseminated via a popular Dutch online social network. Respondents were asked where they searched for health-related information, how they qualified the value of different sources, and their preferences regarding online communication with health care providers. Results were weighed for the Dutch population based on gender, age, and level of education using official statistics. Numbers and percentages or means and standard deviations were presented for different subgroups. One-way ANOVA was used to test for statistical differences. The survey was completed by 635 respondents. The Internet was found to be the number one source for health-related information (82.7%), closely followed by information provided by health care professionals (71.1%). Approximately one-third (32.3%) of the Dutch population search for ratings of health care providers. The most popular information topics were side effects of medication (62.5%) and symptoms (59.7%). Approximately one-quarter of the Dutch population prefer to communicate with a health care provider via social media (25.4%), and 21.2% would like to communicate via a webcam. The Internet is the main source of health-related information for the Dutch population

  19. A Transaction Cost Analysis of Dutch Hospital Care Contracting between hospitals and health insurance companies in a deregulated environment

    OpenAIRE

    Brandenburg, Claudia

    2008-01-01

    textabstractThe Dutch government has started a process of reformation in the Dutch healthcare. The goal of this reformation is cost efficient healthcare in the Netherlands. Hospitals and health insurance companies in the Netherlands experience changes in regulations and funding. They are expected to negotiate about the price and quantities of hospital care. A product-price system for hospital care, called DBC, has been introduced by the government to support these negotiations. This study sho...

  20. Some pain, no gain: experiences with the no-claim rebate in the Dutch health care system

    NARCIS (Netherlands)

    J. Holland; N.J.A. van Exel (Job); F.T. Schut (Erik); W.B.F. Brouwer (Werner)

    2009-01-01

    textabstractTo contain expenditures in an increasingly demand driven health care system, in 2005 a no-claim rebate was introduced in the Dutch health insurance system. Since demand-side cost sharing is a very controversial issue, the no-claim rebate was launched as a consumer friendly bonus system t

  1. The governance of quality management in dutch health care: new developments and strategic challenges.

    Science.gov (United States)

    Maarse, J A M; Ruwaard, D; Spreeuwenberg, C

    2013-01-01

    This article gives a brief sketch of quality management in Dutch health care. Our focus is upon the governance of guideline development and quality measurement. Governance is conceptualized as the structure and process of steering of quality management. The governance structure of guideline development in the Netherlands can be conceptualized as a network without central coordination. Much depends upon the self-initiative of stakeholders. A similar picture can be found in quality measurement. Special attention is given to the development of care standards for chronic disease. Care standards have a broader scope than guidelines and take an explicit patient perspective. They not only contain evidence-based and up-to-date guidelines for the care pathway but also contain standards for self-management. Furthermore, they comprise a set of indicators for measuring the quality of care of the entire pathway covered by the standard. The final part of the article discusses the mission, tasks and strategic challenges of the newly established National Health Care Institute (Zorginstituut Nederland), which is scheduled to be operative in 2013.

  2. An experiment with regulated competition and individual mandates for universal health care: the new Dutch health insurance system.

    Science.gov (United States)

    Rosenau, Pauline Vaillancourt; Lako, Christiaan J

    2008-12-01

    The 2006 Enthoven-inspired Dutch health insurance reform, based on regulated competition with a mandate for individuals to purchase insurance, will interest U.S. policy makers who seek universal coverage. This ongoing experiment includes guaranteed issue, price competition for a standardized basic benefits package, community rating, sliding-scale income-based subsidies for patients, and risk equalization for insurers. Our assessment of the first two years is based on Dutch Central Bank statistics, national opinion polls, consumer surveys, and qualitative interviews with policy makers. The first lesson for the United States is that the new Dutch health insurance model may not control costs. To date, consumer premiums are increasing, and insurance companies report large losses on the basic policies. Second, regulated competition is unlikely to make voters/citizens happy; public satisfaction is not high, and perceived quality is down. Third, consumers may not behave as economic models predict, remaining responsive to price incentives. Finally, policy makers should not underestimate the opposition from health care providers who define their profession as more than simply a job. If regulated competition with individual mandates performs poorly in auspicious circumstances such as the Netherlands, how will this model fare in the United States, where access, quality, and cost challenges are even greater? Might the assumptions of economic theory not apply in the health sector?

  3. Translating the SLIM diabetes prevention intervention into SLIMMER: implications for the Dutch primary health care.

    Science.gov (United States)

    Duijzer, Geerke; Jansen, Sophia C; Haveman-Nies, Annemien; van Bruggen, Rykel; Ter Beek, Josien; Hiddink, Gerrit J; Feskens, Edith J M

    2012-04-01

    All over the world, prevalence and incidence rates of type 2 diabetes mellitus are rising rapidly. Several trials have demonstrated that prevention by lifestyle intervention is (cost-) effective. This calls for translation of these trials to primary health care. This article gives an overview of the translation of the SLIM diabetes prevention intervention to a Dutch real-life setting and discusses the role of primary health care in implementing lifestyle intervention programmes. Currently, a 1-year pilot study, consisting of a dietary and physical activity part, performed by three GPs, three practice nurses, three dieticians and four physiotherapists is being conducted. The process of translating the SLIM lifestyle intervention to regular primary health care is measured by means of the process indicators: reach, acceptability, implementation integrity, applicability and key factors for success and failure of the intervention. Data will be derived from programme records, observations, focus groups and interviews. Based on these results, our programme will be adjusted to fit the role conception of the professionals and the organization structure in which they work.

  4. Care for health. The 2006 Dutch Public Health Status and Forecasts Report

    OpenAIRE

    de Hollander AEM; Hoeymans N; Melse JM; van Oers JAM; Polder JJ; VTV

    2007-01-01

    As in the past a large amount of information on health, prevention and health care in the Netherlands has been collected for this edition of the VTV public health forecast. Public health in the Netherlands is improving, but can still be better. Overweight and unhealthy behaviour, especially among young people, are becoming a source of concern for public health in the future. Furthermore, there are many differences in health and health risks cited among regions and neighbourhoods. Backlogs in ...

  5. Communalization of health care: how to do it properly. Criteria for a just communalization of health care applied to the Dutch situation.

    Science.gov (United States)

    Beneken genaamd Kolmer, D M; Tellings, A; Garretsen, H F L; Bongers, I M B

    2007-03-01

    Communalization of health care refers to the increasing responsibility of citizens to look after their ill or handicapped fellow members of society and to provide care to them. Governments in Western Europe more and more develop health care policies directed at communalization of health care. The article discusses the care responsibilities of individuals based on the views of the philosophers Buber, Levinas, and Ricoeur and on the views of the family therapist Nagy. The care responsibilities of states are discussed in terms of the views of the political philosophers Rawls and Daniels and these are linked to right liberal, left liberal, and Christian-democrat views on care responsibilities of states. Thereupon, four criteria for a proper communalization of health care are proposed and different forms of health care policies with respect to communalization of care are assessed. In the last section, we look closely at several measures in the just reformed Dutch health care system and discuss how far these measures meet our criteria for a proper communalization. We focus in this section on the effects of these measures on family care because more and more family care plays an important role in good functioning of the health care system.

  6. The EFQM excellence model: European and Dutch experiences with the EFQM approach in health care. European Foundation for Quality Management.

    Science.gov (United States)

    Nabitz, U; Klazinga, N; Walburg, J

    2000-06-01

    One way to meet the challenges in creating a high performance organization in health care is the approach of the European Foundation for Quality Management (EFQM). The Foundation is in the tradition of the American Malcolm Baldrige Award and was initiated by the European Commission and 14 European multi-national organizations in 1988. The essence of the approach is the EFQM Model, which can be used as a self-assessment instrument on all levels of a health care organization and as an auditing instrument for the Quality Award. In 1999 the EFQM Model was revised but its principles remained the same. In The Netherlands many health care organizations apply the EFQM Model. In addition to improvement projects, peer review of professional practices, accreditation and certification, the EFQM Approach is used mainly as a framework for quality management and as a conceptualization for organizational excellence. The Dutch National Institute for Quality, the Instituut Nederlandse Kwaliteit, delivers training and supports self-assessment and runs the Dutch quality award programme. Two specific guidelines for health care organizations, 'Positioning and Improving' and 'Self-Assessment', have been developed and are used frequently. To illustrate the EFQM approach in The Netherlands, the improvement project of the Jellinek Centre is described. The Jellinek Centre conducted internal and external assessments and received in 1996, as the first health care organization, the Dutch Quality Prize.

  7. Competition in the Dutch hospital sector: an analysis of health care volume and cost.

    Science.gov (United States)

    Krabbe-Alkemade, Y J F M; Groot, T L C M; Lindeboom, M

    2017-03-01

    This paper evaluates the impact of market competition on health care volume and cost. At the start of 2005, the financing system of Dutch hospitals started to be gradually changed from a closed-end budgeting system to a non-regulated price competitive prospective reimbursement system. The gradual implementation of price competition is a 'natural experiment' that provides a unique opportunity to analyze the effects of market competition on hospital behavior. We have access to a unique database, which contains hospital discharge data of diagnosis treatment combinations (DBCs) of individual patients, including detailed care activities. Difference-in-difference estimates show that the implementation of market-based competition leads to relatively lower total costs, production volume and number of activities overall. Difference-in-difference estimates on treatment level show that the average costs for outpatient DBCs decreased due to a decrease in the number of activities per DBC. The introduction of market competition led to an increase of average costs of inpatient DBCs. Since both volume and number of activities have not changed significantly, we conclude that the cost increase is likely the result of more expensive activities. A possible explanation for our finding is that hospitals look for possible efficiency improvements in predominantly outpatient care products that are relatively straightforward, using easily analyzable technologies. The effects of competition on average cost and the relative shares of inpatient and outpatient treatments on specialty level are significant but contrary for cardiology and orthopedics, suggesting that specialties react differently to competitive incentives.

  8. [Guideline 'Incontinence urine and feces' of the Dutch Preventive Youth Health Care].

    Science.gov (United States)

    Beltman, Maaike; Deurloo, Jacqueline A; van Leerdam, Frank J M; Wierenga-van der Hoeven, Catelijne J; Bulk-Bunschoten, Anneke M W; Kamphuis, Mascha

    2012-01-01

    Continence problems can occur during childhood. This guideline is for the Dutch Youth Health Care (JGZ) and gives recommendations for the prevention, early detection and treatment of these problems. As a preventative measure advices for potty training should be started in children aged 18-24 months. If incontinence is present, it is important to take a history and carry out physical examination. In children over the age of 5 who are incontinent of urine the following are recommended: taking child out of bed, calendar with reward system, bedwetting alarm or voiding diary; children over the age of 8 can follow dry bed training. Faecal incontinence is often associated with constipation. Incontinent children with constipation are given advice about normal eating and exercise patterns. If this is not successful then laxatives are prescribed. The JGZ should refer further if there are indications of an underlying condition; if children over the age of 5 are wet during the day; if children are incontinent of faeces at night; if children are incontinent of faeces but not constipated; if children persistently wet the bed; if there is faecal incontinence despite counselling, and if medication needs to be prescribed.

  9. Health Behaviors, Care Needs and Attitudes towards Self-Prescription: A Cross-Sectional Survey among Dutch Medical Students

    Science.gov (United States)

    Van der Veer, Tjeerd; Frings-Dresen, Monique H. W.; Sluiter, Judith K.

    2011-01-01

    Purpose There is a growing awareness of the potent ways in which the wellbeing of physicians impacts the health of their patients. The purpose of this study was to investigate the health behaviors, care needs and attitudes towards self-prescription of Dutch medical students, and any differences between junior preclinical and senior clinically active students. Methods All students (n = 2695) of a major Dutch medical school were invited for an online survey. Physical activity, eating habits, alcohol consumption, smoking, Body Mass Index, substance use and amount of sleep per night were inquired, as well as their need for different forms of care and their attitude towards self-prescription. Results Data of 902 students were used. Physical activity levels (90% sufficient) and smoking prevalence (94% non-smokers) were satisfying. Healthy eating habits (51% insufficient) and alcohol consumption (46% excessive) were worrying. Body Mass Indexes were acceptable (20% unhealthy). We found no significant differences in health behaviors between preclinical and clinically active students. Care needs were significantly lower among clinically active students. (pUnhealthy behaviors are prevalent among medical students, but are no more prevalent during the clinical study phase. The need for specific forms of care appears lower with study progression. This could be worrying as the acceptance of self-care and self-prescription is higher among senior clinical students. Medical faculties need to address students' unhealthy behaviors and meet their care needs for the benefit of both the future physicians as well as their patients. PMID:22132202

  10. Using patient experiences on Dutch social media to supervise health care services: exploratory study

    NARCIS (Netherlands)

    Belt, T.H. van de; Engelen, L.J.L.P.G.; Verhoef, L.M.; Weide, M.J. van der; Schoonhoven, L.; Kool, R.B.

    2015-01-01

    BACKGROUND: Social media has become mainstream and a growing number of people use it to share health care-related experiences, for example on health care rating sites. These users' experiences and ratings on social media seem to be associated with quality of care. Therefore, information shared by ci

  11. Patient incompetence and substitute decision-making: an analysis of the role of the health care professional in Dutch law.

    Science.gov (United States)

    Welie, Sander P K; Dute, Joseph; Nys, Herman; van Wijmen, Frans C B

    2005-07-01

    In any jurisdiction that takes patient autonomy and patient rights seriously, patient competence is a pivotal concept. Competence, which should be distinguished from criminal responsibility and legal capacity, can be defined as the ability to exercise rights, more in particular the ability to exercise one's right to give or refuse informed consent. It depends upon a patient's competence whether or not this patient has the final say in a health care decision and whether or not the patient can legitimately be subjected to compulsory interventions in that context. These possibly far reaching consequences explain why competence is the topic of a growing amount of legal regulation and why policy attempts are made at operationalising the concept in workable criteria. Although agreed upon criteria for competence do not exist, there is consensus about some preconditions of competence assessment. Two kinds of models of substitute decision-making for incompetent patients are available, i.e. best interests models and representational models. The Dutch Contract of medical treatment Act is treated as an example of the latter. It is shown that in the Dutch model, health care professionals are not at the mercy of patient representatives. On the contrary, health care professionals are supposed to judge their patients' subjective interests and may eventually overrule the representatives. A public debate ought to take place about the basis for this authority.

  12. Competition and quality indicators in the health care sector: empirical evidence from the Dutch hospital sector.

    Science.gov (United States)

    Croes, R R; Krabbe-Alkemade, Y J F M; Mikkers, M C

    2017-01-03

    There is much debate about the effect of competition in healthcare and especially the effect of competition on the quality of healthcare, although empirical evidence on this subject is mixed. The Netherlands provides an interesting case in this debate. The Dutch system could be characterized as a system involving managed competition and mandatory healthcare insurance. Information about the quality of care provided by hospitals has been publicly available since 2008. In this paper, we evaluate the relationship between quality scores for three diagnosis groups and the market power indicators of hospitals. We estimate the impact of competition on quality in an environment of liberalized pricing. For this research, we used unique price and production data relating to three diagnosis groups (cataract, adenoid and tonsils, bladder tumor) produced by Dutch hospitals in the period 2008-2011. We also used the quality indicators relating to these diagnosis groups. We reveal a negative relationship between market share and quality score for two of the three diagnosis groups studied, meaning that hospitals in competitive markets have better quality scores than those in concentrated markets. We therefore conclude that more competition is associated with higher quality scores.

  13. Health behaviors, care needs and attitudes towards self-prescription: a cross-sectional survey among Dutch medical students.

    Directory of Open Access Journals (Sweden)

    Tjeerd Van der Veer

    Full Text Available PURPOSE: There is a growing awareness of the potent ways in which the wellbeing of physicians impacts the health of their patients. The purpose of this study was to investigate the health behaviors, care needs and attitudes towards self-prescription of Dutch medical students, and any differences between junior preclinical and senior clinically active students. METHODS: All students (n = 2695 of a major Dutch medical school were invited for an online survey. Physical activity, eating habits, alcohol consumption, smoking, Body Mass Index, substance use and amount of sleep per night were inquired, as well as their need for different forms of care and their attitude towards self-prescription. RESULTS: Data of 902 students were used. Physical activity levels (90% sufficient and smoking prevalence (94% non-smokers were satisfying. Healthy eating habits (51% insufficient and alcohol consumption (46% excessive were worrying. Body Mass Indexes were acceptable (20% unhealthy. We found no significant differences in health behaviors between preclinical and clinically active students. Care needs were significantly lower among clinically active students. (p<0.05 Student acceptance of self-prescription was significantly higher among clinically active students. (p<0.001 CONCLUSIONS: Unhealthy behaviors are prevalent among medical students, but are no more prevalent during the clinical study phase. The need for specific forms of care appears lower with study progression. This could be worrying as the acceptance of self-care and self-prescription is higher among senior clinical students. Medical faculties need to address students' unhealthy behaviors and meet their care needs for the benefit of both the future physicians as well as their patients.

  14. [A description of children and adolescents with somatic unexplained physical symptoms in a Dutch mental health care institution].

    Science.gov (United States)

    Kouijzer, M E J; Loman, F; van der Feltz-Cornelis, C M

    2013-01-01

    Medically unexplained symptoms (MUS) occur frequently in children and adolescents. Treatment of MUS in children and adolescents takes place mainly in mental health care (MHC) institutions, as does the treatment of adults with MUS. However, there is hardly any literature about the prevalence of MUS in children and adolescents in MHC. To study the prevalence of MUS in children and adolescents in Dutch MHC. Comparisons were drawn between children and adolescents with MUS and those without MUS who had been referred to a Dutch MHC institution. Children and adolescents with MUS had more anxiety and depression and more introvert personality characteristics than children and adolescents without MUS. However, the quality of life of children and adolescents with MUS was similar to that of children and adolescents without MUS. One in five children and adolescents in Dutch MHC had MUS. These children and adolescents had introverted personality characteristics and showed anxious and depressed behavior, withdrawn-depressed behavior, and thought problems. The quality of life of children and adolescents with MUS and those without MUS was below average.

  15. Further evaluation of the Dutch supervision system for suicides of mental health care users

    NARCIS (Netherlands)

    A. Huisman (Annemiek); P.B.M. Robben (Paul); A.J.F.M. Kerkhof (Ad)

    2013-01-01

    textabstractUntil recently, suicides of mental health care users in the Netherlands had to be reported to the Health Care Inspectorate by treating clinicians and medical directors. Interview data from 38 clinicians who reported a suicide and directors of the 28 facilities where they worked indicated

  16. Evaluation of moral case deliberation at the Dutch Health Care Inspectorate: A pilot study

    NARCIS (Netherlands)

    W. Seekles (Wike); G.A. Widdershoven (Guy); P.B.M. Robben (Paul); G. Van Dalfsen (Gonny); B. Molewijk (Bert)

    2016-01-01

    textabstractBackground: Moral case deliberation (MCD) as a form of clinical ethics support is usually implemented in health care institutions and educational programs. While there is no previous research on the use of clinical ethics support on the level of health care regulation, employees of regul

  17. Preferred providers and the credible commitment problem in health insurance: first experiences with the implementation of managed competition in the Dutch health care system.

    Science.gov (United States)

    Boonen, Lieke H H M; Schut, Frederik T

    2011-04-01

    We investigate the impact of the transition towards managed competition in the Dutch health care system on health insurers' contracting behaviour. Specifically, we examine whether insurers have been able to take up their role as prudent buyers of care and examine consumers' attitudes towards insurers' new role. Health insurers' contracting behaviour is investigated by an extensive analysis of available information on purchasing practices by health insurers and by interviews with directors of health care purchasing of the four major health insurers, accounting for 90% of the market. Consumer attitudes towards insurers' new role are investigated by surveys among a representative sample of enrollees over the period 2005-2009. During the first four years of the reform, health insurers were very reluctant to engage in selective contracting and preferred to use 'soft' positive incentives to encourage preferred provider choice rather than engaging in restrictive managed care activities. Consumer attitudes towards channelling vary considerably by type of provider but generally became more negative in the first two years after the reform. Insurers' reluctance to use selective contracting can be at least partly explained by the presence of a credible-commitment problem. Consumers do not trust that insurers with restrictive networks are committed to provide good quality care. The credible-commitment problem seems to be particularly relevant to the Netherlands, since Dutch enrollees are not used to restrictions on provider choice. Since consumers are quite sensitive to differences in provider quality, more reliable information about provider quality is required to reduce the credible-commitment problem.

  18. Health care ethics and health law in the Dutch discussion on end-of-life decisions: a historical analysis of the dynamics and development of both disciplines.

    Science.gov (United States)

    Kater, Loes; Houtepen, Rob; De Vries, Raymond; Widdershoven, Guy

    2003-12-01

    Over the past three or four decades, the concept of medical ethics has changed from a limited set of standards to a broad field of debate and research. We define medical ethics as an arena of moral issues in medicine, rather than a specific discipline. This paper examines how the disciplines of health care ethics and health care law have developed and operated within this arena. Our framework highlights the aspects of jurisdiction (Abbott) and the assignment of responsibilities (Gusfield). This theoretical framework prompted us to study definitions and changing responsibilities in order to describe the development and interaction of health care ethics and health law. We have opted for the context of the Dutch debate about end-of-life decisions as a relevant case study. We argue that the specific Dutch definition of euthanasia as 'intentionally taking the life of another person by a physician, upon that person's request' can be seen as the result of the complex jurisdictional process. This illustrates the more general conclusion that the Dutch debate on end-of-life decisions and the development of the two disciplines must be understood in terms of mutual interaction.

  19. Mental health care as delivered by Dutch general practitioners between 2004 and 2008

    NARCIS (Netherlands)

    Verhaak, Peter F. M.; van Dijk, Christel E.; Nuijen, Jasper; Verheij, Robert A.; Schellevis, Francois G.

    2012-01-01

    Objective. In the field of mental health care, a major role for general practice is advocated. However, not much is known about the treatment and referral of mental health problems in general practice. This study aims at the volume and nature of treatment of mental health problems in general practic

  20. Mental health care as delivered by Dutch general practitioners between 2004 and 2008

    NARCIS (Netherlands)

    Verhaak, Peter F. M.; van Dijk, Christel E.; Nuijen, Jasper; Verheij, Robert A.; Schellevis, Francois G.

    Objective. In the field of mental health care, a major role for general practice is advocated. However, not much is known about the treatment and referral of mental health problems in general practice. This study aims at the volume and nature of treatment of mental health problems in general

  1. A Transaction Cost Analysis of Dutch Hospital Care Contracting between hospitals and health insurance companies in a deregulated environment

    NARCIS (Netherlands)

    C.A. Brandenburg (Claudia)

    2008-01-01

    textabstractThe Dutch government has started a process of reformation in the Dutch healthcare. The goal of this reformation is cost efficient healthcare in the Netherlands. Hospitals and health insurance companies in the Netherlands experience changes in regulations and funding. They are expected

  2. The Dutch health insurance reform: consumer mobility.

    NARCIS (Netherlands)

    Jong, J.D. de; Groenewegen, P.P.; Rijken, M.

    2006-01-01

    On 1 January 2006, a number of far-reaching changes in the Dutch health insurance system came into effect. There is now one type of health care insurance for all. The standard package is compulsory for everyone who lives in The Netherlands or pays wage tax in The Netherlands. In the new system of ma

  3. Some pain, no gain: experiences with the no-claim rebate in the Dutch health care system.

    Science.gov (United States)

    Holland, J; Van Exel, N J A; Schut, F T; Brouwer, W B F

    2009-10-01

    To contain expenditures in an increasingly demand driven health care system, in 2005 a no-claim rebate was introduced in the Dutch health insurance system. Since demand-side cost sharing is a very controversial issue, the no-claim rebate was launched as a consumer friendly bonus system to reward prudent utilization of health services. Internationally, the introduction of a mandatory no-claim rebate in a social health insurance scheme is unprecedented. Consumers were entitled to an annual rebate of 255 eruos if no claims were made. During the year, all health care expenses except for GP visits and maternity care were deducted from the rebate until the rebate became zero. In this article, we discuss the rationale of the no-claim rebate and the available evidence of its effect. Using a questionnaire in a convenience sample, we examined people's knowledge, attitudes, and sensitivity to the incentive scheme. We find that only 4% of respondents stated that they would reduce consumption because of the no-claim rebate. Respondents also indicated that they were willing to accept a high loss of rebate in order to use a medical treatment. However, during the last month of the year many respondents seemed willing to postpone consumption until the next year in order to keep the rebate of the current year intact. A small majority of respondents considered the no-claim rebate to be unfair. Finally, we briefly discuss why in 2008 the no-claim rebate was replaced by a mandatory deductible.

  4. Policy statements and practice guidelines for medical end-of-life decisions in Dutch health care institutions: Developments in the past decade

    NARCIS (Netherlands)

    Pasman, H.R.W.; Wolf, de JT; Hesselink, B.A.M.; Heide, van der A.; Wal, van der G.; Maas, van der P.J.; Philipsen, B.D.

    2009-01-01

    OBJECTIVES: To describe the existence of policy statements on euthanasia and physician-assisted suicide (EAS) and practice guidelines for all medical end-of-life decisions in Dutch health care institutions in 2005, whether the existence of practice guidelines is related to characteristics of institu

  5. Real options in project coalitions in Dutch health care: two case studies of construction projects

    NARCIS (Netherlands)

    van Reedt Dortland, Maartje; Voordijk, Johannes T.; Dewulf, Geert P.M.R.

    2013-01-01

    Uncertainties affecting health organizations inevitably influence real estate decisions since real estate is required to facilitate the primary process in cure and care. Decisions have to be taken when there is little knowledge about the future. Therefore, flexibility is needed in the process of

  6. E-health business model dynamics in long term care: case studies in the Dutch market

    NARCIS (Netherlands)

    Udo, Roderick; Roelfsema, Hein; Kort, Helianthe

    2012-01-01

    Full text via link One of the most important drivers of change in the health care sector is the desire of elderly people to age in place. The growing use of internet applications and communication technology together with innovations in buildings have created new commercial opportunities to cater th

  7. High performance work practices in the health care sector: A dutch case study

    NARCIS (Netherlands)

    Boselie, J.P.P.E.F.

    2010-01-01

    Purpose – This paper aims to present an empirical study of the effect of high performance work practices on commitment and citizenship behaviour in the health care sector. The theory suggests that individual employees are willing “to go the extra mile” when they are given the opportunity to develop

  8. Mental health care Monitor Older adults (MEMO) : monitoring patient characteristics and outcome in Dutch mental health services for older adults

    NARCIS (Netherlands)

    Veerbeek, Marjolein; Voshaar, Richard Oude; Depla, Marja; Pot, Anne Margriet

    2013-01-01

    Information on which older adults attend mental health care and whether they profit from the care they receive is important for policy-makers. To assess this information in daily practice, the Mental health care Monitor Older adults (MEMO) was developed in the Netherlands. The aim of this paper is t

  9. What factors increase Dutch child health care professionals' adherence to a national guideline on preventing child abuse and neglect?

    Science.gov (United States)

    Konijnendijk, Annemieke A J; Boere-Boonekamp, Magda M; Fleuren, Margot A H; Haasnoot, Maria E; Need, Ariana

    2016-03-01

    Guidelines to support health care professionals in early detection of, and responses to, suspected Child Abuse and Neglect (CAN) have become increasingly widely available. Yet little is known about professionals' adherence to these guidelines or the determinants that affect their uptake. This study used a cross-sectional design to assess the adherence of Dutch Child Health Care (CHC) professionals to seven key activities described in a national guideline on preventing CAN. This study also examined the presence and strengths of determinants of guideline adherence. Online questionnaires were filled in between May and July 2013 by 164 CHC professionals. Adherence was defined as the extent to which professionals performed each of seven key activities when they suspected CAN. Thirty-three determinants were measured in relation to the guideline, the health professional, the organisational context and the socio-political context. Bivariate and multivariate regression analyses tested associations between determinants and guideline adherence. Most of the responding CHC professionals were aware of the guideline and its content (83.7%). Self-reported rates of full adherence varied between 19.5% and 42.7%. Stronger habit to use the guideline was the only determinant associated with higher adherence rates in the multivariate analysis. Understanding guideline adherence and associated determinants is essential for developing implementation strategies that can stimulate adherence. Although CHC professionals in this sample were aware of the guideline, they did not always adhere to its key recommended activities. To increase adherence, tailored interventions should primarily focus on enhancing habit strength.

  10. Competition and quality indicators in the health care sector : Empirical evidence from the Dutch hospital sector

    NARCIS (Netherlands)

    Croes, Ramsis; Krabbe, Yvonne; Mikkers, Misja

    2017-01-01

    There is much debate about the effect of competition in healthcare and especially the effect of competition on the quality of healthcare, although empirical evidence on this subject is mixed. The Netherlands provides an interesting case in this debate. The Dutch system could be characterized as a

  11. Competition and quality indicators in the health care sector: empirical evidence from the Dutch hospital sector

    NARCIS (Netherlands)

    Croes, R.R.; Krabbe-Alkemade, Y.J.F.M.; Mikkers, M.C.

    2017-01-01

    textabstractThere is much debate about the effect of competition in healthcare and especially the effect of competition on the quality of healthcare, although empirical evidence on this subject is mixed. The Netherlands provides an interesting case in this debate. The Dutch system could be

  12. Internet and Social Media For Health-Related Information and Communication in Health Care: Preferences of the Dutch General Population

    NARCIS (Netherlands)

    Belt, T.H. van de; Engelen, L.J.; Berben, S.A.A.; Teerenstra, S.; Samsom, M.; Schoonhoven, L.

    2013-01-01

    BACKGROUND: Health care is increasingly featured by the use of Web 2.0 communication and collaborative technologies that are reshaping the way patients and professionals interact. These technologies or tools can be used for a variety of purposes: to instantly debate issues, discover news, analyze re

  13. Internet and Social Media For Health-Related Information and Communication in Health Care: Preferences of the Dutch General Population

    NARCIS (Netherlands)

    Belt, T.H. van de; Engelen, L.J.; Berben, S.A.A.; Teerenstra, S.; Samsom, M.; Schoonhoven, L.

    2013-01-01

    BACKGROUND: Health care is increasingly featured by the use of Web 2.0 communication and collaborative technologies that are reshaping the way patients and professionals interact. These technologies or tools can be used for a variety of purposes: to instantly debate issues, discover news, analyze

  14. Written information material and availability of sexual health care for men experiencing sexual dysfunction after prostate cancer treatment: An evaluation of Dutch urology and radiotherapy departments.

    Science.gov (United States)

    Grondhuis Palacios, L A; Krouwel, E M; Duijn, M; den Oudsten, B L; den Ouden, M E M; Putter, H; Pelger, R C M; Elzevier, H W

    2017-03-01

    Objective was to investigate content of written information material and availability of sexual health care for men experiencing sexual dysfunction (SD) after prostate cancer treatment. A cross-sectional survey was conducted among Dutch urology and radiotherapy departments to evaluate information materials and availability of sexual health care. Out of 71 eligible departments, 34 urology and 15 radiotherapy departments participated in the survey (response rate 69.0%). Fifty-nine brochures corresponding to 31 urology and 11 radiotherapy departments were analysed. In 88.1% of collected information material, sexual health was mentioned. Regarding extensiveness, 20.4% of the brochures contained extensive information, 50.8% moderate amount of information and 28.8% contained little or no information. Urology departments provided pre-treatment nurse consultations more often than radiotherapy departments. Sexual counselling was more frequently provided by urology departments. Urology departments were more aware of adequate referral possibilities. Information material provided by Dutch urology and radiotherapy departments does not address treatment-related SD routinely. Sexual health care is not available everywhere for men experiencing SD. Applying a standard regarding content of sexual health in information material is recommended as well as improved awareness of referral possibilities and enhanced provision of pre-treatment nurse consultations for men experiencing SD after prostate cancer treatment.

  15. Do homosexual persons use health care services more frequently than heterosexuals persons: findings from a Dutch population survey.

    NARCIS (Netherlands)

    Bakker, F.C.; Sandfort, T.G.M.; Vanwesenbeeck, I.; Lindert, H. van; Westert, G.P.

    2006-01-01

    Use of health care services has been suggested to be lower among homo- or bisexual persons than among heterosexual persons, due to a lack of trust in the health care system. However, population-based studies on differences in health care utilization according to sexual orientation are scarce. The pu

  16. Identification and management of psychosocial problems among toddlers in Dutch preventive child health care

    NARCIS (Netherlands)

    Reijneveld, S.A.; Brugman, E.; Verhulst, F.C.; Verloove-Vanhorick, S.P.

    2004-01-01

    Objectives: To assess the degree to which preventive child health professionals (CHPs) identify and manage psychosocial problems among preschool children in the general population and to determine the association with parent-reported behavioral and emotional problems, sociodemographic factors, and m

  17. Identification and management of psychosocial problems among toddlers in Dutch preventive child health care

    NARCIS (Netherlands)

    Reijneveld, S.A.; Brugman, E.; Verhulst, F.C.; Verloove-Vanhorick, S.P.

    2004-01-01

    Objectives: To assess the degree to which preventive child health professionals (CHPs) identify and manage psychosocial problems among preschool children in the general population and to determine the association with parent-reported behavioral and emotional problems, sociodemographic factors, and m

  18. External validation of Acute Physiology and Chronic Health Evaluation IV in Dutch intensive care units and comparison with Acute Physiology and Chronic Health Evaluation II and Simplified Acute Physiology Score II

    NARCIS (Netherlands)

    S. Brinkman; F. Bakhshi-Raiez; A. Abu-Hanna; E. de Jonge; R.J. Bosman; L. Peelen; N.F. de Keizer

    2011-01-01

    Purpose: The aim of this study was to validate and compare the performance of the Acute Physiology and Chronic Health Evaluation (APACHE) IV in the Dutch intensive care unit (ICU) population to the APACHE II and Simplified Acute Physiology Score (SAPS) II. Materials and Methods: This is a prospectiv

  19. Health care in the Netherlands.

    NARCIS (Netherlands)

    Weel, C. van; Schers, H.J.; Timmermans, A.

    2012-01-01

    This article analyzes Dutch experiences of health care reform--in particular in primary care--with emphasis on lessons for current United States health care reforms. Recent major innovations were the introduction of private insurance based on the principles of primary care-led health care and

  20. Efficiency and competition in the Dutch non-life insurance industry: Effects of the 2006 health care reform

    NARCIS (Netherlands)

    Bikker, Jaap; Popescu, Adelina

    2014-01-01

    This paper investigates the cost efficiency and competitive behaviour of the non-life – or property and casualty – insurance market in the Netherlands over the period 1995-2012. We focus on the 2006 health care reform, where public health care insurance has been included in the non-life insurance se

  1. How can collaboration be strengthened between public health and primary care? : A Dutch multiple case study in seven neighbourhoods

    NARCIS (Netherlands)

    Storm, Ilse; van Gestel, Anke; van de Goor, Ien; van Oers, Hans

    2015-01-01

    BACKGROUND: Although public health and primary care share the goal of promoting the health and wellbeing of the public, the two health sectors find it difficult to develop mutually integrated plans and to collaborate with each other. The aim of this multiple case study was to compare seven neighbour

  2. The use of mystery guests by the Dutch Health Inspectorate: Results of a pilot study in long-term intramural elderly care.

    Science.gov (United States)

    Adams, Samantha A; Paul, Katharina T; Ketelaars, Corry; Robben, Paul

    2015-06-01

    This paper examines the use of 'mystery guests' as an instrument for monitoring quality and safety in healthcare. The Dutch Health Inspectorate initiated a mystery guest pilot project in elderly care as a response to political and social pressure. An independent evaluation of this project revealed that the primary goal of this approach--to provide a better view of the exigencies of daily practice in elderly care--was not met. Inspectors did not use the information delivered by the mystery guests because how they evaluated quality and reported findings did not align with practices used by the health inspectorate. Additionally, the inspectors felt that other instruments being developed were more appropriate for providing a better view of practice. While political pressure is important for effecting change in general, the specific instruments to be used for formal supervision of health institutions should be developed and implemented within the organization in accordance with existing standards and approaches. The choice to implement a new supervision instrument, including sending mystery guests into care institutions, should be preceded by an ethical analysis that takes into account the specific context of its use. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  3. Suffering in silence? : The adequacy of Dutch mental health care provision for ethnic Chinese in the Netherlands

    NARCIS (Netherlands)

    Liu, Cha-Hsuan

    2014-01-01

    Compared to other ethnic groups in the Netherlands, Chinese are less likely to use mental health care yet present more serious symptoms at the first consultation. However, the reason for these differences is unknown because of the scarcity of research. This doctoral research sets out to fill this ga

  4. Suffering in silence? : The adequacy of Dutch mental health care provision for ethnic Chinese in the Netherlands

    NARCIS (Netherlands)

    Liu, Cha-Hsuan

    2014-01-01

    Compared to other ethnic groups in the Netherlands, Chinese are less likely to use mental health care yet present more serious symptoms at the first consultation. However, the reason for these differences is unknown because of the scarcity of research. This doctoral research sets out to fill this

  5. Suffering in silence? : The adequacy of Dutch mental health care provision for ethnic Chinese in the Netherlands

    NARCIS (Netherlands)

    Liu, Cha-Hsuan

    2014-01-01

    Compared to other ethnic groups in the Netherlands, Chinese are less likely to use mental health care yet present more serious symptoms at the first consultation. However, the reason for these differences is unknown because of the scarcity of research. This doctoral research sets out to fill this ga

  6. [Dutch Preventive Youth Health Care Service guideline on children born too early and/or too small for gestational age].

    Science.gov (United States)

    van der Pal, Sylvia M; Heerdink, Nen; Kamphuis, Mascha; Pols, Margreet A

    2014-01-01

    In children who are born prematurely or whose birth weight is too low for gestational age (small for gestational age (SGA)) intensive care and follow up are desirable.However, obstacles include the shared care of children born very preterm (care service (and other professionals) and the identification of possible late onset health problems in children born late preterm (32-37 weeks of gestation). This guideline is multidisciplinary and evidence based and is relevant to all professionals involved in the care of this group of children. The main recommendations are: (a) timely and complete transfer of information after discharge from hospital; (b) structured exchange of information in aftercare; (c) assigning a case manager to each child; (d) monitoring growth and development by adjusting age for preterm birth, and (e) using special growth charts for children born preterm to evaluate growth and development.

  7. Subjective Oral Health in Dutch Adults

    Directory of Open Access Journals (Sweden)

    Gijsbert H.W. Verrips

    2013-05-01

    Full Text Available Aim: To determine whether the subjective oral health (SOH of the Dutch adult population was associated with clinical and demographic variables. Methods: A clinical examination was conducted in a sample of 1,018 people from the Dutch city of ‘s-Hertogenbosch. SOH was measured using the Dutch translation of the short form of the Oral Health Impact Profile (OHIP-NL14. Results: The average score on the OHIP-NL14 was 2.8 ± 5.9 and 51% of the respondents had a score of 0. Dental status was the most important predictor of SOH. Conclusions:  The SOH in the Dutch adult population was much better than in groups of adults in Australia, the United Kingdom and New Zealand. Nevertheless, there were important variations in SOH related to dental and socio-economic status.

  8. Health risks encountered by Dutch medical students during an elective in the tropics and the quality and comprehensiveness of pre-and post-travel care

    Directory of Open Access Journals (Sweden)

    Vandenbroucke Jan P

    2010-12-01

    Full Text Available Abstract Background Clinical and research electives abroad offer medical students many unique experiences. However, participating in an unfamiliar health-care setting combined with limited medical experience may place students at risk of illness. To improve pre-and post-travel care, we assessed the health risks and the quality and comprehensiveness of pre-and post-travel care in a cohort of Dutch medical students returning form an elective abroad. Methods All medical students who had performed an elective in the tropics between July 2006 and December 2008 were sent an informative email asking them to complete a web-based questionnaire. Results 180 of 242 (74% students completed the questionnaire. Regarding the risk of bloodborne viral infection: 67% of all students and 32% of junior students engaged in procedures that constitute a risk of exposure to bloodborne viral infection, often in countries with high HIV prevalence rates. None of nine students who experienced possible or certain mucosal or percutaneous exposure to potentially infectious body fluids reported the exposure at the time it occurred and none used PEP. Regarding other health risks: 8 of 40 (20% students stopped using mefloquine due to adverse effects. This left a sizeable proportion unprotected in countries that are hyperendemic for malaria. Post-travel screening for schistosomiasis, tuberculosis (tuberculin skin test and carriage of methicillin-resistant Staphylococcus aureus (MRSA encompassed approximately half of all students who should have been screened. Conclusions Based on the results of this study we have adopted an integral set of measures to reduce the health risks associated with an elective abroad. The pre and post-travel consult has been centralized and standardized as well as the distribution of PEP. In addition we have developed a mandatory module on Global Health for all medical students planning an elective abroad.

  9. Negative attitude of highly educated parents and health care workers towards future vaccinations in the Dutch childhood vaccination program

    NARCIS (Netherlands)

    Hak, E; Schönbeck, Y; De Melker, H; Van Essen, G A; Sanders, E A M

    2005-01-01

    BACKGROUND: It is unknown whether further expansion of the Dutch childhood vaccination program with other vaccines will be accepted and whom should be targeted in educational strategies. AIM: To determine attitudes of parents towards possible future vaccinations for their children and the behavioura

  10. Negative attitude of highly educated parents and health care workers towards future vaccinations in the Dutch childhood vaccination program

    NARCIS (Netherlands)

    Hak, E; Schönbeck, Y; De Melker, H; Van Essen, G A; Sanders, E A M

    2005-01-01

    BACKGROUND: It is unknown whether further expansion of the Dutch childhood vaccination program with other vaccines will be accepted and whom should be targeted in educational strategies. AIM: To determine attitudes of parents towards possible future vaccinations for their children and the

  11. Design and methods of the Hospital Elder Life Program (HELP), a multicomponent targeted intervention to prevent delirium in hospitalized older patients: efficacy and cost-effectiveness in Dutch health care

    OpenAIRE

    Strijbos, Marije; Steunenberg, Bas; Schuurmans,, Marieke J.; Mast, van der, N.; Inouye, Sharon

    2013-01-01

    Background The Hospital Elder Life Program (HELP) has been shown to be highly efficient and (cost-)effective in reducing delirium incidence in the USA. HELP provides multicomponent protocols targeted at specific risk factors for delirium and introduces a different view on care organization, with trained volunteers playing a pivotal role. The primary aim of this study is the quantification of the (cost-)effectiveness of HELP in the Dutch health care system. The second aim is to investigate the...

  12. The Dutch Complementary and Alternative Medicine (CAM) protocol: to ensure the safe and effective use of complementary and alternative medicine within Dutch mental health care

    NARCIS (Netherlands)

    Hoenders, H.J.R.; Appelo, M.T.; van den Brink, E.H.; Hartogs, B.M.A.; de Jong, J.T.V.M.

    2011-01-01

    Background: Complementary and alternative medicine (CAM) is subject to heated debates and prejudices. Studies show that CAM is widely used by psychiatric patients, usually without the guidance of a therapist and without the use of a solid working method, leading to potential health risks. Aim: The

  13. The Dutch Complementary and Alternative Medicine (CAM) protocol: to ensure the safe and effective use of complementary and alternative medicine within Dutch mental health care

    NARCIS (Netherlands)

    Hoenders, H.J.R.; Appelo, M.T.; van den Brink, E.H.; Hartogs, B.M.A.; de Jong, J.T.V.M.

    2011-01-01

    Background: Complementary and alternative medicine (CAM) is subject to heated debates and prejudices. Studies show that CAM is widely used by psychiatric patients, usually without the guidance of a therapist and without the use of a solid working method, leading to potential health risks. Aim: The p

  14. Consumer price sensitivity in Dutch health insurance

    NARCIS (Netherlands)

    M. van Dijk (Machiel); M. Pomp (Marc); R.C.H.M. Douven (Rudy); T. Laske-Aldershof (Trea); F.T. Schut (Erik); W. de Boer (Willem); A. Boo (Anne)

    2008-01-01

    textabstractAim: To estimate the price sensitivity of consumer choice of health insurance firm. Method: Using paneldata of the flows of insured betweenpairs of Dutch sickness funds during the period 1993-2002, we estimate the sensitivity of these flows to differences in insurance premium. Results:

  15. Addressing risk factors for child abuse among high risk pregnant women: design of a randomised controlled trial of the nurse family partnership in Dutch preventive health care

    Directory of Open Access Journals (Sweden)

    Mejdoubi Jamila

    2011-10-01

    Full Text Available Abstract Background Low socio-economic status combined with other risk factors affects a person's physical and psychosocial health from childhood to adulthood. The societal impact of these problems is huge, and the consequences carry on into the next generation(s. Although several studies show these consequences, only a few actually intervene on these issues. In the United States, the Nurse Family Partnership focuses on high risk pregnant women and their children. The main goal of this program is primary prevention of child abuse. The Netherlands is the first country outside the United States allowed to translate and culturally adapt the Nurse Family Partnership into VoorZorg. The aim of the present study is to assess whether VoorZorg is as effective in the Netherland as in the United States. Methods The study consists of three partly overlapping phases. Phase 1 was the translation and cultural adaptation of Nurse Family Partnership and the design of a two-stage selection procedure. Phase 2 was a pilot study to examine the conditions for implementation. Phase 3 is the randomized controlled trial of VoorZorg compared to the care as usual. Primary outcome measures were smoking cessation during pregnancy and after birth, birth outcomes, child development, child abuse and domestic violence. The secondary outcome measure was the number of risk factors present. Discussion This study shows that the Nurse Family Partnership was successfully translated and culturally adapted into the Dutch health care system and that this program fulfills the needs of high-risk pregnant women. We hypothesize that this program will be effective in addressing risk factors that operate during pregnancy and childhood and compromise fetal and child development. Trial registration Current Controlled Trials ISRCTN16131117

  16. Cure for the future: the real options approach in corporate real estate management. An exploratory study in Dutch health care

    NARCIS (Netherlands)

    Reedt Dortland, van M.W.J.

    2013-01-01

    Health organizations face increasingly more and complex uncertainties which influences the provision of healthcare. Real estate facilitates this primary process and therefore has to change accordingly. Corporate Real Estate Management is the discipline that develops strategies that match the current

  17. Adding Value by Health Care Real Estate: Parameters and Priorities

    NARCIS (Netherlands)

    Van der Voordt, D.J.M.

    2015-01-01

    Purpose Due to the transition of the Dutch health care sector from a governmentally steered domain towards regulated market forces, health care organisations have become fully responsible for their real estate. This paper explores if/how Dutch health care organisations adopt the concept of adding v

  18. Cancer Patients Use Hospital-Based Care Until Death : A Further Analysis of the Dutch Bone Metastasis Study

    NARCIS (Netherlands)

    Meeuse, Jan J.; van der Linden, Yvette M.; Post, Wendy J.; Wanders, Rinus; Gans, Rijk O. B.; Leer, Jan Willem H.; Reyners, Anna K. L.

    2011-01-01

    Purpose: To describe health care utilization (HCU) at the end of life in cancer patients. These data are relevant to plan palliative care services, and to develop training programs for involved health care professionals. Methods: The Dutch Bone Metastasis Study (DBMS) was a nationwide study proving

  19. Cancer patients use hospital-based care until death: a further analysis of the dutch bone metastasis study

    NARCIS (Netherlands)

    Meeuse, J.J.; Linden, Y.M. van der; Post, W.J.; Wanders, R.; Gans, R.O.; Leer, J.W.H.; Reyners, A.K.

    2011-01-01

    Abstract Purpose: To describe health care utilization (HCU) at the end of life in cancer patients. These data are relevant to plan palliative care services, and to develop training programs for involved health care professionals. Methods: The Dutch Bone Metastasis Study (DBMS) was a nationwide study

  20. Technology for transparency: The case of the web-based Dutch national health portal

    NARCIS (Netherlands)

    Ossebaard, Hans Cornelis; van Gemert-Pijnen, Julia E.W.C.; Seydel, E.R.

    2012-01-01

    Against a backdrop of New Public Management and healthcare system reform the Dutch Ministry of Health commissioned the National Institute for Public Health and the Environment (RIVM) to develop, host and manage an online public national health and care portal. The portal aims to facilitate consumer

  1. MRSA Prevalence and Associated Risk Factors among Health-care Workers in Non-outbreak Situations in the Dutch-German EUREGIO

    Directory of Open Access Journals (Sweden)

    Ricarda Sassmannshausen

    2016-08-01

    Full Text Available Preventing the spread of methicillin-resistant Staphylococcus aureus (MRSA in healthcare facilities is a major infection control target. However, only a few studies have assessed the potential role of healthcare workers (HCWs for MRSA dissemination. To investigate the MRSA prevalence and the risk factors for MRSA colonization among HCWs, nasopharyngeal swabs were taken between June 2010 and January 2011 from 726 employees from nine acute care hospitals with different care levels within the German part of a Dutch-German border region (EUREGIO. The isolated MRSA strains were investigated using spa typing. The overall MRSA prevalence among HCWs in a non-outbreak situation was 4.6% (33 of 726, and was higher in nurses (5.6 %, 29 of 514 than in physicians (1.2%, 1 of 83. Possible risk factors associated with MRSA colonization were a known history of MRSA carriage and the presence of acne. Intensive contact with patients may facilitate MRSA transmission between patients and HCWs. Furthermore, an accumulation of risk factors was accompanied by an increased MRSA prevalence in HCW.

  2. Primary care and public health a natural alliance? The introduction of the guidelines for obesity and undernutrition of the Dutch College of General Practitioners.

    NARCIS (Netherlands)

    Avendonk, M.J.P van; Mensink, P.A.J.S.; Drenthen, A.J.; Binsbergen, J.J. van

    2012-01-01

    The prevalence of obesity and overweight is increasing globally and forms a huge public health problem. On the other hand, the prevalence of malnutrition or undernutrition is substantial, especially in nursing homes or in the elderly at home. Primary care and public health are separate disciplines.

  3. Improving primary health care through technological innovation.

    NARCIS (Netherlands)

    Groenewegen, P.P.; Hutten, J.B.F.

    1989-01-01

    As a result of policy changes and developments on the demand side, the importance of technology in primary health care will grow fast. An approach to the implementation of new technologies in primary health care is presented in this article. First we describe the main problems in Dutch primary healt

  4. A qualitative exploration of factors that facilitate and impede adherence to child abuse prevention guidelines in Dutch preventive child health care

    NARCIS (Netherlands)

    Konijnendijk, Annemieke A.J.; Boere-Boonekamp, Magda M.; Haasnoot-Smallegange, Riet M.E.; Need, Ariana

    2014-01-01

    Rationale, aims and objectives In the Netherlands, evidence-based child abuse prevention (CAP) guidelines have been developed to support child health care professionals (CHPs) in recognizing and responding to suspected child abuse. The aim of this study was to identify factors related to characteris

  5. Design and methods of the Hospital Elder Life Program (HELP), a multicomponent targeted intervention to prevent delirium in hospitalized older patients: efficacy and cost-effectiveness in Dutch health care.

    Science.gov (United States)

    Strijbos, Marije J; Steunenberg, Bas; van der Mast, Roos C; Inouye, Sharon K; Schuurmans, Marieke J

    2013-07-23

    The Hospital Elder Life Program (HELP) has been shown to be highly efficient and (cost-)effective in reducing delirium incidence in the USA. HELP provides multicomponent protocols targeted at specific risk factors for delirium and introduces a different view on care organization, with trained volunteers playing a pivotal role. The primary aim of this study is the quantification of the (cost-)effectiveness of HELP in the Dutch health care system. The second aim is to investigate the experiences of patients, families, professionals and trained volunteers participating in HELP. A multiple baseline approach (also known as a stepped-wedge design) will be used to evaluate the (cost-) effectiveness of HELP in a cluster randomized controlled study. All patients aged 70 years and older who are at risk for delirium and are admitted to cardiology, internal medicine, geriatrics, orthopedics and surgery at two participating community hospitals will be included. These eight units are implementing the intervention in a successive order that will be determined at random. The incidence of delirium, the primary outcome, will be measured with the Confusion Assessment Method (CAM). Secondary outcomes include the duration and severity of delirium, quality of life, length of stay and the use of care services up to three months after hospital discharge. The experiences of patients, families, professionals and volunteers will be investigated using a qualitative design based on the grounded theory approach. Professionals and volunteers will be invited to participate in focus group interviews. Additionally, a random sample of ten patients and their families from each hospital unit will be interviewed at home after discharge. We hypothesize that HELP will reduce delirium incidence during hospital admission and decrease the duration and severity of delirium and length of hospital stays among these older patients, which will lead to reduced health care costs. The results of this study may

  6. [Health care insurance for Africa].

    Science.gov (United States)

    Schellekens, O P; Lindner, M E; van Esch, J P L; van Vugt, M; Rinke de Wit, T F

    2007-12-01

    Long-term substantial development aid has not prevented many African countries from being caught in a vicious circle in health care: the demand for care is high, but the overburdened public supply of low quality care is not aligned with this demand. The majority of Africans therefore pay for health care in cash, an expensive and least solidarity-based option. This article describes an innovative approach whereby supply and demand of health care can be better aligned, health care can be seen as a value chain and health insurance serves as the overarching mechanism. Providing premium subsidies for patients who seek health care through private, collective African health insurance schemes stimulates the demand side. The supply of care improves by investing in medical knowledge, administrative systems and health care infrastructure. This initiative comes from the Health Insurance Fund, a unique collaboration of public and private sectors. In 2006 the Fund received Euro 100 million from the Dutch Ministry of Foreign Affairs to implement insurance programmes in Africa. PharmAccess Foundation is the Fund's implementing partner and presents its first experiences in Africa.

  7. Health care in patients 1 year post-stroke in general practice : research on the utilisation of the Dutch Transmural Protocol transient ischaemic attack/cerebrovascular accident

    NARCIS (Netherlands)

    de Weerd, L.; Rutgers, A.W.F.; Groenier, K.H.; van der Meer, K.

    2012-01-01

    This study evaluates the kind of aftercare that ischaemic stroke patients receive and the extent that aftercare fulfils the criteria of the 'Dutch Transmural Protocol transient ischaemic attack/cerebrovascular accident'. Fifty-seven patients were interviewed 1 year post-stroke about secondary

  8. [Medical microbiology laboratories in Dutch hospitals: essential for safe patient care].

    Science.gov (United States)

    Bonten, M J M

    2008-12-06

    The Netherlands Health Care Inspectorate investigated the quality of medical microbiology laboratories in Dutch hospitals. By and large the laboratories fulfilled the requirements for appropriate care, although some processes were unsatisfactory and some were insufficiently formalised. In the Netherlands, laboratories for medical microbiology are integrated within hospitals and medical microbiologists are responsible for the diagnostic processes as well as for co-treatment of patients, infection prevention and research. This integrated model contrasts to the more industrialised model in many other countries, where such laboratories are physically distinct from hospitals with a strong focus on diagnostics. The Inspectorate also concludes that the current position of medical microbiology in Dutch hospitals is necessary for patient safety and that outsourcing of these facilities is considered unacceptable.

  9. Residential mental health assessment within Dutch criminal cases : A discussion

    NARCIS (Netherlands)

    van der Leij, JBJ; Jackson, JL; Malsch, M; Nijboer, JF

    2001-01-01

    In Dutch criminal cases in which doubts arise about the defendant's mental health, a forensic assessment will be requested. This is provided either by the multidisciplinary staff of residential clinics who conduct forensic evaluations for the court, or by mental health professionals contracted on a

  10. Health care in patients 1 year post-stroke in general practice: research on the utilisation of the Dutch Transmural Protocol transient ischaemic attack/cerebrovascular accident.

    Science.gov (United States)

    de Weerd, L; Rutgers, A W F; Groenier, K H; van der Meer, K

    2012-01-01

    This study evaluates the kind of aftercare that ischaemic stroke patients receive and the extent that aftercare fulfils the criteria of the 'Dutch Transmural Protocol transient ischaemic attack/cerebrovascular accident'. Fifty-seven patients were interviewed 1 year post-stroke about secondary prevention and aftercare. Forty general practitioners (GPs) completed a questionnaire about guidance and secondary prevention (concerning medication and lifestyle advice). Most patients would like to see their GP more regularly. More aftercare was required than was planned. The use of aspirin remained the same, fewer patients used statins and more used antihypertensives. Of the 40 GPs who participated, 12% did not apply prevention. Blood pressure, glucose and cholesterol were measured in 84%, 28% and 40% of patients. All of these measures were often elevated, but treatment was not given. Lifestyle advice was offered to one-quarter of patients. Considering all of the advice given in the Dutch Protocol, several aspects can be improved in relation to secondary prevention. Too little attention is paid to giving lifestyle advice, stricter medical checkups by GPs are necessary and there is a decrease in use of preventive medication, partly because GPs monitors use of medication inadequately. The use of the Dutch Protocol in aftercare can be improved by a more detailed description of advice.

  11. The ideal of biopsychosocial chronic care: How to make it real? A qualitative study among Dutch stakeholders

    Directory of Open Access Journals (Sweden)

    van Dijk-de Vries Anneke

    2012-03-01

    Full Text Available Abstract Background Chronically ill patients often experience psychosocial problems in everyday life. A biopsychosocial approach is considered to be essential in chronic care. In Dutch primary health care the current biomedically oriented clinical practice may conflict with the biopsychosocial approach. This study is aimed to explore the views of Dutch stakeholders on achieving a biopsychosocial approach to the care of patients with chronic diseases. Methods In a qualitative explorative study design, we held semi-structured interviews with stakeholders, face-to-face or by telephone. Data were analysed using content analysis. Thirty representatives of Dutch patients with chronic illnesses, primary care professionals, policy makers, health inspectorate, health insurers, educational institutes and researchers were interviewed. Results Stakeholders were aware that a systematic biopsychosocial care approach is lacking in current practice. Opportunities for effective change are multidimensional. Achieving a biopsychosocial approach to care relates to active patient participation, the training of professionals, high-quality guidelines, protocols and tools, integrated primary care, research and financial issues. Conclusions Although the principles and importance of the biopsychosocial model have been recognized, the provision of care that starts from the medical, emotional or social needs of individual patients does not fit in easily with the current Dutch health care system. All parties involved need to make a commitment to realize the ideal of biopsychosocial chronic care. Together they need to equip health professionals with skills to understand patients' multifaceted needs and to reward integrated biopsychosocial care. Patients need to be empowered to be active partners in their own care.

  12. Health on Course? Key Messages from the 2002 Dutch Public Health Status and Forecasts Report

    NARCIS (Netherlands)

    Oers JAM van; VTV

    2003-01-01

    The third Dutch Public Health Status and Forecasts (PHSF) report once again contains a large amount of up-todate information about Dutch public health status, prevention and healthcare and includes international and regional comparisons. This brochure contains the Key Messages of the 2002 PHSF summa

  13. [The guideline Oral Health Care for dependent residents in long term care facilities, 2007: dire necessity!

    NARCIS (Netherlands)

    Putten, GJ van der; Visschere, L De; Obbergen, J. van; Schols, J.G.J.H.; Baat, C. de

    2008-01-01

    The oral health status of residents in Dutch nursing homes is rather poor, especially of those depending on caregivers for their oral health care. Moreover, when care dependency is rising, the provision of good oral health care becomes more difficult. With more elderly people still having (parts of)

  14. Exit and voice in dutch social health insurance.

    NARCIS (Netherlands)

    Gress, S.; Delnoij, D.; Groenewegen, P.P.

    2003-01-01

    According to Hirschmann's concept of exit and voice, people have two options to make sure that firms or organisations realise what they (their consumers or members) are interested in (Hirschmann 1970). In the Dutch public health insurance system voice existed for a long time, but exit was only intro

  15. Dutch health insurance reform: the new role of collectives.

    NARCIS (Netherlands)

    Groenewegen, P.P.; Jong, J.D. de

    2007-01-01

    In the new Dutch health insurance system individuals have the option of joining a collective insurance contract. Insurers are allowed to offer premium reductions of up to 10% to members of collectives, based on the number of insurees. Collectives might exert more influence on insurers than individua

  16. Dutch health insurance reform: the new role of collectives.

    NARCIS (Netherlands)

    Groenewegen, P.P.; Jong, J.D. de

    2007-01-01

    In the new Dutch health insurance system individuals have the option of joining a collective insurance contract. Insurers are allowed to offer premium reductions of up to 10% to members of collectives, based on the number of insurees. Collectives might exert more influence on insurers than

  17. Maternal cytomegalovirus infection prevention: the role of Dutch primary care midwives.

    NARCIS (Netherlands)

    Pereboom, M.T.R.; Manniën, J.; Spelten, E.R.; Hutton, E.K.; Schellevis, F.G.

    2014-01-01

    Objective: to assess the knowledge of cytomegalovirus (CMV) infection among Dutch primary care midwives, and clinical approaches to informing women about CMV. Design: cross-sectional study, using self-administered questionnaires. Participants: 330 Dutch primary care midwives. Setting: primary midwif

  18. Psychometric properties of the Dutch version of the hospital-level consumer assessment of health plans survey (R) instrument

    NARCIS (Netherlands)

    O.A. Arah; A.H.A. ten Asbroek; D.M.J. Delnoij; J.S. de Koning; P.J.A. Stam; A.H. Poll; B. Vriens; P.F. Schmidt; N.S. Klazinga

    2006-01-01

    Objectives. To assess the reliability and validity of a translated version of the American Hospital-level Consumer Assessment of Health Plans Survey (R) (H-CAHPS) instrument for use in Dutch health care. Data Sources/Study Setting. Primary survey data from adults aged 18 years or more who were recen

  19. A trend analysis in referrals during pregnancy and labour in Dutch midwifery care 1988-2004

    NARCIS (Netherlands)

    Amelink-Verburg, M.P.; Rijnders, M.E.B.; Buitendijk, S.E.

    2009-01-01

    Objective To assess the trends and patterns of referral from midwives to obstetricians within the Dutch maternity care system from 1988 to 2004, and the differences in referral patterns between nulliparous and parous women. Design A descriptive study. Setting The Dutch midwifery database (LVR1), whi

  20. A trend analysis in referrals during pregnancy and labour in Dutch midwifery care 1988-2004

    NARCIS (Netherlands)

    Amelink-Verburg, M.P.; Rijnders, M.E.B.; Buitendijk, S.E.

    2009-01-01

    Objective To assess the trends and patterns of referral from midwives to obstetricians within the Dutch maternity care system from 1988 to 2004, and the differences in referral patterns between nulliparous and parous women. Design A descriptive study. Setting The Dutch midwifery database (LVR1),

  1. COMMUNITY HEALTH & PRIMARY HEALTH CARE

    African Journals Online (AJOL)

    the_monk

    payment for health care services; a widely used strategy to supplement ... and opportunities for sustainable health care financing for low income communities in sub-. Saharan ..... funding and rising costs for health care services, More so, evidence from research studies have ... provider payment method has the potential to.

  2. The importance of job characteristics in determining medical care-seeking in the Dutch working population, a longitudinal survey study

    Directory of Open Access Journals (Sweden)

    Steenbeek Romy

    2012-08-01

    Full Text Available Abstract Background The working population is ageing, which will increase the number of workers with chronic health complaints, and, as a consequence, the number of workers seeking health care. It is very important to understand factors that influence medical care-seeking in order to control the costs. I will investigate which work characteristics independently attribute to later care-seeking in order to find possibilities to prevent unnecessary or inefficient care-seeking. Methods Data were collected in a longitudinal two-wave study (n = 2305 workers. The outcome measures were visits (yes/no and frequency to a general practitioner (GP, a physical therapist, a medical specialist and/or a mental health professional. Multivariate regression analyses were carried out separately for men and women for workers with health complaints. Results In the Dutch working population, personal, health, and work characteristics, but not sickness absence, were associated with later care-seeking. Work characteristics independently attributed to medical care-seeking but only for men and only for the frequency of visits to the GP. Women experience more health complaints and seek health care more often than men. For women, experiencing a work handicap (health complaints that impede work performance was the only work characteristic associated with more care-seeking (GP. For men, work characteristics that led to less care-seeking were social support by colleagues (GP frequency, high levels of decision latitude (GP frequency and high levels of social support by the supervisor (medical specialist. Other work characteristics led to more care-seeking: high levels of engagement (GP, full time work (GP frequency and experiencing a work handicap (physical therapist. Conclusions We can conclude that personal and health characteristics are most important when explaining medical care-seeking in the Dutch working population. Work characteristics independently attributed to

  3. The importance of job characteristics in determining medical care-seeking in the Dutch working population, a longitudinal survey study.

    Science.gov (United States)

    Steenbeek, Romy

    2012-08-31

    The working population is ageing, which will increase the number of workers with chronic health complaints, and, as a consequence, the number of workers seeking health care. It is very important to understand factors that influence medical care-seeking in order to control the costs. I will investigate which work characteristics independently attribute to later care-seeking in order to find possibilities to prevent unnecessary or inefficient care-seeking. Data were collected in a longitudinal two-wave study (n = 2305 workers). The outcome measures were visits (yes/no and frequency) to a general practitioner (GP), a physical therapist, a medical specialist and/or a mental health professional. Multivariate regression analyses were carried out separately for men and women for workers with health complaints. In the Dutch working population, personal, health, and work characteristics, but not sickness absence, were associated with later care-seeking. Work characteristics independently attributed to medical care-seeking but only for men and only for the frequency of visits to the GP. Women experience more health complaints and seek health care more often than men. For women, experiencing a work handicap (health complaints that impede work performance) was the only work characteristic associated with more care-seeking (GP). For men, work characteristics that led to less care-seeking were social support by colleagues (GP frequency), high levels of decision latitude (GP frequency) and high levels of social support by the supervisor (medical specialist). Other work characteristics led to more care-seeking: high levels of engagement (GP), full time work (GP frequency) and experiencing a work handicap (physical therapist). We can conclude that personal and health characteristics are most important when explaining medical care-seeking in the Dutch working population. Work characteristics independently attributed to medical care-seeking but only for men and only for the

  4. The effects of selective decontamination in Dutch Intensive Care Units

    NARCIS (Netherlands)

    Oostdijk, E.A.N.

    2013-01-01

    Infections are an important complication in the treatment of critical ill patients in Intensive Care Units (ICUs) and are associated with increased mortality, morbidity and health care costs. Selective Decontamination of the Digestive Tract (SDD) and Selective Oropharyngeal Decontamination (SOD) are

  5. The role of CAHPS/patient experiences in the Dutch health care system: developing a questionnaire for patients who underwent cataract surgery or total hip or knee arthroplasty.

    NARCIS (Netherlands)

    Brouwer, W.; Gelsema, T.; Delnoij, D.

    2005-01-01

    Background: In the Netherlands, there is a growing need for standardized disease specific instruments to measure performance to aid consumer choice, provider contracting and performance improvement. Initiated by the Netherlands Organisation for Health Research and Development a whole series of quest

  6. Nutritional deficiency in Dutch primary care : data from general practice research and registration networks

    NARCIS (Netherlands)

    van Wayenburg, CAM; van de Laar, FA; de Waal, MWM; Okkes, IM; van den Akker, M; van der Veen, WJ; Schellevis, FG; van Staveren, WA; van Binsbergen, JJ; van Weel, C

    2005-01-01

    Objective: To explore incidence and prevalence rates of nutritional deficiency in adults in general practice. Methods: Six Dutch general practice research and registration networks supplied incidence and prevalence rates of nutritional deficiency by the International Classification of Primary Care (

  7. Health care operations management

    NARCIS (Netherlands)

    Carter, M.W.; Hans, Elias W.; Kolisch, R.

    2012-01-01

    Health care operations management has become a major topic for health care service providers and society. Operations research already has and further will make considerable contributions for the effective and efficient delivery of health care services. This special issue collects seven carefully

  8. Ethnic inequalities in patient safety in Dutch hospital care

    NARCIS (Netherlands)

    van Rosse, F.

    2015-01-01

    This thesis shows the first results of Dutch studies on the relation between ethnicity and patient safety. We used mixed methods to identify patient safety outcomes and patient safety risks in a cohort study in 4 urban hospitals among 763 Dutch patients and 576 ethnic minority patients. In a record

  9. National Health Care Survey

    Science.gov (United States)

    This survey encompasses a family of health care provider surveys, including information about the facilities that supply health care, the services rendered, and the characteristics of the patients served.

  10. COMMUNITY HEALTH & PRIMARY HEALTH CARE

    African Journals Online (AJOL)

    the_monk

    Department of Community Health & Primary Care, College of Medicine, University of Lagos, Idi-Araba, P.M.B. ... the child's health, culturally based beliefs and ..... immunization safety as this was a rural ... Charles SW, Olalekan AU, Peter MN,.

  11. Teamwork in health care.

    Science.gov (United States)

    Landman, Natalie; Aannestad, Liv K; Smoldt, Robert K; Cortese, Denis A

    2014-01-01

    It is becoming increasingly clear that maintaining and improving the health of the population, and doing so in a financially sustainable manner, requires the coordination of acute medical care with long-term care, and social support services, that is, team-based care. Despite a growing body of evidence on the benefits of team-based care, the health care ecosystem remains "resistant" to a broader implementation of such care models. This resistance is a function of both system-wide and organizational barriers, which result primarily from fragmentation in reimbursement for health care services, regulatory restrictions, and the siloed nature of health professional education. To promote the broader adoption of team-based care models, the health care system must transition to pay for value reimbursement, as well as break down the educational silos and move toward team-based and value-based education of health professionals.

  12. Residential mental health assessment within Dutch criminal cases: a discussion.

    Science.gov (United States)

    van der Leij, J B; Jackson, J L; Malsch, M; Nijboer, J F

    2001-01-01

    In Dutch criminal cases in which doubts arise about the defendant's mental health, a forensic assessment will be requested. This is provided either by the multidisciplinary staff of residential clinics who conduct forensic evaluations for the court, or by mental health professionals contracted on a part-time basis by district courts. This article discusses the procedures applied in such cases as well as the relevant legal provisions. It focuses particularly on the clinical observation, evaluation, and reporting that is carried out over a number of weeks in the residential setting of the Pieter Baan Centrum. Specific attention is paid to procedures applied in this clinic. It is suggested that Dutch procedures for the use of mental health expertise can best be characterized by three aspects: multidisciplinary observation and reporting, the use of a sliding scale for indicating degree of responsibility, and, finally, the involvement and payment of experts by the state as such, rather than by the prosecution and/or the defense.

  13. Medicalization and obstetric care: an analysis of developments in Dutch midwifery.

    Science.gov (United States)

    Smeenk, Anke D J; ten Have, Henk A M J

    2003-01-01

    The Dutch system of obstetric care is often recommended for midwife-attended births, the high number of home deliveries, and the low rate of intervention during pregnancy and labour. In this contribution, the question is addressed whether processes of medicalization can be demonstrated in the Dutch midwife practice. Medicalization of pregnancy and childbirth is often criticized because it creates dependency on the medical system and infringement of the autonomy of pregnant women. It is concluded that medicalization is present in the practice of Dutch independent midwives, however it is less clear and outspoken than in hospital policies.

  14. Patient-centeredness and quality management in Dutch diabetes care organizations after a 1-year intervention

    Directory of Open Access Journals (Sweden)

    Campmans-Kuijpers MJ

    2016-10-01

    Full Text Available Marjo JE Campmans-Kuijpers,1 Lidwien C Lemmens,2 Caroline A Baan,2 Guy EHM Rutten1 1Julius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht, 2Centre for Nutrition, Prevention and Health Services, National Institute of Public Health and the Environment, Bilthoven, Utrecht, the Netherlands Background: More focus on patient-centeredness in care for patients with type 2 diabetes requests increasing attention to diabetes quality management processes on patient-centeredness by managers in primary care groups and outpatient clinics. Although patient-centered care is ultimately determined by the quality of interactions between patients and clinicians at the practice level, it should be facilitated at organizational level too. This nationwide study aimed to assess the state of diabetes quality management on patient-centeredness at organizational level and its possibilities to improve after a tailored intervention.Methods: This before–after study compares the quality management on patient-centeredness within Dutch diabetes care groups and outpatient clinics before and after a 1-year stepwise intervention. At baseline, managers of 51 diabetes primary care groups and 28 outpatient diabetes clinics completed a questionnaire about the organization’s quality management program. Patient-centeredness (0%–100% was operationalized in six subdomains: facilitating self-management support, individualized care plan support, patients’ access to medical files, patient education policy, safeguarding patients’ interests, and formal patient involvement. The intervention consisted of feedback and benchmark and if requested a telephone call and/or a consultancy visit. After 1 year, the managers completed the questionnaire again. The 1-year changes were examined by dependent (non parametric tests.Results: Care groups improved significantly on patient-centeredness (from 47.1% to 53.3%; P=0.002, and on its subdomains “access to

  15. Health on Course? The 2002 Dutch Public Health Status and Forecasts Report

    NARCIS (Netherlands)

    Oers JAM van; VTV

    2003-01-01

    The third Dutch Public Health Status and Forecasts (PHSF) report once again contains a large amount of up-todate information about public health status, prevention and healthcare in the Netherlands. International comparisons and regional comparisons within the Netherlands are presented as well. Dut

  16. Integrating care by implementation of bundled payments: results from a national survey on the experience of Dutch dietitians

    Science.gov (United States)

    Tol, J.; Swinkels, I.C.S.; Struijs, J.N.; Veenhof, C.; de Bakker, D.H

    2013-01-01

    Introduction In the Netherlands, bundled payments were introduced as part of a strategy to redesign chronic care delivery. Under this strategy new entities of health care providers in primary care are negotiating with health insurers about the price for a bundle of services for several chronic conditions. This study evaluates the level of involvement of primary health care dietitians in these entities and the experienced advantages and disadvantages. Methods In August 2011, a random sample of 800 Dutch dietitians were invited by email to complete an online questionnaire (net response rate 34%). Results Two-thirds participated in a diabetes disease management programme, mostly for diabetes care, financed by bundled payments (n=130). Positive experiences of working in these programmes were an increase in: multidisciplinary collaboration (68%), efficiency of health care (40%) and transparency of health care quality (25%). Negative aspects were an increase in administrative tasks (61%), absence of payment for patients with comorbidity (38%) and concerns about substitution of care (32%). Discussion/conclusion Attention is needed for payment of patients with co- or multi-morbidity within the bundled fee. Substitution of dietary care by other disciplines needs to be further examined since it may negatively affect the quality of treatment. Task delegation and substitution of care may require other competencies from dietitians. Further development of coaching and negotiation skills may help dietitians prepare for the future. PMID:24399924

  17. Integrating care by implementation of bundled payments: results from a national survey on the experience of Dutch dietitians

    Directory of Open Access Journals (Sweden)

    Jacqueline Tol

    2013-12-01

    Full Text Available Introduction: In the Netherlands, bundled payments were introduced as part of a strategy to redesign chronic care delivery. Under this strategy new entities of health care providers in primary care are negotiating with health insurers about the price for a bundle of services for several chronic conditions. This study evaluates the level of involvement of primary health care dietitians in these entities and the experienced advantages and disadvantages.Methods: In August 2011, a random sample of 800 Dutch dietitians were invited by email to complete an online questionnaire (net response rate 34%.Results: Two-thirds participated in a diabetes disease management programme, mostly for diabetes care, financed by bundled payments (n=130. Positive experiences of working in these programmes were an increase in: multidisciplinary collaboration (68%, efficiency of health care (40% and transparency of health care quality (25%. Negative aspects were an increase in administrative tasks (61%, absence of payment for patients with comorbidity (38% and concerns about substitution of care (32%.Discussion/conclusion: Attention is needed for payment of patients with co- or multi-morbidity within the bundled fee. Substitution of dietary care by other disciplines needs to be further examined since it may negatively affect the quality of treatment. Task delegation and substitution of care may require other competencies from dietitians. Further development of coaching and negotiation skills may help dietitians prepare for the future.

  18. Integrating care by implementation of bundled payments: results from a national survey on the experience of Dutch dietitians

    Directory of Open Access Journals (Sweden)

    Jacqueline Tol

    2013-12-01

    Full Text Available Introduction: In the Netherlands, bundled payments were introduced as part of a strategy to redesign chronic care delivery. Under this strategy new entities of health care providers in primary care are negotiating with health insurers about the price for a bundle of services for several chronic conditions. This study evaluates the level of involvement of primary health care dietitians in these entities and the experienced advantages and disadvantages. Methods: In August 2011, a random sample of 800 Dutch dietitians were invited by email to complete an online questionnaire (net response rate 34%. Results: Two-thirds participated in a diabetes disease management programme, mostly for diabetes care, financed by bundled payments (n=130. Positive experiences of working in these programmes were an increase in: multidisciplinary collaboration (68%, efficiency of health care (40% and transparency of health care quality (25%. Negative aspects were an increase in administrative tasks (61%, absence of payment for patients with comorbidity (38% and concerns about substitution of care (32%. Discussion/conclusion: Attention is needed for payment of patients with co- or multi-morbidity within the bundled fee. Substitution of dietary care by other disciplines needs to be further examined since it may negatively affect the quality of treatment. Task delegation and substitution of care may require other competencies from dietitians. Further development of coaching and negotiation skills may help dietitians prepare for the future.

  19. De standaard 'opsporing visuele stoornissen 0-19 jaar' van de jeugdgezondheidszorg [The guideline 'Detection of visual disorders at the age of 0-19' from the Dutch association of child health care

    NARCIS (Netherlands)

    Velzen-Mol, H.W.M. van; Blankespoor, M.N.; Wagenaar-Fischer, M.M.; Leerdam, F.J.M. van

    2003-01-01

    The child health-care guideline 'Detection of visual disorders at the age of 0-19' draws attention to the importance of early detection of visual disorders and provides guidelines to child health-care workers for detecting disorders during routine check-ups. Children under the age of 3 are examined

  20. Oral health related quality of life among imprisoned Dutch forensic psychiatric patients.

    Science.gov (United States)

    Buunk-Werkhoven, Yvonne A B; Dijkstra, Arie; Schaub, Rob M H; van der Schans, Cees P; Spreen, Marinus

    2010-01-01

    Because dental health and oral pathology may affect forensic psychiatric patients' well being, it is important to be able to assess oral health related quality of life (OH-QoL) in these patients. Two studies were conducted among Dutch forensic psychiatric male patients to assess the psychometric properties and some potential predictors of the Oral Health Impact Profile-14 (OHIP-14) as a measure of OH-QoL. Study 1 involved 40 patients who completed the OHIP-14 before receiving professional dental care and were retested 3 months later. The internal consistency was good, the test-retest correlations were fair, and over the 3 months follow-up no significant changes in OH-QoL were observed. Study 2 consisted of 39 patients who completed an improved version of the original OHIP-14, as well as measures to validate of the OHIP. Dental anxiety and unhealthy dentition jointly explained 26.7% of the variance in OH-QoL, and the better patients performed their oral hygiene behavior, the better their OH-QoL. It is concluded that the Dutch OHIP-14 is a useful instrument, and that nurses, especially in forensic nursing, should pay particularly attention to dental anxiety when encouraging patients to visit OH professionals and to perform adequate oral hygiene self-care.

  1. Connecting Health and Labour: Bringing together occupational health and primary care to improve the health of working people

    NARCIS (Netherlands)

    Ivanov, I.D.; Buijs, P.

    2012-01-01

    The global conference "Connecting Health and Labour: What Role for Occupational health in Primary Health Care?" took place in The Hague from 29 November to 1 December 2011. The conference was organized by WHO in collaboration with TNO Work and Health and the Dutch government and with support from

  2. Connecting Health and Labour: Bringing together occupational health and primary care to improve the health of working people. Executive summary

    NARCIS (Netherlands)

    Anonymous

    2012-01-01

    The global conference "Connecting Health and Labour: What Role for Occupational health in Primary Health Care?" took place in The Hague from 29 November to 1 December 2011. The conference was organized by WHO in collaboration with TNO Work and Health and the Dutch government and with support from

  3. Consumer choice in the Dutch health insurance market.

    NARCIS (Netherlands)

    Maat, M.J.P. van der; Jong, J.D. de

    2010-01-01

    Background: In the last decades, health care reforms based on introducing managed competition have been implemented in several countries. The policy assumption is that managed competition leads to lower prices and increases the quality of health care. However, not much is known about the underlying

  4. Consumer choice in the Dutch health insurance market.

    NARCIS (Netherlands)

    Maat, M.J.P. van der; Jong, J.D. de

    2010-01-01

    Background: In the last decades, health care reforms based on introducing managed competition have been implemented in several countries. The policy assumption is that managed competition leads to lower prices and increases the quality of health care. However, not much is known about the underlying

  5. Health-Related Physical Fitness in Dutch Children With Developmental Coordination Disorder

    NARCIS (Netherlands)

    van der Hoek, Frouwien D.; Stuive, Ilse; Reinders-Messelink, Heleen A.; Holty, Lian; de Blecourt, Alida C. E.; Maathuis, Carel G. B.; van Weert, Ellen

    2012-01-01

    Objective: To compare components of health-related physical fitness between Dutch children with clinically diagnosed developmental coordination disorder (DCD) and typically developing children (TDC), and to examine associations between motor performance problems and components of health-related

  6. Health-Related Physical Fitness in Dutch Children With Developmental Coordination Disorder

    NARCIS (Netherlands)

    van der Hoek, Frouwien D.; Stuive, Ilse; Reinders-Messelink, Heleen A.; Holty, Lian; de Blecourt, Alida C. E.; Maathuis, Carel G. B.; van Weert, Ellen

    2012-01-01

    Objective: To compare components of health-related physical fitness between Dutch children with clinically diagnosed developmental coordination disorder (DCD) and typically developing children (TDC), and to examine associations between motor performance problems and components of health-related fitn

  7. Children's hand hygiene behaviour and available facilities: an observational study in Dutch day care centres.

    Science.gov (United States)

    van Beeck, A H Elise; Zomer, Tizza P; van Beeck, Eduard F; Richardus, Jan Hendrik; Voeten, Helene A C M; Erasmus, Vicki

    2016-04-01

    Children attending day care centres are at increased risk of infectious diseases, in particular gastrointestinal and respiratory infections. Hand hygiene of both caregivers and children is an effective prevention measure. This study examined hand hygiene behaviour of children attending day care centres, and describes hygiene facilities at day care centres. Data were collected at 115 Dutch day care centres, among 2318 children cared for by 231 caregivers (August to October 2010). Children's hand hygiene behaviour was observed and data on hand hygiene facilities of the day care centres collected by direct unobtrusive observation. National guidelines indicate hand hygiene is required before eating, after toilet use and after playing outside. Among 1930 observed hand hygiene opportunities for children, overall adherence to hand hygiene guidelines was 31% (95% CI: 29-33%). Adherence after both toilet use and playing outside was 48%. Hands were less frequently washed before eating, where guideline adherence was 15%. In 38% of the playrooms there was no soap within reach of children and 17% had no towel facilities. In over 40% of the playrooms, appropriate hand hygiene facilities for children were lacking. Adequate hand washing facilities were available for children in only half of the participating day care centres in our study and children washed their hands in only 15-48% of the occasions defined by official guidelines. More attention is needed to hand hygiene of children attending day care centres in the prevention of infectious diseases. © The Author 2015. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

  8. A healthy judgement? Health and Health care in the Netherlands in international perspective

    NARCIS (Netherlands)

    Achterberg PW; Kramers PGN; Wilk AE van der; VTV

    2002-01-01

    International comparisons of health and health care are increasingly used to 'benchmark' national health system performances. This report summarises earlier Dutch RIVM reports. It analyses: 1) the policy relevance of several other international reports, among which the WHO2000 report, which compared

  9. COMMUNITY HEALTH & PRIMARY HEALTH CARE

    African Journals Online (AJOL)

    adedamla

    catastrophic health expenditures (CHE) and risk of being impoverished as a result of cost of care were assessed. Statistical ... Impact and contributors to cost of managing long term conditions in a ... sectors is ongoing, it has become clear that.

  10. COMMUNITY HEALTH & PRIMARY HEALTH CARE

    African Journals Online (AJOL)

    Journal of Community Medicine and Primary Health Care. ... This is one of the factors that determine whether or ..... Expired vaccines found in fridge / cold box .... date vaccine temperature monitoring charts. were stored on refrigerator door ...

  11. COMMUNITY HEALTH & PRIMARY HEALTH CARE

    African Journals Online (AJOL)

    user

    This was a cross-sectional, multi clinic study involving 265 mothers whose children had erupted at least a tooth and attending the ... parents, health care workers and personal experiences were the sources of beliefs ..... Ethiopians abroad.

  12. Planning in Dutch health promotion practice: a comprehensive view.

    Science.gov (United States)

    Lezwijn, Jeanette; Wagemakers, Annemarie; Vaandrager, Lenneke; Koelen, Maria; van Woerkum, Cees

    2014-06-01

    Health promotion has a strong tradition of using planning models based on an a priori set of goals and processes defined by professionals. Those rational models only partly fit with today's view and practice of health promotion, where programmes can be considered as processes because they are guided by principles such as community participation and intersectoral collaboration. The aim of this paper is to provide a comprehensive view on approaches to planning in health promotion practice. To investigate these, Whittington's typology has been used. Whittington identifies four approaches to planning, i.e. classical, evolutionary, processual and systemic. In a retrospective multiple case study, we describe actual planning processes used in the development and implementation of a healthy ageing programme in three Dutch municipalities. These processes were described using data gathered by: interviews, participant observation and document analysis, and external auditing. Characteristics of the four planning approaches were used to interpret the data. The results show that, in practice, all forms of planning approaches were used, depending on the degree of complexity and dynamics of the context, the phase of the health promotion programme, and the time available. Our findings suggest that in the emergent practice of health promotion different approaches to planning are used. To make those planning approaches explicit and manageable for practice and science, discussion and reflection between stakeholders are essential.

  13. Employee motivation and employee performance in child care : the effects of the introduction of market forces on employees in the Dutch child-care sector

    NARCIS (Netherlands)

    Plantinga, Mirjam

    2006-01-01

    Employee Motivation and Employee Performance in Child Care: The Effects of the Introduction of Market Focus on Employees in the Dutch Child-Care Sector Mirjam Plantinga (RUG) This research describes and explains the effects of the introduction of market forces in the Dutch child-care sector on

  14. Employee Motivation and Employee Performance in Child Care : The effects of the Introduction of Market Forces on Employees in the Dutch Child-Care Sector

    NARCIS (Netherlands)

    Plantinga, Mirjam

    2006-01-01

    This research describes and explains the effects of the introduction of market forces in the Dutch child-care sector on employee governance, motivation and performance. The Dutch child-care sector is transitioning from a welfare sector into a market sector. The transition process in child care is

  15. Employee motivation and employee performance in child care : the effects of the introduction of market forces on employees in the Dutch child-care sector

    NARCIS (Netherlands)

    Plantinga, Mirjam

    2006-01-01

    Employee Motivation and Employee Performance in Child Care: The Effects of the Introduction of Market Focus on Employees in the Dutch Child-Care Sector Mirjam Plantinga (RUG) This research describes and explains the effects of the introduction of market forces in the Dutch child-care sector on emplo

  16. Employee Motivation and Employee Performance in Child Care : The effects of the Introduction of Market Forces on Employees in the Dutch Child-Care Sector

    NARCIS (Netherlands)

    Plantinga, Mirjam

    2006-01-01

    This research describes and explains the effects of the introduction of market forces in the Dutch child-care sector on employee governance, motivation and performance. The Dutch child-care sector is transitioning from a welfare sector into a market sector. The transition process in child care is co

  17. Health care utilization

    DEFF Research Database (Denmark)

    Jacobsen, Christian Bøtcher; Andersen, Lotte Bøgh; Serritzlew, Søren

    An important task in governing health services is to control costs. The literatures on both costcontainment and supplier induced demand focus on the effects of economic incentives on health care costs, but insights from these literatures have never been integrated. This paper asks how economic cost...... make health professionals provide more of this service to each patient, but that lower user payment (unexpectedly) does not necessarily mean higher total cost or a stronger association between the number of patients per supplier and the health care utilization. This implies that incentives...... are important, but that economics cannot alone explain the differences in health care utilization....

  18. Equity in health care.

    Science.gov (United States)

    La Rosa-Salas, Virginia; Tricas-Sauras, Sandra

    2008-01-01

    It has long been known that a segment of the population enjoys distinctly better health status and higher quality of health care than others. To solve this problem, prioritization is unavoidable, and the question is how priorities should be set. Rational priority setting would seek equity amongst the whole population, the extent to which people receive equal care for equal needs. Equity in health care is an ethical imperative not only because of the intrinsic worth of good health, or the value that society places on good health, but because, without good health, people would be unable to enjoy life's other sources of happiness. This paper also argues the importance of the health care's efficiency, but at the same time, it highlights how any innovation and rationalization undertaken in the provision of the health system should be achieved from the consideration of human dignity, making the person prevail over economic criteria. Therefore, the underlying principles on which this health care equity paper is based are fundamental human rights. The main aim is to ensure the implementation of these essential rights by those carrying out public duties. Viewed from this angle, equity in health care means equality: equality in access to services and treatment, and equality in the quality of care provided. As a result, this paper attempts to address both human dignity and efficiency through the context of equity to reconcile them in the middle ground.

  19. Monastic retreat and pastoral care in the Dutch Reformed tradition

    Directory of Open Access Journals (Sweden)

    C.H. (Kaaiman Schutte

    2006-10-01

    Full Text Available Of late, there has been a growing interest in retreat among clergy and members of congregations in the Dutch Reformed tradition in South Africa. The article investigates the relevance of the monastic traditions for this growing interest in Reformed circles. It focuses on aspects of retreat such as the role of holy places in the monastic traditions (e.g., monasteries, cathedrals, retreat centers and the experience of silence, solitude, regeneration, divine presence and spiritual formation. Proceeding from an epistemological reflection on the subject as described in a previous article, the aim of this article is to explore the “action of retreat” as a narrative research journey and pilgrimage in order to investigate the relevance of the Benedictine, Franciscan and Taizé monastic-mystic traditions (seen as an associative/mystic spirituality for retreat in the Dutch Reformed tradition (which is seen as a disassociative/rational/ dogmatic spirituality.

  20. Lean health care.

    Science.gov (United States)

    Hawthorne, Henry C; Masterson, David J

    2013-01-01

    Principles of Lean management are being adopted more widely in health care as a way of improving quality and safety while controlling costs. The authors, who are chief executive officers of rural North Carolina hospitals, explain how their organizations are using Lean principles to improve quality and safety of health care delivery.

  1. Health care marketing management.

    Science.gov (United States)

    Cooper, P D

    1979-01-01

    Health Care Marketing Management is the process of understanding the needs and the wats of a target market. Its purpose is to provide a viewpoint from which to integrate the analysis, planning, implementation (or organization) and control of the health care delivery system.

  2. Indian Health Service: Find Health Care

    Science.gov (United States)

    ... and Human Services Indian Health Service The Federal Health Program for American Indians and Alaska Natives Feedback ... Forgot Password IHS Home Find Health Care Find Health Care IMPORTANT If you are having a health ...

  3. Mental health problems of Dutch adolescents: the association with adolescents' and their parents' educational level.

    Science.gov (United States)

    Havas, Jano; Bosma, Hans; Spreeuwenberg, Cor; Feron, Frans J

    2010-06-01

    We studied the hypothesis of socioeconomic equalization regarding adolescents' mental health problems by examining whether a low educational level of adolescents and their parents shows independent (cumulative) or dependent (including interactive) associations with adolescents' mental health problems, or whether equalization occurred. Cross-sectional data were obtained from the preventive Youth Health Care Centre in a relatively deprived Dutch former mining area. Participants were 1861 adolescents aged 13 or 14 years (response rate 71.7%). The self-administered Dutch version of the Strengths and Difficulties Questionnaire (SDQ) was used to identify adolescents' mental health problems. Multiple logistic regression analyses were used to examine the associations, and linear regression models to check the robustness of the findings. A low educational level of adolescents was strongly related to their mental health problems (OR = 5.37; 95% CI: 3.31-8.70). The initially high odds ratios for adolescents with low-educated parents (OR = 1.72; 95% CI: 1.14-2.59) disappeared after controlling for the adolescents' own educational level (OR = 1.12; 95% CI: 0.73-1.74). In terms of interactions, no specifically increased odds were found, e.g. for low-educated adolescents with high-educated parents. There was no evidence for socioeconomic equalization regarding adolescents' mental health problems. Lower educated adolescents had substantially higher odds of having mental health problems, regardless of their parents' education. The odds may be affected by differences in intelligence and life events. Youth healthcare workers should collaborate closely with schools to intervene in time, particularly among low-educated adolescents. More interventions are probably needed to reduce these major inequities.

  4. Benchmarking HIV health care

    DEFF Research Database (Denmark)

    Podlekareva, Daria; Reekie, Joanne; Mocroft, Amanda

    2012-01-01

    ABSTRACT: BACKGROUND: State-of-the-art care involving the utilisation of multiple health care interventions is the basis for an optimal long-term clinical prognosis for HIV-patients. We evaluated health care for HIV-patients based on four key indicators. METHODS: Four indicators of health care were...... assessed: Compliance with current guidelines on initiation of 1) combination antiretroviral therapy (cART), 2) chemoprophylaxis, 3) frequency of laboratory monitoring, and 4) virological response to cART (proportion of patients with HIV-RNA 90% of time on cART). RESULTS: 7097 Euro...... to North, patients from other regions had significantly lower odds of virological response; the difference was most pronounced for East and Argentina (adjusted OR 0.16[95%CI 0.11-0.23, p HIV health care utilization...

  5. Consultation with specialist palliative care services in palliative sedation: considerations of Dutch physicians.

    Science.gov (United States)

    Koper, Ian; van der Heide, Agnes; Janssens, Rien; Swart, Siebe; Perez, Roberto; Rietjens, Judith

    2014-01-01

    Palliative sedation is considered a normal medical practice by the Royal Dutch Medical Association. Therefore, consultation of an expert is not considered mandatory. The European Association of Palliative Care (EAPC) framework for palliative sedation, however, is more stringent: it considers the use of palliative sedation without consulting an expert as injudicious and insists on input from a multi-professional palliative care team. This study investigates the considerations of Dutch physicians concerning consultation about palliative sedation with specialist palliative care services. Fifty-four physicians were interviewed on their most recent case of palliative sedation. Reasons to consult were a lack of expertise and the view that consultation was generally supportive. Reasons not to consult were sufficient expertise, the view that palliative sedation is a normal medical procedure, time pressure, fear of disagreement with the service and regarding consultation as having little added value. Arguments in favour of mandatory consultation were that many physicians lack expertise and that palliative sedation is an exceptional intervention. Arguments against mandatory consultation were practical obstacles that may preclude fulfilling such an obligation (i.e. lack of time), palliative sedation being a standard medical procedure, corroding a physician's responsibility and deterring physicians from applying palliative sedation. Consultation about palliative sedation with specialist palliative care services is regarded as supportive and helpful when physicians lack expertise. However, Dutch physicians have both practical and theoretical objections against mandatory consultation. Based on the findings in this study, there seems to be little support among Dutch physicians for the EAPC recommendations on obligatory consultation.

  6. Appropriate care for shelter-based abused women: concept mapping with Dutch clients and professionals

    NARCIS (Netherlands)

    Jonker, I.E.; Jansen, C.C.M.; Christians, M.G.M.; Wolf, J.R.L.M.

    2014-01-01

    We conducted a concept mapping exercise to gain insight into the perspectives held by abused women and professionals with regard to appropriate care in Dutch women's shelters. Three brainstorming sessions generated 92 statements that were then rated by 56 clients and 51 professionals. A total of 11

  7. Current Dermatologic Care in Dutch Nursing Homes and Possible Improvements: A Nationwide Survey

    NARCIS (Netherlands)

    Lubeek, S.F.; Geer, E.R. van der; Gelder, M.M. van; Koopmans, R.T.; Kerkhof, P.C. van de; Gerritsen, M.J.

    2015-01-01

    OBJECTIVES: To assess the provision and need of dermatologic care among Dutch nursing home patients and to obtain recommendations for improvement. DESIGN: Cross-sectional nationwide survey. SETTING: All 173 nursing home organizations in the Netherlands. PARTICIPANTS: Physicians working in nursing

  8. Manifestations of integrated public health policy in Dutch municipalities.

    Science.gov (United States)

    Peters, Dorothee; Harting, Janneke; van Oers, Hans; Schuit, Jantine; de Vries, Nanne; Stronks, Karien

    2016-06-01

    Integrated public health policy (IPHP) aims at integrating health considerations into policies of other sectors. Since the limited empirical evidence available may hamper its further development, we systematically analysed empirical manifestations of IPHP, by placing policy strategies along a continuum of less-to-more policy integration, going from intersectoral action (IA) to healthy public policy (HPP) to health in all policies (HiAP). Our case study included 34 municipal projects of the Dutch Gezonde Slagkracht Programme (2009-15), which supports the development and implementation of IPHP on overweight, alcohol and drug abuse, and smoking. Our content analysis of project application forms and interviews with all project leaders used a framework approach involving the policy strategies and the following policy variables: initiator, actors, policy goals, determinants and policy instruments. Most projects showed a combination of policy strategies. However, manifestations of IPHP in overweight projects predominantly involved IA. More policy integration was apparent in alcohol/drugs projects (HPP) and in all-theme projects (HiAP). More policy integration was related to broad goal definitions, which allowed for the involvement of actors representing several policy sectors. This enabled the implementation of a mix of policy instruments. Determinants of health were not explicitly used as a starting point of the policy process. If a policy problem justifies policy integration beyond IA, it might be helpful to start from the determinants of health (epidemiological reality), systematically transform them into policy (policy reality) and set broad policy goals, since this gives actors from other sectors the opportunity to participate.

  9. Responsiveness of the Dutch Endometriosis Health Profile-30 (EHP-30) questionnaire

    NARCIS (Netherlands)

    Burgt, T.J. van de; Kluivers, K.B.; Hendriks, J.C.M.

    2013-01-01

    OBJECTIVE: To evaluate the responsiveness to change and the minimal clinical important difference (MCID) of the Dutch Endometriosis Health Profile-30 (EHP-30) questionnaire. STUDY DESIGN: Prospective cohort study among endometriosis patients attending the Radboud University Nijmegen Medical Centre a

  10. Dutch health websites and their ability to inform people with low health literacy.

    Science.gov (United States)

    Meppelink, Corine S; van Weert, Julia C M; Brosius, Anna; Smit, Edith G

    2017-06-10

    To evaluate whether Dutch online health information (OHI) generally reflects message elements that support information processing and understanding among people with low health literacy. We content-analyzed one hundred Dutch webpages about Ebola, fibromyalgia, ALS, losing weight, borderline personality disorder, hemorrhoids, ADD, bladder infection, shingles, and chicken pox. The codebook covered the following domains: images and videos, readability level, Suitability Assessment of Materials (SAM), advertising, interactive features, and reliability cues. Thirty-seven webpages contained informative images that visualized the text. Twelve webpages incorporated videos, six of which were animations. Readability varied widely, but 79.2% of the texts exceeded the recommended B1 level. Half of the webpages had inadequate SAM scores; five were classified as superior. Interactive features were infrequently used. Many webpages included only a few elements that help users evaluate the reliability of OHI. Four presented a quality label. Over a wide range of health-related topics, Dutch OHI does not generally contain message elements that improve information processing among people with low health literacy. Communication professionals should make better use of digital message features. Videos, narration, and interactivity are scarcely used but can be valuable for people with low health literacy. Copyright © 2017 Elsevier B.V. All rights reserved.

  11. COMMUNITY HEALTH & PRIMARY HEALTH CARE

    African Journals Online (AJOL)

    Lifestyle Changes and the Risk of Colorectal Cancer among. Immigrants in the United .... food rich in red meat, animal fat, sugars and refined of CRC in Africa .... region to improve health care delivery and secure the is obtainable in the UK, ...

  12. Resilient health care

    DEFF Research Database (Denmark)

    Hollnagel, E.; Braithwaite, J.; Wears, R. L.

    engineering's unique approach emphasises the usefulness of performance variability, and that successes and failures have the same aetiology. This book contains contributions from acknowledged international experts in health care, organisational studies and patient safety, as well as resilience engineering......Health care is everywhere under tremendous pressure with regard to efficiency, safety, and economic viability - to say nothing of having to meet various political agendas - and has responded by eagerly adopting techniques that have been useful in other industries, such as quality management, lean...... production, and high reliability. This has on the whole been met with limited success because health care as a non-trivial and multifaceted system differs significantly from most traditional industries. In order to allow health care systems to perform as expected and required, it is necessary to have...

  13. Your Health Care Team

    Science.gov (United States)

    ... Disease (Nephropathy) Gastroparesis Mental Health Step On Up Treatment & Care Blood Glucose Testing Medication Doctors, Nurses & More ... us get closer to curing diabetes and better treatments for those living with diabetes. Other Ways to ...

  14. Managed health care.

    Science.gov (United States)

    Curtiss, F R

    1989-04-01

    The fundamental components of managed-care plans are described; the development of managed-care programs is discussed; and the impact of managed care on pharmacy services and the price, quality, and accessibility of health care are reviewed. Health care can be considered to be managed when at least one of the following fundamental components is present: prospective pricing, "UCR" (usual, customary, and reasonable) pricing of services, peer review, mandatory use review, benefit redesign, capitation payments, channeling, quality criteria, and health promotion. The managed-care industry consists of health maintenance organizations (HMOs), preferred provider organizations (PPOs), and managed fee-for-service plans. Managed-care reimbursement principles involve transferring some or all of the impetus for controlling use of services to the health-care provider. Means by which this is done include prospective pricing, services bundling, price discounts and negotiated fees, and capitation financing and reimbursement. Financial risk-sharing arrangements with providers--including hospitals, physicians, pharmacies, and home-care companies--are necessary for any managed-care plan to attain true control over its service costs. Use-review and use-management services are also fundamental to containing health-care spending. These include retrospective, concurrent, and prospective reviews of the necessity and appropriateness of medical services. Use management, like services bundling and prospective pricing, has been more effective in reducing costs of hospital inpatient services than costs associated with ambulatory care. Per case payments and services bundling have made individual charges for items irrelevant to hospital revenue. This has forced hospital pharmacy managers to become more sensitive to cost management. Drug formularies, improved productivity, and use of prescribing protocols are means by which hospital pharmacies have controlled costs. However, since shorter hospital

  15. Identifying health care quality attributes.

    Science.gov (United States)

    Ramsaran-Fowdar, Roshnee R

    2005-01-01

    Evaluating health care quality is important for consumers, health care providers, and society. Developing a measure of health care service quality is an important precursor to systems and organizations that value health care quality. SERVQUAL has been proposed as a broad-based measure of service quality that may be applicable to health care settings. Results from a study described in this paper verify SERVQUAL dimensions, but demonstrate additional dimensions that are specific to health care settings.

  16. Sexual health of Dutch medical students: nothing to worry about.

    Science.gov (United States)

    Fickweiler, Freek; Keers, Joost C; Weijmar Schultz, Willibrord C M

    2011-09-01

    Little is known about the sexual lives and development of medical students because of relatively small sample sizes and, in particular, low response rates in research. Enhancing medical students' awareness and understanding of sexual behavior is imperative, as gaps in knowledge might impede effective sexual health consultations in their later professional practice. The aim of this study was to provide insight into the sexual lives and development of medical students. The main outcome measures of this study are demographic, contextual, and sexual data based on validated surveys. Preclinical medical students aged under 26 years were approached during scheduled classes and by e-mail to complete a web-based questionnaire. Our results were compared with international and Dutch normative data. Ordinal regression analysis and Pearson's correlation analysis were used to assess relationships between variables. A total of 1,598 questionnaires were returned (response rate 52%: 1,198 by women, 400 by men). There were 719 first-year students (mean age 19.17 years) and 879 third-year students (mean age 21.5 years). Gender distribution differences were seen in all the cohorts and were corrected for. Compared with international and Dutch (88%) normative data, our first- (62.7%; Psexual experience and showed different advancements in sexual behavior. However, these differences decreased, which suggests that medical students "catch-up" as their age increases. Sexual behavior in our sample did not differ from international data, except for a strikingly high sexual satisfaction (80%). We also confirmed that social and environmental characteristics change with alterations in sexual behavior. Although contraceptive measures were used more frequently (98%; P=0.006), sexually transmitted diseases were more common (4.6%; P=0.008), which suggests inappropriate use of protective measures. Independent predictive determinants for protective sexual behavior were the form of relationship

  17. Mercury and health care

    Directory of Open Access Journals (Sweden)

    Rustagi Neeti

    2010-01-01

    Full Text Available Mercury is toxic heavy metal. It has many characteristic features. Health care organizations have used mercury in many forms since time immemorial. The main uses of mercury are in dental amalgam, sphygmomanometers, and thermometers. The mercury once released into the environment can remain for a longer period. Both acute and chronic poisoning can be caused by it. Half of the mercury found in the atmosphere is human generated and health care contributes the substantial part to it. The world has awakened to the harmful effects of mercury. The World Health Organization and United Nations Environmental Programme (UNEP have issued guidelines for the countries′ health care sector to become mercury free. UNEP has formed mercury partnerships between governments and other stakeholders as one approach to reducing risks to human health and the environment from the release of mercury and its compounds to the environment. Many hospitals are mercury free now.

  18. Mercury and health care

    Science.gov (United States)

    Rustagi, Neeti; Singh, Ritesh

    2010-01-01

    Mercury is toxic heavy metal. It has many characteristic features. Health care organizations have used mercury in many forms since time immemorial. The main uses of mercury are in dental amalgam, sphygmomanometers, and thermometers. The mercury once released into the environment can remain for a longer period. Both acute and chronic poisoning can be caused by it. Half of the mercury found in the atmosphere is human generated and health care contributes the substantial part to it. The world has awakened to the harmful effects of mercury. The World Health Organization and United Nations Environmental Programme (UNEP) have issued guidelines for the countries’ health care sector to become mercury free. UNEP has formed mercury partnerships between governments and other stakeholders as one approach to reducing risks to human health and the environment from the release of mercury and its compounds to the environment. Many hospitals are mercury free now. PMID:21120080

  19. Mercury and health care.

    Science.gov (United States)

    Rustagi, Neeti; Singh, Ritesh

    2010-08-01

    Mercury is toxic heavy metal. It has many characteristic features. Health care organizations have used mercury in many forms since time immemorial. The main uses of mercury are in dental amalgam, sphygmomanometers, and thermometers. The mercury once released into the environment can remain for a longer period. Both acute and chronic poisoning can be caused by it. Half of the mercury found in the atmosphere is human generated and health care contributes the substantial part to it. The world has awakened to the harmful effects of mercury. The World Health Organization and United Nations Environmental Programme (UNEP) have issued guidelines for the countries' health care sector to become mercury free. UNEP has formed mercury partnerships between governments and other stakeholders as one approach to reducing risks to human health and the environment from the release of mercury and its compounds to the environment. Many hospitals are mercury free now.

  20. Perceived need for mental health care and barriers to care in the Netherlands and Australia.

    NARCIS (Netherlands)

    Prins, M.; Meadows, G.; Bobevski, I.; Graham, A.; Verhaak, P.; Meer, K. van der; Penninx, B.; Bensing, J.

    2011-01-01

    PURPOSE: This study of Australian and Dutch people with anxiety or depressive disorder aims to examine people's perceived needs and barriers to care, and to identify possible similarities and differences. METHODS: Data from the Australian National Survey of Mental Health and Well-Being and the Nethe

  1. Perceived need for mental health care and barriers to care in the Netherlands and Australia

    NARCIS (Netherlands)

    Prins, Marijn; Meadows, Graham; Bobevski, Irene; Graham, Annette; Verhaak, Peter; van der Meer, Klaas; Penninx, Brenda; Bensing, Jozien

    2011-01-01

    This study of Australian and Dutch people with anxiety or depressive disorder aims to examine people's perceived needs and barriers to care, and to identify possible similarities and differences. Data from the Australian National Survey of Mental Health and Well-Being and the Netherlands Study of De

  2. Barriers to Health Care for Chinese in the Netherlands

    Directory of Open Access Journals (Sweden)

    Cha-Hsuan Liu

    2011-01-01

    Full Text Available This study examines utilisation of the Dutch health care system by Chinese people in the Netherlands as well as their attitudes to the system, paying special attention to mental health. Information was gathered by semistructured interviews (=102. The main issues investigated are access, help-seeking behaviour, and quality of care. Results showed that most respondents used Dutch health care as their primary method of managing health problems. Inadequate knowledge about the system and lack of Dutch language proficiency impede access to care, in particular registration with a General Practitioner (GP. Users complained that the care given differed from what they expected. Results also showed that the major problems are to be found in the group coming from the Chinese-speaking region. Western concepts of mental health appear to be widely accepted by Chinese in the Netherlands. However, almost half of our respondents believed that traditional Chinese medicine or other methods can also help with mental health problems. The provision of relevant information in Chinese appears to be important for improving access. Better interpretation and translation services, especially for first-generation migrants from the Chinese-speaking region, are also required.

  3. Health care technology assessment

    Science.gov (United States)

    Goodman, Clifford

    1994-12-01

    The role of technology in the cost of health care is a primary issue in current debates concerning national health care reform. The broad scope of studies for understanding technological impacts is known as technology assessment. Technology policy makers can improve their decision making by becoming more aware, and taking greater advantage, of key trends in health care technology assessment (HCTA). HCTA is the systematic evaluation of the properties, impacts, and other attributes of health care technologies, including: technical performance; clinical safety and efficacy/effectiveness; cost-effectiveness and other economic attributes; appropriate circumstances/indications for use; and social, legal, ethical, and political impacts. The main purpose of HCTA is to inform technology-related policy making in health care. Among the important trends in HCTA are: (1) proliferation of HCTA groups in the public and private sectors; (2) higher standards for scientific evidence concerning technologies; (3) methodological development in cost analyses, health-related quality of life measurement, and consolidation of available scientific evidence (e.g., meta-analysis); (4) emphasis on improved data on how well technologies work in routine practice and for traditionally under-represented patient groups; (5) development of priority-setting methods; (6) greater reliance on medical informatics to support and disseminate HCTA findings.

  4. Primary health care.

    Science.gov (United States)

    Kitai, A

    1986-07-01

    Development of primary care in Japan in still relatively unorganized and unstructured. As mentioned above, the author describes some strengths and weaknesses of the Japanese primary care system. In addressing the weaknesses the following suggestions are offered for the Japanese primary care delivery system: Increase the number of emergency rooms for all day, especially on holidays and at night. Introduce an appointment system. Introduce an open system of hospitals. Coordinate with public hospitals and primary care clinics. Organize the referral system between private practitioners and community hospitals. Increase the number of paramedical staff. Strengthen group practice among primary care physicians. Increase the establishment of departments of primary care practice with government financial incentives to medical schools and teaching hospitals. Develop a more active and direct teaching role for primary care practice or family practice at undergraduate, graduate, and postgraduate levels. Improve and maintain present health insurance payment method, shifting from quantity of care to quality and continuity of care. Introduce formal continuing education. Introduce formal training programs of primary care and strengthen ambulatory care teaching programs.

  5. Organizing Rural Health Care

    DEFF Research Database (Denmark)

    Bunkenborg, Mikkel

    2012-01-01

    The liberalization of health care in the course of three decades of ‘reform and opening up’ has given people in rural China access to a diverse range of treatment options, but the health care system has also been marred by accusations of price hikes, fake pharmaceuticals, and medical malpractice....... This chapter offers an ethnographic description of health as an issue in a Hebei township and it focuses on a popular and a statist response to the perceived inadequacy of the rural health care system. The revival of religious practices in rural China is obviously motivated by many factors, but in the township...... in question, various forms of healing play a significant role in religious movements and the rising cost of medical services as well as a general distrust of formal medical institutions seem to be part of the reason why people choose to follow spirit mediums and religious movements that offer alternative...

  6. Translating Dutch: challenges and opportunities in reforming health financing in Ireland.

    Science.gov (United States)

    Ryan, P; Thomas, S; Normand, C

    2009-09-01

    In 2006, Dutch authorities introduced a new health financing system of compulsory private for-profit insurance with strong government regulation. This system has recently attracted attention in Ireland. This paper assesses the theoretical arguments and evidence for applying the Dutch ideas to Ireland. In particular, the authors address how it would help the stated health system policy objectives of improving value for money, fairness and capacity. While the current Dutch reform is still a work in progress, it offers the headline attraction of a single tier system with few waiting lists. Nevertheless, the Dutch system of managed competition may entail risks for Ireland relating to ensuring sufficient system capacity, protecting those on low-incomes and ensuring cost control.

  7. Sexual orientation and mental and physical health status: findings from a Dutch population survey.

    NARCIS (Netherlands)

    Sandfort, T.G.M.; Bakker, F.; Schellevis, F.G.; Vanwesenbeeck, I.

    2006-01-01

    OBJECTIVES: We sought to determine whether sexual orientation is related to mental and physical health and health behaviors in the general population. METHODS: Data was derived from a health interview survey that was part of the second Dutch National Survey of General Practice, carried out in 2001

  8. Exploring patient safety culture in Dutch primary care.

    NARCIS (Netherlands)

    Verbakel, N.J.; Melle, M. van; Langelaan, M.; Verheij, T.J.M.; Wagner, C.; Zwart, D.L.M.

    2014-01-01

    Objective: To explore perceptions of safety culture in nine different types of primary care professions and to study possible differences. Design Cross-sectional survey: Setting: Three hundred and thirteen practices from nine types of primary care profession groups in the Netherlands. Participants:

  9. Health care reforms

    Directory of Open Access Journals (Sweden)

    Marušič Dorjan

    2016-09-01

    Full Text Available In large systems, such as health care, reforms are underway constantly. The article presents a definition of health care reform and factors that influence its success. The factors being discussed range from knowledgeable personnel, the role of involvement of international experts and all stakeholders in the country, the importance of electoral mandate and governmental support, leadership and clear and transparent communication. The goals set need to be clear, and it is helpful to have good data and analytical support in the process. Despite all debates and experiences, it is impossible to clearly define the best approach to tackle health care reform due to a different configuration of governance structure, political will and state of the economy in a country.

  10. Health care reforms.

    Science.gov (United States)

    Marušič, Dorjan; Prevolnik Rupel, Valentina

    2016-09-01

    In large systems, such as health care, reforms are underway constantly. The article presents a definition of health care reform and factors that influence its success. The factors being discussed range from knowledgeable personnel, the role of involvement of international experts and all stakeholders in the country, the importance of electoral mandate and governmental support, leadership and clear and transparent communication. The goals set need to be clear, and it is helpful to have good data and analytical support in the process. Despite all debates and experiences, it is impossible to clearly define the best approach to tackle health care reform due to a different configuration of governance structure, political will and state of the economy in a country.

  11. Resilient health care

    DEFF Research Database (Denmark)

    Hollnagel, E.; Braithwaite, J.; Wears, R. L.

    production, and high reliability. This has on the whole been met with limited success because health care as a non-trivial and multifaceted system differs significantly from most traditional industries. In order to allow health care systems to perform as expected and required, it is necessary to have......Health care is everywhere under tremendous pressure with regard to efficiency, safety, and economic viability - to say nothing of having to meet various political agendas - and has responded by eagerly adopting techniques that have been useful in other industries, such as quality management, lean...... concepts and methods that are able to cope with this complexity. Resilience engineering provides that capacity because its focus is on a system's overall ability to sustain required operations under both expected and unexpected conditions rather than on individual features or qualities. Resilience...

  12. Health care need

    DEFF Research Database (Denmark)

    Hasman, Andreas; Hope, Tony; Østerdal, Lars Peter

    2006-01-01

    The argument that scarce health care resources should be distributed so that patients in 'need' are given priority for treatment is rarely contested. In this paper, we argue that if need is to play a significant role in distributive decisions it is crucial that what is meant by need can...... be precisely articulated. Following a discussion of the general features of health care need, we propose three principal interpretations of need, each of which focuses on separate intuitions. Although this account may not be a completely exhaustive reflection of what people mean when they refer to need...

  13. Burnout and health care utilization.

    Science.gov (United States)

    Jackson, C N; Manning, M R

    1995-01-01

    This study explores the relationship between burnout and health care utilization of 238 employed adults. Burnout was measured by the Maslach Burnout Inventory and health care utilization by insurance company records regarding these employees' health care costs and number of times they accessed health care services over a one year period. ANOVAs were conducted using Golembiewski and Munzenrider's approach to define the burnout phase. Significant differences in health care costs were found.

  14. Effects and side-effects of integrating care: the case of mental health care in the Netherlands

    Directory of Open Access Journals (Sweden)

    Giel J.M. Hutschemaekers

    2007-08-01

    Full Text Available Purpose Description and analysis of the effects and side-effects of integrated mental health care in the Netherlands. Context of case Due to a number of large-scale mergers, Dutch mental health care has become an illustration of integration and coherence of care services. This process of integration, however, has not only brought a better organisation of care but apparently has also resulted in a number of serious side-effects. This has raised the question whether integration is still the best way of reorganising mental health care. Data sources Literature, data books, patients and professionals, the advice of the Dutch Commission for Mental Health Care, and policy papers. Case description Despite its organisational and patient-centred integration, the problems in the Dutch mental health care system have not diminished: long waiting lists, insufficient fine tuning of care, public order problems with chronic psychiatric patients, etc. These problems are related to a sharp rise in the number of mental health care registrations in contrast with a decrease of registered patients in first-level services. This indicates that care for people with mental health problems has become solely a task for the mental health care services (monopolisation. At the same time, integrated institutions have developed in the direction of specialised medical care (homogenisation. Monopolisation and homogenisation together have put the integrated institutions into an impossible divided position. Conclusions and discussion Integration of care within the institutions in the Netherlands has resulted in withdrawal of other care providers. These side-effects lead to a new discussion on the real nature and benefits of an integrated mental health care system. Integration requires also a broadly shared vision on good care for the various target groups. This would require a radicalisation of the distinction between care providers as well as a recognition of the different goals of

  15. Nursing care community health

    Directory of Open Access Journals (Sweden)

    Diana Acosta-Salazar

    2016-07-01

    Full Text Available Process Nursing Care (PAE is a systematic tool that facilitates the scientificity of care in community practice nurse, the application of scientific method in community practice, allows nursing to provide care in logical, systematic and comprehensive reassessing interventions to achieve the proposed results. It began with the valuation of Marjory Gordon Functional Patterns and then at the stage of diagnosis and planning North American Nursing Diagnosis Association (NANDA, Nursing Interventions Classification (NIC and Nursing Outcomes Classification (NOC is interrelate. It is a descriptive and prospective study. Diagnosis was made by applying the instruments measuring scale of the socio-demographic characteristics, symptom questionnaire for early detection of mental disorders in the community and appreciation for functional patterns. The PAE includes more frequent diagnoses, criteria outcomes, indicators, interventions and activities to manage community issues. alteration was evidenced in patterns: Adaptation and Stress Tolerance, Self-perception-Self-concept-, Role-Relationships, sleep and rest and Perception and Health Management. A standardized NANDA-NIC-NOC can provide inter care holistic care from the perspective of community mental health with a degree of scientific nature that frames the professional work projecting the individual, family and community care.

  16. Information in Health Care.

    Science.gov (United States)

    Mayeda, Tadashi A.

    The report stresses the fact that while there is unity in the continuum of medicine, information in health care is markedly different from information in medical education and research. This difference is described as an anomaly in that it appears to deviate in excess of normal variation from needs common to research and education. In substance,…

  17. Primary health care use among ethnic minorities in the Netherlands: a comparative study

    NARCIS (Netherlands)

    A.H. Uiters (Anna Helena (Helen))

    2007-01-01

    textabstractThis thesis aims to provide insight into differences in the actual use of health care services by ethnic minorities as compared to the indigenous Dutch population. Furthermore, the role of different determinants of health care utilisation is studied in order to establish to what

  18. Quality indicators for pharmaceutical care: a comprehensive set with national scores for Dutch community pharmacies.

    Science.gov (United States)

    Teichert, Martina; Schoenmakers, Tim; Kylstra, Nico; Mosk, Berend; Bouvy, Marcel L; van de Vaart, Frans; De Smet, Peter A G M; Wensing, Michel

    2016-08-01

    Background The quality of pharmaceutical care in community pharmacies in the Netherlands has been assessed annually since 2008. The initial set has been further developed with pharmacists and patient organizations, the healthcare inspectorate, the government and health insurance companies. The set over 2012 was the first set of quality indicators for community pharmacies which was validated and supported by all major stakeholders. The aims of this study were to describe the validated set of quality indicators for community pharmacies and to report their scores over 2012. In subanalyses the score development over 5 years was described for those indicators, that have been surveyed before and remained unchanged. Methods Community pharmacists in the Netherlands were invited in 2013 to provide information for the set of 2012. Quality indicators were mapped by categories relevant for pharmaceutical care and defined for structures, processes and dispensing outcomes. Scores for categorically-measured quality indicators were presented as the percentage of pharmacies reporting the presence of a quality aspect. For numerical quality indicators, the mean of all reported scores was expressed. In subanalyses for those indicators that had been questioned previously, scores were collected from earlier measurements for pharmacies providing their scores in 2012. Multilevel analysis was used to assess the consistency of scores within one pharmacy over time by the intra-class correlation coefficient (ICC). Results For the set in 2012, 1739 Dutch community pharmacies (88 % of the total) provided information for 66 quality indicators in 10 categories. Indicator scores on the presence of quality structures showed relatively high quality levels. Scores for processes and dispensing outcomes were lower. Subanalyses showed that overall indicators scores improved within pharmacies, but this development differed between pharmacies. Conclusions A set of validated quality indicators provided

  19. Developing a national performance indicator framework for the Dutch health system.

    NARCIS (Netherlands)

    Asbroek, A.H.A. ten; Arah, O.A.; Geelhoed, J.; Custers, J.; Delnoij, D.M.; Klazinga, N.S.

    2004-01-01

    Objective. To report on the first phase of the development of a national performance indicator framework for the Dutch health system. Methods. In January 2002, we initiated an informed interactive process with the intended users-policymakers at the Ministry of Health, Welfare and Sport—and academics

  20. Pediatric Surgical Care in a Dutch Military Hospital in Afghanistan

    NARCIS (Netherlands)

    Idenburg, Floris J.; Van Dongen, Thijs T C F; Tan, Edward C T H; Hamming, Jaap H.; Leenen, Luke P H; Hoencamp, Rigo

    2015-01-01

    Background   From August 2006–August 2010, as part of the ISAF mission, the Armed Forces of the Netherlands deployed a role 2 enhanced Medical Treatment Facility (R2E-MTF) to Uruzgan province, Afghanistan. Although from the principle doctrine not considered a primary task, care was delivered to civi

  1. Pregnancy and labour in the dutch maternity care system: What is normal? The role division between midwives and obstetricians

    NARCIS (Netherlands)

    Amelink-Verburg, M.P.; Buitendijk, S.E.

    2010-01-01

    Introduction: In the Dutch maternity care system, the role division between independently practising midwives (who take care of normal pregnancy and childbirth) and obstetricians (who care for pathologic pregnancy and childbirth) has been established in the so-called " List of Obstetric Indications"

  2. Doing masculinity, not doing health? a qualitative study among dutch male employees about health beliefs and workplace physical activity

    Directory of Open Access Journals (Sweden)

    de Rijk Angelique

    2010-11-01

    Full Text Available Abstract Background Being female is a strong predictor of health promoting behaviours. Workplaces show great potential for lifestyle interventions, but such interventions do not necessarily take the gendered background of lifestyle behaviours into account. A perspective analyzing how masculine gender norms affect health promoting behaviours is important. This study aims to explore men's health beliefs and attitudes towards health promotion; in particular, it explores workplace physical activity in relation to masculine ideals among male employees. Methods In the Fall of 2008, we interviewed 13 white Dutch male employees aged 23-56 years. The men worked in a wide range of professions and occupational sectors and all interviewees had been offered a workplace physical activity program. Interviews lasted approximately one to one-and-a-half hour and addressed beliefs about health and lifestyle behaviours including workplace physical activity, as well as normative beliefs about masculinity. Thematic analysis was used to analyze the data. Results Two normative themes were found: first, the ideal man is equated with being a winner and real men are prepared to compete, and second, real men are not whiners and ideally, not vulnerable. Workplace physical activity is associated with a particular type of masculinity - young, occupied with looks, and interested in muscle building. Masculine norms are related to challenging health while taking care of health is feminine and, hence, something to avoid. Workplace physical activity is not framed as a health measure, and not mentioned as of importance to the work role. Conclusions Competitiveness and nonchalant attitudes towards health shape masculine ideals. In regards to workplace physical activity, some men resist what they perceive to be an emphasis on muscled looks, whereas for others it contributes to looking self-confident. In order to establish a greater reach among vulnerable employees such as ageing men

  3. Doing masculinity, not doing health? a qualitative study among dutch male employees about health beliefs and workplace physical activity

    Science.gov (United States)

    2010-01-01

    Background Being female is a strong predictor of health promoting behaviours. Workplaces show great potential for lifestyle interventions, but such interventions do not necessarily take the gendered background of lifestyle behaviours into account. A perspective analyzing how masculine gender norms affect health promoting behaviours is important. This study aims to explore men's health beliefs and attitudes towards health promotion; in particular, it explores workplace physical activity in relation to masculine ideals among male employees. Methods In the Fall of 2008, we interviewed 13 white Dutch male employees aged 23-56 years. The men worked in a wide range of professions and occupational sectors and all interviewees had been offered a workplace physical activity program. Interviews lasted approximately one to one-and-a-half hour and addressed beliefs about health and lifestyle behaviours including workplace physical activity, as well as normative beliefs about masculinity. Thematic analysis was used to analyze the data. Results Two normative themes were found: first, the ideal man is equated with being a winner and real men are prepared to compete, and second, real men are not whiners and ideally, not vulnerable. Workplace physical activity is associated with a particular type of masculinity - young, occupied with looks, and interested in muscle building. Masculine norms are related to challenging health while taking care of health is feminine and, hence, something to avoid. Workplace physical activity is not framed as a health measure, and not mentioned as of importance to the work role. Conclusions Competitiveness and nonchalant attitudes towards health shape masculine ideals. In regards to workplace physical activity, some men resist what they perceive to be an emphasis on muscled looks, whereas for others it contributes to looking self-confident. In order to establish a greater reach among vulnerable employees such as ageing men, worksite health promotion

  4. Flourishing in health care

    OpenAIRE

    Edgar, Andrew Robert; Pattison, Stephen

    2016-01-01

    The purpose of this paper is to offer an account of ‘flourishing’ that is relevant to health care provision, both in terms of the flourishing of the individual patient and carer, and in terms of the flourishing of the caring institution. It is argued that, unlike related concepts such as ‘happiness’, ‘well-being’ or ‘quality of life’, ‘flourishing’ uniquely has the power to capture the importance of the vulnerability of human being. Drawing on the likes of Heidegger and Nussbaum, it is argued...

  5. Children's rights to health care.

    Science.gov (United States)

    Brock, D W

    2001-04-01

    This paper will explore the application of an account of justice in health and health care to the special case of children. It is tempting to hold that children require no special treatment in an account of just health care; justice requires guaranteeing access to at least basic health care services to all persons, whatever their age group, within the constraints of a society's resources. However, I will argue that for a number of reasons we need to address what justice requires specifically for children from the health care system, even if the answer must be embedded within a general account of justice in health and health care.

  6. The Dutch health insurance reform: switching between insurers, a comparison between the general population and the chronically ill and disabled

    Directory of Open Access Journals (Sweden)

    Groenewegen Peter P

    2008-03-01

    Full Text Available Abstract Background On 1 January 2006 a number of far-reaching changes in the Dutch health insurance system came into effect. In the new system of managed competition consumer mobility plays an important role. Consumers are free to change their insurer and insurance plan every year. The idea is that consumers who are not satisfied with the premium or quality of care provided will opt for a different insurer. This would force insurers to strive for good prices and quality of care. Internationally, the Dutch changes are under the attention of both policy makers and researchers. Questions answered in this article relate to switching behaviour, reasons for switching, and differences between population categories. Methods Postal questionnaires were sent to 1516 members of the Dutch Health Care Consumer Panel and to 3757 members of the National Panel of the Chronically ill and Disabled (NPCD in April 2006. The questionnaire was returned by 1198 members of the Consumer Panel (response 79% and by 3211 members of the NPCD (response 86%. Among other things, questions were asked about choices for a health insurer and insurance plan and the reasons for this choice. Results Young and healthy people switch insurer more often than elderly or people in bad health. The chronically ill and disabled do not switch less often than the general population when both populations are comparable on age, sex and education. For the general population, premium is more important than content, while the chronically ill and disabled value content of the insurance package as well. However, quality of care is not important for either group as a reason for switching. Conclusion There is increased mobility in the new system for both the general population and the chronically ill and disabled. This however is not based on quality of care. If reasons for switching are unrelated to the quality of care, it is hard to believe that switching influences the quality of care. As yet there

  7. Influence of parental employment status on Dutch and Slovak adolescents' health

    Directory of Open Access Journals (Sweden)

    Salonna Ferdinand

    2006-10-01

    Full Text Available Abstract Background Recent research shows the possibility that the link between parental employment status and children's health can be affected by different cultural or societal settings. The aim of this study was to explore whether the effect of father's and mother's employment status on several aspects of adolescents' health differs between Slovakia and the Netherlands. Methods Two data sets were used: 2616 Slovak adolescents (mean age 14.9 and 2054 Dutch adolescents (mean age 16.3. Self-rated health, GHQ-12, long-term well-being and Rosenberg self-esteem scale were used to assess the health of adolescents. Parental employment status was classified into the following categories: employed, unemployed, disabled, housewife (among mothers only. Logistic regression analyses were done separately for males and females. Results Results indicate that having an unemployed father negatively influences self-rated health and long-term well-being of Slovak male adolescents, but has no effect on the health of Dutch adolescents. Secondly, having a disabled father has a negative effect on the psychological well-being of Dutch males and the self-rated health of females, but does not influence the health of Slovak adolescents. Thirdly, having a mother who is disabled, unemployed or a housewife has a negative effect on the self-esteem of Slovak adolescents. Fourthly, Dutch males whose mother was a housewife had worse long-term well-being than those with an unemployed mother, whereas Dutch females whose mother was a housewife reported better psychological well-being than those with an employed mother. Conclusion To conclude briefly our results, father's unemployment seems to be a better predictor of health for Slovak adolescents, father's disablement of health for Dutch ones. Mother's employment status seemed to be important for the self-esteem of Slovak adolescents and mother as a housewife for the health of Dutch ones. This suggests that the link between

  8. Adherence to chronic medication in Dutch primary care.

    NARCIS (Netherlands)

    Dijk, L. van; Somai, D.; Heerdink, E.; Dulmen, S. van; Sluijs, E.; Ridder, D. de; Bensing, J.

    2006-01-01

    Background: Non-adherence is a major public health problem. Despite the large amount of research in this area there is still need for research on determinants of non-adherente. For example, the influence of prescribers on adherence in their patient population is not clear. Objectives: 1) To identify

  9. Effect evaluation of a supervised versus non-supervised implementation of an oral health care guideline in nursing homes: a cluster randomised controlled clinical trial.

    NARCIS (Netherlands)

    Visschere, L. De; Schols, J.; Putten, G.J. van der; Baat, C. de; Vanobbergen, J.

    2012-01-01

    OBJECTIVE: To compare a supervised versus a non-supervised implementation of an oral health care guideline in Flanders (Belgium). BACKGROUND: The key factor in realising good oral health is daily oral hygiene care. In 2007, the Dutch guideline 'Oral health care in care homes for elderly people' was

  10. Consumer evaluation of complaint handling in the Dutch health insurance market.

    NARCIS (Netherlands)

    Wendel, S.; Jong, J.D. de; Curfs, E.C.

    2011-01-01

    Background: How companies deal with complaints is a particularly challenging aspect in managing the quality of their service. In this study we test the direct and relative effects of service quality dimensions on consumer complaint satisfaction evaluations and trust in a company in the Dutch health

  11. Confirmative factor analysis of the dimensions of the Child Oral Health Impact Profile (Dutch version)

    NARCIS (Netherlands)

    L.M. Geels; J. Hoogstraten; B. Prahl-Andersen

    2008-01-01

    The aim of this study was to examine the subscales of the Child Oral Health Impact Profile (COHIP). The Dutch version of the COHIP consists of the subscales 'Oral Symptoms', 'Functional Well-being', 'Emotional Well-being', 'School', and 'Peer Interaction'. The questionnaire was administered to a sam

  12. Educational Differences in Adolescents' Sexual Health : A Pervasive Phenomenon in a National Dutch Sample

    NARCIS (Netherlands)

    De Graaf, Hanneke; Vanwesenbeeck, Wilhelmina; Meijer, Suzanne

    2015-01-01

    Educational level is strongly associated with age of first intercourse and risk of unintended pregnancies. This study examined these associations in a large representative sample of Dutch adolescents and also included associations of educational level with other sexual health aspects. Adolescents ag

  13. Validation of the Dutch functional, communicative and critical health literacy scales

    NARCIS (Netherlands)

    Vaart, van der Rosalie; Drossaert, Constance H.C.; Taal, Erik; Klooster, ten Peter M.; Hilderink-Koertshuis, Rianne T.E.; Klaase, Joost M.; Laar, van de Mart A.F.J.

    2012-01-01

    Objective: While most existing health literacy (HL) measures focus primarily on reading comprehension, the functional, communicative and critical HL scales from Ishikawa et al. [19] aim to measure a broader HL spectrum. The objective of this study was to evaluate the validity of the Dutch translatio

  14. Does stimulating self-care increase self-care behaviour for minor illnesses of Dutch and Turkish inhabitants of a deprived area in The Netherlands?

    NARCIS (Netherlands)

    Plass, A.M.C.; Timmermans, D.R.M.; Wal, G. van der

    2006-01-01

    OBJECTIVE: The aim of the present study was to examine whether self-care behaviour increases after a self-care stimulating intervention that proved to be successful in reducing care-seeking behaviour for minor illnesses of Turkish and Dutch inhabitants of a deprived area in the Netherlands, and to s

  15. Perspectives on Salutogenesis of Scholars Writing in Dutch

    NARCIS (Netherlands)

    Vaandrager, L.; Koelen, M.; Dieleman, F.

    2017-01-01

    It is quite uncommon in The Netherlands to publish in Dutch so most publications about salutogenesis are in English. However, we identified 19 publications written in Dutch. These are publications in the field of development psychology, workplace health, mental health, medicine, care for people with

  16. Quality of diabetes care in Dutch care groups: no differences between diabetes patients with and without co-morbidity

    Directory of Open Access Journals (Sweden)

    Simone R de Bruin

    2013-12-01

    Full Text Available Objective: To evaluate the relationship between presence and nature of co-morbidity and quality of care for diabetes patients enrolled in diabetes disease management programmes provided by care groups.Methods: We performed an observational study within eight Dutch diabetes care groups. Data from patient record systems of care groups and patient questionnaires were used to determine quality of care. Quality of care was measured as provision of the recommended diabetes care, patients’ achievement of recommended clinical outcomes and patients’ perception of coordination and integration of care.Results: 527 diabetes patients without and 1187 diabetes patients with co-morbidity were included. Of the co-morbid patients, 7.8% had concordant co-morbid conditions only, 63.8% had discordant co-morbid diseases only and 28.4% had both types of conditions. Hardly any differences were observed between patients with and without co-morbidity in terms of provided care, achievement of clinical outcomes and perceived coordination and integration of care.Conclusions: Our study implies that care groups are able to provide similar quality of diabetes care for diabetes patients with and without co-morbidity. Considering the expected developments regarding additional disease management programmes in care groups, it is of importance to monitor quality of care, including patient experiences, for all chronic diseases. It will then become clear whether accountable provider-led organisations such as care groups are able to ensure quality of care for the increasing number of patients with multiple chronic conditions.

  17. Betting against health care.

    Science.gov (United States)

    Appleby, C

    1996-06-20

    Health care firms of all types helped fuel the biggest short-selling frenzy in the New York Stock Exchange's history, recently hitting a record 2.2 billion shares. While some analysts say this means nothing, the fact is that many investors are "shorting" the stock; in other words, they're betting against it. What appears as a lack of confidence may be nothing more than a simple quirk of Wall Street. Good, bad or indifferent, selling short is no tall tale.

  18. Health care engineering

    CERN Document Server

    Frize, Monique

    2013-01-01

    Part II of Health Care Engineering begins with statistics on the occurrence of medical errors and adverse events, and includes some technological solutions. A chapter on electronic medical records follows. The knowledge management process divided into four steps is described; this includes a discussion on data acquisition, storage, and retrieval. The next two chapters discuss the other three steps of the knowledge management process (knowledge discovery, knowledge translation, knowledge integration and sharing). The last chapter briefly discusses usability studies and clinical trials.This two-

  19. FastStats: Home Health Care

    Science.gov (United States)

    ... Day Services Centers Home Health Care Hospice Care Nursing Home Care Residential Care Communities Screenings Mammography Pap Tests Disability ... Care National Study of Long-Term Care Providers Nursing Home Care Residential Care Communities Centers for Medicare and Medicaid ...

  20. Outpatient costs in pharmaceutically treated diabetes patients with and without a diagnosis of depression in a Dutch primary care setting

    Directory of Open Access Journals (Sweden)

    Bosmans Judith E

    2012-02-01

    Full Text Available Abstract Background To assess differences in outpatient costs among pharmaceutically treated diabetes patients with and without a diagnosis of depression in a Dutch primary care setting. Methods A retrospective case control study over 3 years (2002-2004. Data on 7128 depressed patients and 23772 non-depressed matched controls were available from the electronic medical record system of 20 general practices organized in one large primary care organization in the Netherlands. A total of 393 depressed patients with diabetes and 494 non-depressed patients with diabetes were identified in these records. The data that were extracted from the medical record system concerned only outpatient costs, which included GP care, referrals, and medication. Results Mean total outpatient costs per year in depressed diabetes patients were €1039 (SD 743 in the period 2002-2004, which was more than two times as high as in non-depressed diabetes patients (€492, SD 434. After correction for age, sex, type of insurance, diabetes treatment, and comorbidity, the difference in total annual costs between depressed and non-depressed diabetes patients changed from €408 (uncorrected to €463 (corrected in multilevel analyses. Correction for comorbidity had the largest impact on the difference in costs between both groups. Conclusions Outpatient costs in depressed patients with diabetes are substantially higher than in non-depressed patients with diabetes even after adjusting for confounders. Future research should investigate whether effective treatment of depression among diabetes patients can reduce health care costs in the long term.

  1. The effect of deinstitutionalization on the longitudinal continuity of mental health care in the Netherlands

    NARCIS (Netherlands)

    Pijl, YJ; Sytema, S

    2004-01-01

    Background Deinstitutionalization has been accompanied by a decreasing continuity of care in a number of countries. This study evaluates the effects of the Dutch model for deinstitutionalizing mental health care. Methods Details of users and their use of community- and hospital-based services betwee

  2. Personal Care in Learning Health Care Systems.

    Science.gov (United States)

    Miller, Franklin G; Kim, Scott Y H

    2015-12-01

    The idea of a "learning health care system"--one that systematically integrates clinical research with medical care--has received considerable attention recently. Some commentators argue that under certain conditions pragmatic comparative effectiveness randomized trials can be conducted ethically within the context of a learning health care system without the informed consent of patients for research participation. In this article, we challenge this perspective and contend that conducting randomized trials of individual treatment options without consent is neither necessary nor desirable to promote and sustain learning health care systems. Our argument draws on the normative conception of personal care developed by Charles Fried in a landmark 1974 book on the ethics of randomized controlled trials.

  3. Reforming the health care system: implications for health care marketers.

    Science.gov (United States)

    Petrochuk, M A; Javalgi, R G

    1996-01-01

    Health care reform has become the dominant domestic policy issue in the United States. President Clinton, and the Democratic leaders in the House and Senate have all proposed legislation to reform the system. Regardless of the plan which is ultimately enacted, health care delivery will be radically changed. Health care marketers, given their perspective, have a unique opportunity to ensure their own institutions' success. Organizational, managerial, and marketing strategies can be employed to deal with the changes which will occur. Marketers can utilize personal strategies to remain proactive and successful during an era of health care reform. As outlined in this article, responding to the health care reform changes requires strategic urgency and action. However, the strategies proposed are practical regardless of the version of health care reform legislation which is ultimately enacted.

  4. The development of socio-economic health differences in childhood: results of the Dutch longitudinal PIAMA birth cohort

    Directory of Open Access Journals (Sweden)

    Smit Henriette A

    2011-04-01

    Full Text Available Abstract Background People with higher socio-economic status (SES are generally in better health. Less is known about when these socio-economic health differences set in during childhood and how they develop over time. The goal of this study was to prospectively study the development of socio-economic health differences in the Netherlands, and to investigate possible explanations for socio-economic variation in childhood health. Methods Data from the Dutch Prevention and Incidence of Asthma and Mite Allergy (PIAMA birth cohort study were used for the analyses. The PIAMA study followed 3,963 Dutch children during their first eight years of life. Common childhood health problems (i.e. eczema, asthma symptoms, general health, frequent respiratory infections, overweight, and obesity were assessed annually using questionnaires. Maternal educational level was used to indicate SES. Possible explanatory lifestyle determinants (breastfeeding, smoking during pregnancy, smoking during the first three months, and day-care centre attendance and biological determinants (maternal age at birth, birthweight, and older siblings were analysed using generalized estimating equations. Results This study shows that socio-economic differences in a broad range of health problems are already present early in life, and persist during childhood. Children from families with low socio-economic backgrounds experience more asthma symptoms (odds ratio (OR 1.27; 95% Confidence Interval (CI 1.08-1.49, poorer general health (OR 1.36; 95% CI 1.16-1.60, more frequent respiratory infections (OR 1.57; 95% CI 1.35-1.83, more overweight (OR 1.42; 95% CI 1.16-1.73, and more obesity (OR 2.82; 95% CI 1.80-4.41. The most important contributors to the observed childhood socio-economic health disparities are socio-economic differences in maternal age at birth, breastfeeding, and day-care centre attendance. Conclusions Socio-economic health disparities already occur very early in life. Socio

  5. Occupational Health for Health Care Providers

    Science.gov (United States)

    Health care workers are exposed to many job hazards. These can include Infections Needle injuries Back injuries ... prevention practices. They can reduce your risk of health problems. Use protective equipment, follow infection control guidelines, ...

  6. The German health care system and health care reform.

    Science.gov (United States)

    Kamke, K

    1998-02-01

    This article presents a structured survey of the German health care and health insurance system, and analyzes major developments of current German health policy. The German statutory health insurance system has been known as a system that provides all citizens with ready access to comprehensive high quality medical care at a cost the country considered socially acceptable. However, an increasing concern for rapidly rising health care expenditure led to a number of cost-containment measures since 1977. The aim was to bring the growth of health care expenditure in line with the growth of wages and salaries of the sickness fund members. The recent health care reforms of 1989 and 1993 yielded only short-term reductions of health care expenditure, with increases in the subsequent years. 'Stability of the contribution rate' is the uppermost political objective of current health care reform initiatives. Options under discussion include reductions in the benefit package and increases of patients' co-payments. The article concludes with the possible consequences of the 1997 health care reform of which the major part became effective 1 July 1997.

  7. Comparing Dutch Case management care models for people with dementia and their caregivers: The design of the COMPAS study

    Directory of Open Access Journals (Sweden)

    MacNeil Vroomen Janet

    2012-05-01

    Full Text Available Abstract Background Dementia care in the Netherlands is shifting from fragmented, ad hoc care to more coordinated and personalised care. Case management contributes to this shift. The linkage model and a combination of intensive case management and joint agency care models were selected based on their emerging prominence in the Netherlands. It is unclear if these different forms of case management are more effective than usual care in improving or preserving the functioning and well-being at the patient and caregiver level and at the societal cost. The objective of this article is to describe the design of a study comparing these two case management care models against usual care. Clinical and cost outcomes are investigated while care processes and the facilitators and barriers for implementation of these models are considered. Design Mixed methods include a prospective, observational, controlled, cohort study among persons with dementia and their primary informal caregiver in regions of the Netherlands with and without case management including a qualitative process evaluation. Inclusion criteria for the cohort study are: community-dwelling individuals with a dementia diagnosis who are not terminally-ill or anticipate admission to a nursing home within 6 months and with an informal caregiver who speaks fluent Dutch. Person with dementia-informal caregiver dyads are followed for two years. The primary outcome measure is the Neuropsychiatric Inventory for the people with dementia and the General Health Questionnaire for their caregivers. Secondary outcomes include: quality of life and needs assessment in both persons with dementia and caregivers, activity of daily living, competence of care, and number of crises. Costs are measured from a societal perspective using cost diaries. Process indicators measure the quality of care from the participant’s perspective. The qualitative study uses purposive sampling methods to ensure a wide variation of

  8. Re-Minding the Dutch

    Directory of Open Access Journals (Sweden)

    H. Pols

    2009-01-01

    Full Text Available Re-Minding the DutchVerward van Geest is commended because of its careful, balanced, detailed, meticulously researched, and comprehensive approach of the development of the psychiatric profession in the Netherlands. The authors relate Dutch developments to initiatives abroad, some of which were taken up by Dutch psychiatrists and developed further. The development of the extensive network of out-patient mental health facilities in particular, which makes the Dutch system stand apart from that of most others, receives a lot of attention. Unfortunately, the history of psychiatry in the former Dutch colonial empire is not covered. The study is applauded for providing a wealth of material that could give a new impulse to discussions about the nature of mental health in the Netherlands, such as the following: How are supply and demand in mental health care related to each other? Do individuals with a lower socio-economic status have adequate access to care? How did the relationship between biological, social, and psychological approaches to mental illness and individual distress change over time?

  9. Accountability in Health Care

    DEFF Research Database (Denmark)

    Vrangbæk, Karsten; Byrkjeflot, Haldor

    2016-01-01

    The debate on accountability within the public sector has been lively in the past decade. Significant progress has been made in developing conceptual frameworks and typologies for characterizing different features and functions of accountability. However, there is a lack of sector specific...... adjustment of such frameworks. In this article we present a framework for analyzing accountability within health care. The paper makes use of the concept of "accountability regime" to signify the combination of different accountability forms, directions and functions at any given point in time. We show...... that reforms can introduce new forms of accountability, change existing accountability relations or change the relative importance of different accountability forms. They may also change the dominant direction and shift the balance between different functions of accountability. We further suggest...

  10. Federalism and Health Care

    Directory of Open Access Journals (Sweden)

    G. Alan Tarr

    2011-10-01

    Full Text Available President Barack Obama proposed a major overhaul of the American healthsystem, and in 2010 the U.S. Congress enacted his proposal, the PatientProtection and Affordable Care Act. Opponents of the Act challenged itsconstitutionality in federal court, claiming that it exceeds the powers grantedto the federal government under the Commerce Clause and the NecessaryProper Clause of the federal Constitution. Some courts have upheldthe law, but others have agreed with the critics, in particular ruling thatthe provision requiring citizens to buy health insurance is unconstitutional.Eventually the U.S. Supreme Court will rule on the issue. This article tracesthe controversy, surveys the interpretation of pertinent constitutional provisionsin past cases, analyzes the constitutional arguments presented byproponents and opponents of the Act, and concludes that the Act is constitutional.

  11. Three decades of eating disorders in Dutch primary care: decreasing incidence of bulimia nervosa but not of anorexia nervosa.

    Science.gov (United States)

    Smink, F R E; van Hoeken, D; Donker, G A; Susser, E S; Oldehinkel, A J; Hoek, H W

    2016-04-01

    Whether the incidence of eating disorders in Western, industrialized countries has changed over time has been the subject of much debate. The purpose of this primary-care study was to examine changes in the incidence of eating disorders in The Netherlands during the 1980s, 1990s and 2000s. A nationwide network of general practitioners (GPs), serving a representative sample (~1%) of the total Dutch population, recorded newly diagnosed patients with anorexia nervosa (AN) and bulimia nervosa (BN) in their practice during 1985-1989, 1995-1999, and 2005-2009. GPs are key players in the Dutch healthcare system, as their written referral is mandatory in order to get access to specialized (mental) healthcare, covered by health insurance. Health insurance is virtually universal in The Netherlands (99% of the population). A substantial number of GPs participated in all three study periods, during which the same case identification criteria were used and the same psychiatrist was responsible for making the final diagnoses. Incidence rates were calculated and for comparison between periods, incidence rate ratios. The overall incidence rate of BN decreased significantly in the past three decades (from 8.6 per 100,000 person-years in 1985-1989 to 6.1 in 1995-1999, and 3.2 in 2005-2009). The overall incidence of AN remained fairly stable during three decades, i.e. 7.4 per 100,000 person-years in 1985-1989, 7.8 in 1995-1999, and 6.0 in 2005-2009. The incidence rate of BN decreased significantly over the past three decades, while the overall incidence rate of AN remained stable.

  12. Seeking Access to Long-Term Care: Legal Consciousness of Dutch Retirement Migrants on the Costa Blanca

    Directory of Open Access Journals (Sweden)

    Anoeshka Gehring

    2013-12-01

    Full Text Available As EU citizens, Dutch retirement migrants can move and reside freely within the European Union. This enables their fluid migratory pattern and the formation of transnational ties between the Netherlands and Spain. However, national laws and nationally organised welfare systems within the EU may bind some retirement migrants to one of the two countries. Retirement migrants move at a stage in their lifecycle associated with a possible deterioration of health, therefore they are forced to think about accessing care provisions in the Netherlands and/or Spain. By focusing on the ways Dutch retirement migrants talk about and seek access to long-term care in both countries, this contribution explores the legal consciousness of Dutch retirement migrants in a transnational setting. Since legal consciousness research mainly focuses on a nation-state setting, this contribution argues that theories on legal consciousness should develop further in order to open its analysis frame to include transnational migrants who have to deal with more than one legal system. Como ciudadanos de la UE, los emigrantes jubilados holandeses pueden circular y residir libremente en la Unión Europea. Esto permite un patrón migratorio fluido y la formación de lazos transnacionales entre los Países Bajos y España. Sin embargo, las leyes nacionales y los sistemas de bienestar social organizados a nivel nacional dentro de la UE pueden obligar a algunos emigrantes jubilados hacia uno de los dos países. Los emigrantes jubilados se mueven en una etapa de su ciclo de vida asociada a un posible deterioro de la salud, por lo tanto, se ven obligados a pensar y organizar el acceso a los cuidados sanitarios en los Países Bajos y/o España. Al centrarse en los modos en los que los emigrantes jubilados holandeses hablan y buscan acceso a los cuidados a largo plazo en ambos países, esta contribución explora la conciencia jurídica de los emigrantes jubilados holandeses en un entorno

  13. Health and Disability: Partnerships in Health Care

    Science.gov (United States)

    Tracy, Jane; McDonald, Rachael

    2015-01-01

    Background: Despite awareness of the health inequalities experienced by people with intellectual disability, their health status remains poor. Inequalities in health outcomes are manifest in higher morbidity and rates of premature death. Contributing factors include the barriers encountered in accessing and receiving high-quality health care.…

  14. Health and Disability: Partnerships in Health Care

    Science.gov (United States)

    Tracy, Jane; McDonald, Rachael

    2015-01-01

    Background: Despite awareness of the health inequalities experienced by people with intellectual disability, their health status remains poor. Inequalities in health outcomes are manifest in higher morbidity and rates of premature death. Contributing factors include the barriers encountered in accessing and receiving high-quality health care.…

  15. Flourishing in Health Care.

    Science.gov (United States)

    Edgar, Andrew; Pattison, Stephen

    2016-06-01

    The purpose of this paper is to offer an account of 'flourishing' that is relevant to health care provision, both in terms of the flourishing of the individual patient and carer, and in terms of the flourishing of the caring institution. It is argued that, unlike related concepts such as 'happiness', 'well-being' or 'quality of life', 'flourishing' uniquely has the power to capture the importance of the vulnerability of human being. Drawing on the likes of Heidegger and Nussbaum, it is argued that humans are at once beings who are autonomous and thereby capable of making sense of their lives, but also subject to the contingencies of their bodies and environments. To flourish requires that one engages, imaginatively and creatively, with those contingencies. The experience of illness, highlighting the vulnerability of the human being, thereby becomes an important experience, stimulating reflection in order to make sense of one's life as a narrative. To flourish, it is argued, is to tell a story of one's life, realistically engaging with vulnerability and suffering, and thus creating a framework through which one can meaningful and constructively go on with one's life.

  16. Supportive care for children with acute leukemia - Report of a survey on supportive care by the Dutch Childhood Leukemia Study Group. Part I

    NARCIS (Netherlands)

    Postma, A; Van Leeuwen, EF; Gerritsen, EJA; Roord, JJ; De vries-Hospers, HG

    1998-01-01

    The Dutch Childhood Leukemia Study Group celebrated its 20th anniversary by conducting a nationwide survey on supportive care for children with leukemia. Pediatricians were asked about daily practice and current perceptions with regard to supportive care. The results are discussed and compared to re

  17. Spiritual Care Education of Health Care Professionals

    Directory of Open Access Journals (Sweden)

    Donia Baldacchino

    2015-05-01

    Full Text Available Nurses and health care professionals should have an active role in meeting the spiritual needs of patients in collaboration with the family and the chaplain. Literature criticizes the impaired holistic care because the spiritual dimension is often overlooked by health care professionals. This could be due to feelings of incompetence due to lack of education on spiritual care; lack of inter-professional education (IPE; work overload; lack of time; different cultures; lack of attention to personal spirituality; ethical issues and unwillingness to deliver spiritual care. Literature defines spiritual care as recognizing, respecting, and meeting patients’ spiritual needs; facilitating participation in religious rituals; communicating through listening and talking with clients; being with the patient by caring, supporting, and showing empathy; promoting a sense of well-being by helping them to find meaning and purpose in their illness and overall life; and referring them to other professionals, including the chaplain/pastor. This paper outlines the systematic mode of intra-professional theoretical education on spiritual care and its integration into their clinical practice; supported by role modeling. Examples will be given from the author’s creative and innovative ways of teaching spiritual care to undergraduate and post-graduate students. The essence of spiritual care is being in doing whereby personal spirituality and therapeutic use of self contribute towards effective holistic care. While taking into consideration the factors that may inhibit and enhance the delivery of spiritual care, recommendations are proposed to the education, clinical, and management sectors for further research and personal spirituality to ameliorate patient holistic care.

  18. Engaging cultural resources to promote mental health in Dutch LSES neighborhoods: study of a community-based participatory media project.

    Science.gov (United States)

    Knibbe, Mare; de Vries, Marten; Horstman, Klasien

    2015-09-28

    Community-based participatory media projects form a promising new strategy for mental health promotion that can help address the mental health-gap identified by the World Health Organization. (2008b) mhGAP, Mental Health Gap Action Programme: Scaling Up Care for Mental, Neurological and Substance Use Disorders. World Health Organization, Geneva. In this article we present an ethnographic study about a participatory media project that was developed to promote mental health in selected Dutch low socio-economic status neighborhoods. Through narrowcastings (group film viewings), participant observation and interviews we mapped the ways in which the media project effected and facilitated the collective sense-making process of the audience with regard to sources of stress impacting mental health and opportunities for action. These determinants of mental health are shaped by cultural dimensions, since the cultural context shapes everyday experiences of stress as well as the resources and skills to manage them. Our analysis shows that the media project engaged cultural resources to challenge stressful social scripts. We conclude that more attention should be paid to cultural narratives in a community to understand how health promotion strategies can support social resilience.

  19. COMMUNITY HEALTH & PRIMARY HEALTH CARE

    African Journals Online (AJOL)

    2Department of Health Policy and Management, Faculty of Public Health, College of Medicine and University ... 86 (21%) had primary school education, 210 (51.3%) were married, and 357 (87.3%) were employed. ...... patient satisfaction and behavioral intentions in. 5. .... Psychological Assessment 1995; 7 (3):309-319.

  20. COMMUNITY HEALTH & PRIMARY HEALTH CARE

    African Journals Online (AJOL)

    user

    2Department of Community Health, University of Benin, Benin City, Nigeria. ... public health problem that can lead to a great burden of disability in the community. ..... women. Equally worthy of note, is the fact that a higher proportion of females ...

  1. Current Dermatologic Care in Dutch Nursing Homes and Possible Improvements: A Nationwide Survey.

    Science.gov (United States)

    Lubeek, Satish F K; van der Geer, Eric R; van Gelder, Marleen M H J; Koopmans, Raymond T C M; van de Kerkhof, Peter C M; Gerritsen, Marie-Jeanne P

    2015-08-01

    To assess the provision and need of dermatologic care among Dutch nursing home patients and to obtain recommendations for improvement. Cross-sectional nationwide survey. All 173 nursing home organizations in the Netherlands. Physicians working in nursing homes. Web-based questionnaire concerning the burden of skin diseases in nursing home patients, diagnostic procedures and therapy, collaboration with dermatologists, physicians' level of education, and suggestions for improvement. A total of 126 (72.8%) nursing home organizations, with 1133 associated physicians participated in our study and received the questionnaire. A total of 347 physicians (30.6%) completed the questionnaire. Almost all respondents (99.4%) were recently confronted with skin diseases, mostly (pressure) ulcers, eczema, and fungal infections. Diagnostic and treatment options were limited because of a lack of availability and experience of the physicians. More live consultation of dermatologists was suggested as being important to improve dermatologic care. Other suggestions were better education, more usage of telemedicine applications, and better availability of diagnostic and/or treatment procedures like cryotherapy. Physicians in nursing homes are frequently confronted with skin diseases. Several changes in organization of care and education are expected to improve dermatologic care in nursing home patients. Copyright © 2015 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.

  2. Manifestations of integrated public health policy in Dutch municipalities

    NARCIS (Netherlands)

    Peters, D.; Harting, J.; van Oers, H.; Schuit, J.; de Vries, N.; Stronks, K.

    2014-01-01

    Integrated public health policy (IPHP) aims at integrating health considerations into policies of other sectors. Since the limited empirical evidence available may hamper its further development, we systematically analysed empirical manifestations of IPHP, by placing policy strategies along a contin

  3. Manifestations of integrated public health policy in Dutch municipalities

    NARCIS (Netherlands)

    Peters, D.; Harting, J.; van Oers, J.A.M.; Schuit, J.; Stronks, K.

    2016-01-01

    Integrated public health policy (IPHP) aims at integrating health considerations into policies of other sectors. Since the limited empirical evidence available may hamper its further development, we systematically analysed empirical manifestations of IPHP, by placing policy strategies along a contin

  4. Manifestations of integrated public health policy in Dutch municipalities

    NARCIS (Netherlands)

    Peters, D.; Harting, J.; van Oers, J.A.M.; Schuit, J.; Stronks, K.

    2016-01-01

    Integrated public health policy (IPHP) aims at integrating health considerations into policies of other sectors. Since the limited empirical evidence available may hamper its further development, we systematically analysed empirical manifestations of IPHP, by placing policy strategies along a

  5. Manifestations of integrated public health policy in Dutch municipalities

    NARCIS (Netherlands)

    Peters, D.; Harting, J.; van Oers, J.A.M.; Schuit, J.; Stronks, K.

    2016-01-01

    Integrated public health policy (IPHP) aims at integrating health considerations into policies of other sectors. Since the limited empirical evidence available may hamper its further development, we systematically analysed empirical manifestations of IPHP, by placing policy strategies along a contin

  6. Health literacy of Dutch adults: a cross sectional survey.

    NARCIS (Netherlands)

    Heide, I. van der; Rademakers, J.; Schipper, M.; Droomers, M.; Sorensen, K.; Uiters, E.

    2013-01-01

    Background: Relatively little knowledge is available to date about health literacy among the general population in Europe. It is important to gain insights into health literacy competences among the general population, as this might contribute to more effective health promotion and help clarify soci

  7. Health literacy of Dutch adults: a cross sectional survey.

    NARCIS (Netherlands)

    Heide, I. van der; Rademakers, J.; Schipper, M.; Droomers, M.; Sorensen, K.; Uiters, E.

    2013-01-01

    Background: Relatively little knowledge is available to date about health literacy among the general population in Europe. It is important to gain insights into health literacy competences among the general population, as this might contribute to more effective health promotion and help clarify soci

  8. Health promotion innovation in primary health care

    OpenAIRE

    Alexandra McManus

    2013-01-01

    Previously, the main focus of primary health care practices was to diagnose and treat patients. The identification of risk factors for disease and the prevention of chronic conditions have become a part of everyday practice. This paper provides an argument for training primary health care (PHC) practitioners in health promotion, while encouraging them to embrace innovation within their practice to streamline the treatment process and improve patient outcomes. Electronic modes of communication...

  9. Dutch Chronic Pancreatitis Registry (CARE) : Design and rationale of a nationwide prospective evaluation and follow-up

    NARCIS (Netherlands)

    Ali, U. Ahmed; Issa, Y.; van Goor, H.; van Eijck, C. H.; Nieuwenhuijs, V. B.; Keulemans, Y.; Fockens, P.; Busch, O. R.; Drenth, J. P.; Dejong, C. H.; van Dullemen, H. M.; van Hooft, J. E.; Siersema, P. D.; Spanier, B. W. M.; Poley, J. W.; Poen, A. C.; Timmer, R.; Seerden, T.; Tan, A. C.; Thijs, W. J.; Witteman, B. J. M.; Romkens, T. E. H.; Roeterdink, A. J.; Gooszen, H. G.; Van Santvoort, H. C.; Bruno, M. J.; Boermeester, M. A.

    2015-01-01

    Background: Chronic pancreatitis is a complex disease with many unanswered questions regarding the natural history and therapy. Prospective longitudinal studies with long-term follow-up are warranted. Methods: The Dutch Chronic Pancreatitis Registry (CARE) is a nationwide registry aimed at prospecti

  10. COMMUNITY HEALTH & PRIMARY HEALTH CARE

    African Journals Online (AJOL)

    the_monk

    be used to design policies and programmes to help workers identify environmental health risks, and improve their ... and his/her co-workers, who are subject to (SHE) departments and the Staff Clinic. It ... television and internet sources.

  11. COMMUNITY HEALTH & PRIMARY HEALTH CARE

    African Journals Online (AJOL)

    adedamla

    Cervical cancer remains a major public health challenge in developing countries ... relation to knowledge on cervical cancer, primary level of education ... Latin America and Southeast Asia. ... practices such as level of awareness, educational.

  12. Negative health care experiences of immigrant patients: a qualitative study

    Directory of Open Access Journals (Sweden)

    Stronks Karien

    2011-01-01

    Full Text Available Abstract Background Negative events are abusive, potentially dangerous or life-threatening health care events, as perceived by the patient. Patients' perceptions of negative events are regarded as a potentially important source of information about the quality of health care. We explored negative events in hospital care as perceived by immigrant patients. Methods Semi-structured individual and group interviews were conducted with respondents about negative experiences of health care. Interviews were transcribed and analyzed using a framework method. A total of 22 respondents representing 7 non-Dutch ethnic origins were interviewed; each respondent reported a negative event in hospital care or treatment. Results Respondents reported negative events in relation to: 1 inadequate information exchange with care providers; 2 different expectations between respondents and care providers about medical procedures; 3 experienced prejudicial behavior on the part of care providers. Conclusions We identified three key situations in which negative events were experienced by immigrant patients. Exploring negative events from the immigrant patient perspective offers important information to help improve health care. Our results indicate that care providers need to be trained in adequately exchanging information with the immigrant patient and finding out specific patient needs and perspectives on illness and treatment.

  13. Heaviness, intensity, and intimacy: Dutch elder care in the context of retrenchment of the welfare state

    NARCIS (Netherlands)

    B. Da Roit; J. de Klerk

    2014-01-01

    In the Netherlands the recent shift to a ‘participation society’ has led to a reconfiguration of health care arrangements for long-term care. The new long-term care act, scheduled to commence January 2015, forms the political realization of the participation society: people are expected to decrease

  14. Diaspora, disease, and health care.

    Science.gov (United States)

    Wick, Jeannette Y; Zanni, Guido R

    2007-03-01

    When groups of people relocate from their homelands to other nations, especially if the movement is involuntary, minority populations are created in the countries that receive them. The issues related to these diaspora and diasporic communities--any groups that have been dispersed outside their traditional homelands--are financial, social, historical, political, or religious. In health care, issues include heritable diseases, cultural barriers, patients' health care beliefs, and unique disease presentations. In long-term care, many residents and health care providers have relocated to the United States from other countries.

  15. Foster Care and Child Health.

    Science.gov (United States)

    McDavid, Lolita M

    2015-10-01

    Children in foster care need more from health providers than routine well-child care. The changes in legislation that were designed to prevent children from languishing in foster care also necessitate a plan that works with the child, the biological family, and the foster family in ensuring the best outcome for the child. This approach acknowledges that most foster children will return to the biological family. Recent research on the effect of adverse childhood experiences across all socioeconomic categories points to the need for specifically designed, focused, and coordinated health and mental health services for children in foster care. Copyright © 2015 Elsevier Inc. All rights reserved.

  16. Allying health care and housing.

    Science.gov (United States)

    Murphy, Lillian

    2005-01-01

    There is a wealth of evidence that health is inextricably linked to housing. For instance, research has shown that those in substandard housing have poorer health outcomes than other groups, and they often must forgo costly medication in order to pay for housing. Further, the health care and housing concerns faced by the underserved often compound one another--people with poor health often have trouble maintaining housing, and those with substandard homes, in turn, often have trouble maintaining their health. Three groups are especially vulnerable to the health care risks associated with housing issues: children, seniors, and the chronically homeless. As the research suggests, substandard housing is a contributing factor to the U.S. health care crisis. Therefore, as part of its efforts to reform the nation's health care system, the ministry should address housing issues as well. Seven Catholic health systems are doing this through the Strategic Health Care Partnership. The partnership, in collaboration with Mercy Housing, enables the seven organizations to work together to create healthy communities. The partnership's key goal is to increase access to affordable housing and health care. Just providing homes often is not enough, however. A holistic approach, through which supportive services are offered to the underserved, is most effective.

  17. Anal Health Care Basics

    Science.gov (United States)

    Chang, Jason; McLemore, Elisabeth; Tejirian, Talar

    2016-01-01

    Despite the fact that countless patients suffer from anal problems, there tends to be a lack of understanding of anal health care. Unfortunately, this leads to incorrect diagnoses and treatments. When treating a patient with an anal complaint, the primary goals are to first diagnose the etiology of the symptoms correctly, then to provide an effective and appropriate treatment strategy. The first step in this process is to take an accurate history and physical examination. Specific questions include details about bowel habits, anal hygiene, and fiber supplementation. Specific components of the physical examination include an external anal examination, a digital rectal examination, and anoscopy if appropriate. Common diagnoses include pruritus ani, anal fissures, hemorrhoids, anal abscess or fistula, fecal incontinence, and anal skin tags. However, each problem presents differently and requires a different approach for management. It is of paramount importance that the correct diagnosis is reached. Common errors include an inaccurate diagnosis of hemorrhoids when other pathology is present and subsequent treatment with a steroid product, which is harmful to the anal area. Most of these problems can be avoided by improving bowel habits. Adequate fiber intake with 30 g to 40 g daily is important for many reasons, including improving the quality of stool and preventing colorectal and anal diseases. In this Special Report, we provide an overview of commonly encountered anal problems, their presentation, initial treatment options, and recommendations for referral to specialists. PMID:27723447

  18. Anal Health Care Basics.

    Science.gov (United States)

    Chang, Jason; Mclemore, Elisabeth; Tejirian, Talar

    2016-01-01

    Despite the fact that countless patients suffer from anal problems, there tends to be a lack of understanding of anal health care. Unfortunately, this leads to incorrect diagnoses and treatments. When treating a patient with an anal complaint, the primary goals are to first diagnose the etiology of the symptoms correctly, then to provide an effective and appropriate treatment strategy.The first step in this process is to take an accurate history and physical examination. Specific questions include details about bowel habits, anal hygiene, and fiber supplementation. Specific components of the physical examination include an external anal examination, a digital rectal examination, and anoscopy if appropriate.Common diagnoses include pruritus ani, anal fissures, hemorrhoids, anal abscess or fistula, fecal incontinence, and anal skin tags. However, each problem presents differently and requires a different approach for management. It is of paramount importance that the correct diagnosis is reached. Common errors include an inaccurate diagnosis of hemorrhoids when other pathology is present and subsequent treatment with a steroid product, which is harmful to the anal area.Most of these problems can be avoided by improving bowel habits. Adequate fiber intake with 30 g to 40 g daily is important for many reasons, including improving the quality of stool and preventing colorectal and anal diseases.In this Special Report, we provide an overview of commonly encountered anal problems, their presentation, initial treatment options, and recommendations for referral to specialists.

  19. Health care's service fanatics.

    Science.gov (United States)

    Merlino, James I; Raman, Ananth

    2013-05-01

    The Cleveland Clinic has long had a reputation for medical excellence. But in 2009 the CEO acknowledged that patients did not think much of their experience there and decided to act. Since then the Clinic has leaped to the top tier of patient-satisfaction surveys, and it now draws hospital executives from around the world who want to study its practices. The Clinic's journey also holds Lessons for organizations outside health care that must suddenly compete by creating a superior customer experience. The authors, one of whom was critical to steering the hospital's transformation, detail the processes that allowed the Clinic to excel at patient satisfaction without jeopardizing its traditional strengths. Hospital leaders: Publicized the problem internally. Seeing the hospital's dismal service scores shocked employees into recognizing that serious flaws existed. Worked to understand patients' needs. Management commissioned studies to get at the root causes of dissatisfaction. Made everyone a caregiver. An enterprisewide program trained everyone, from physicians to janitors, to put the patient first. Increased employee engagement. The Clinic instituted a "caregiver celebration" program and redoubled other motivational efforts. Established new processes. For example, any patient, for any reason, can now make a same-day appointment with a single call. Set patients' expectations. Printed and online materials educate patients about their stays--before they're admitted. Operating a truly patient-centered organization, the authors conclude, isn't a program; it's a way of life.

  20. Design and methods of the Hospital Elder Life Program (HELP), a multicomponent targeted intervention to prevent delirium in hospitalized older patients: efficacy and cost-effectiveness in Dutch health care

    NARCIS (Netherlands)

    Strijbos, Marije; Steunenberg, Bas; Mast, Roos van der; Inouye, Sharon; Schuurmans, Marieke

    2013-01-01

    The Hospital Elder Life Program (HELP) has been shown to be highly efficient and (cost-)effective in reducing delirium incidence in the USA. HELP provides multicomponent protocols targeted at specific risk factors for delirium and introduces a different view on care organization, with trained volunt

  1. Validation of the dutch version of the health education impact questionnaire (HEIQ) and comparison of the Dutch translation with the English, German and French HEIQ

    DEFF Research Database (Denmark)

    Ammerlaan, Judy W.; van Os-Medendorp, Harmieke; Sont, Jacob K.

    2017-01-01

    Background: The Health Education Impact Questionnaire (heiQ) evaluates the effectiveness of health education and self-management programs provided to people dealing with a wide range of conditions. Aim of this study was to translate, culturally adapt and validate the Dutch translation of the hei...... difficulty was D≥0.65 for all items in scales showing acceptable fit indices, except for the reversed Emotional distress scale. Composite reliability ranged between 0.67 and 0.85. Test-retest reliability (n=93) ICC varied between 0.61 and 0.84. Comparisons with other translations showed comparable fit...... for evaluating the impact of health education and self-management programs. Given the wide applications of the heiQ and the comparability of the Dutch results with the English, German and French version, the heiQ is a practical and useful questionnaire to evaluate the impact of self-management support programs...

  2. Teens, technology, and health care.

    Science.gov (United States)

    Leanza, Francesco; Hauser, Diane

    2014-09-01

    Teens are avid users of new technologies and social media. Nearly 95% of US adolescents are online at least occasionally. Health care professionals and organizations that work with teens should identify online health information that is both accurate and teen friendly. Early studies indicate that some of the new health technology tools are acceptable to teens, particularly texting, computer-based psychosocial screening, and online interventions. Technology is being used to provide sexual health education, medication reminders for contraception, and information on locally available health care services. This article reviews early and emerging studies of technology use to promote teen health. Copyright © 2014 Elsevier Inc. All rights reserved.

  3. COMMUNITY HEALTH & PRIMARY HEALTH CARE

    African Journals Online (AJOL)

    the_monk

    Tobacco is a risk factor Organization (WHO) at World Health Assembly for six of the ... information. Stata statistical software version 11 was used to describe the data and determine ... Only 5% of respondents ever received training on tobacco control. .... Pharmacist. 54. 23.2 .... and dental students surveyed in Lagos by .15.

  4. COMMUNITY HEALTH & PRIMARY HEALTH CARE

    African Journals Online (AJOL)

    the_monk

    2012-05-01

    May 1, 2012 ... quality service delivery as perceived by the respondents', however it remains ... However, there remain the problems of inequities in tertiary ... unrelenting struggle in financing health households to the financial risk ... other things improve efficiency in utilization of Using a cross-sectional approach, this study.

  5. COMMUNITY HEALTH & PRIMARY HEALTH CARE

    African Journals Online (AJOL)

    adedamla

    eligible patients as they emerged from the pharmacy with their ... compare proportions while student's t-test was used to compare .... preference between the free and B.I. health services in an LGA in ... and training manual for the development.

  6. COMMUNITY HEALTH & PRIMARY HEALTH CARE

    African Journals Online (AJOL)

    study assessed the knowledge and practice of disease surveillance and notification ... for active surveillance especially if an outbreak Health workers play a key role in .... ethical clearance was obtained from the ethics and Eighty one percent of .... Salami S. Knowledge of disease notification among New York: John Wiley ...

  7. Ethnic differences in mental health among incarcerated youths: do Moroccan immigrant boys show less psychopathology than native Dutch boys?

    Science.gov (United States)

    Veen, Violaine; Stevens, Gonneke; Doreleijers, Theo; van der Ende, Jan; Vollebergh, Wilma

    2010-05-01

    Psychiatric disorders are highly prevalent among incarcerated youth. However, whereas ethnic minority youths are overrepresented in the juvenile justice system, limited research is available on their mental health. In this study, differences in mental health problems between incarcerated adolescents of native Dutch and Moroccan origin, were examined. Child Behavior Checklist and Youth Self-Report scores were compared between incarcerated adolescents of native Dutch and Moroccan origin. Their scores were also compared to those of native Dutch and Moroccan immigrant youths in the general, non-incarcerated population. Native Dutch incarcerated adolescents showed higher levels of various mental health problems than incarcerated adolescents with a Moroccan background. Compared to the general population, incarcerated youths showed higher levels of mental health problems, but this deviation was much larger for native Dutch than for Moroccan immigrant youths. These ethnic differences in mental health problems could not be explained by ethnic differences in socio-economic background and social desirable answering tendencies. Incarcerated youths of Moroccan origin show less psychopathology than incarcerated native Dutch youths, which might be explained by disparities in sentencing procedures.

  8. Patient-centeredness and quality management in Dutch diabetes care organizations after a 1-year intervention

    Science.gov (United States)

    Campmans-Kuijpers, Marjo JE; Lemmens, Lidwien C; Baan, Caroline A; Rutten, Guy EHM

    2016-01-01

    Background More focus on patient-centeredness in care for patients with type 2 diabetes requests increasing attention to diabetes quality management processes on patient-centeredness by managers in primary care groups and outpatient clinics. Although patient-centered care is ultimately determined by the quality of interactions between patients and clinicians at the practice level, it should be facilitated at organizational level too. This nationwide study aimed to assess the state of diabetes quality management on patient-centeredness at organizational level and its possibilities to improve after a tailored intervention. Methods This before–after study compares the quality management on patient-centeredness within Dutch diabetes care groups and outpatient clinics before and after a 1-year stepwise intervention. At baseline, managers of 51 diabetes primary care groups and 28 outpatient diabetes clinics completed a questionnaire about the organization’s quality management program. Patient-centeredness (0%–100%) was operationalized in six subdomains: facilitating self-management support, individualized care plan support, patients’ access to medical files, patient education policy, safeguarding patients’ interests, and formal patient involvement. The intervention consisted of feedback and benchmark and if requested a telephone call and/or a consultancy visit. After 1 year, the managers completed the questionnaire again. The 1-year changes were examined by dependent (non) parametric tests. Results Care groups improved significantly on patient-centeredness (from 47.1% to 53.3%; P=0.002), and on its subdomains “access to medical files” (from 42.0% to 49.4%), and “safeguarding patients’ interests” (from 58.1% to 66.2%). Outpatient clinics, which scored higher at baseline (66.7%) than care groups, did not improve on patient-centeredness (65.6%: P=0.54) or its subdomains. “Formal patient involvement” remained low in both care groups (23.2%) and

  9. Hope for health and health care.

    Science.gov (United States)

    Stempsey, William E

    2015-02-01

    Virtually all activities of health care are motivated at some level by hope. Patients hope for a cure; for relief from pain; for a return home. Physicians hope to prevent illness in their patients; to make the correct diagnosis when illness presents itself; that their prescribed treatments will be effective. Researchers hope to learn more about the causes of illness; to discover new and more effective treatments; to understand how treatments work. Ultimately, all who work in health care hope to offer their patients hope. In this paper, I offer a brief analysis of hope, considering the definitions of Hobbes, Locke, Hume and Thomas Aquinas. I then differentiate shallow and deep hope and show how hope in health care can remain shallow. Next, I explore what a philosophy of deep hope in health care might look like, drawing important points from Ernst Bloch and Gabriel Marcel. Finally, I suggest some implications of this philosophy of hope for patients, physicians, and researchers.

  10. Competition policy for health care provision in the Netherlands.

    Science.gov (United States)

    Schut, Frederik T; Varkevisser, Marco

    2017-02-01

    In the Netherlands in 2006 a major health care reform was introduced, aimed at reinforcing regulated competition in the health care sector. Health insurers were provided with strong incentives to compete and more room to negotiate and selectively contract with health care providers. Nevertheless, the bargaining position of health insurers vis-à-vis both GPs and hospitals is still relatively weak. GPs are very well organized in a powerful national interest association (LHV) and effectively exploit the long-standing trust relationship with their patients. They have been very successful in mobilizing public support against unfavorable contracting practices of health insurers and enforcement of the competition act. The rapid establishment of multidisciplinary care groups to coordinate care for patients with chronic diseases further strengthened their position. Due to ongoing horizontal consolidation, hospital markets in the Netherlands have become highly concentrated. Only recently the Dutch competition authority prohibited the first hospital merger. Despite the highly concentrated health insurance market, it is unclear whether insurers will have sufficient countervailing buyer power vis-à-vis GPs and hospitals to effectively fulfill their role as prudent buyer of care, as envisioned in the reform. To prevent further consolidation and anticompetitive coordination, strict enforcement of competition policy is crucially important for safeguarding the potential for effective insurer-provider negotiations about quality and price.

  11. [A Maternal Health Care System Based on Mobile Health Care].

    Science.gov (United States)

    Du, Xin; Zeng, Weijie; Li, Chengwei; Xue, Junwei; Wu, Xiuyong; Liu, Yinjia; Wan, Yuxin; Zhang, Yiru; Ji, Yurong; Wu, Lei; Yang, Yongzhe; Zhang, Yue; Zhu, Bin; Huang, Yueshan; Wu, Kai

    2016-02-01

    Wearable devices are used in the new design of the maternal health care system to detect electrocardiogram and oxygen saturation signal while smart terminals are used to achieve assessments and input maternal clinical information. All the results combined with biochemical analysis from hospital are uploaded to cloud server by mobile Internet. Machine learning algorithms are used for data mining of all information of subjects. This system can achieve the assessment and care of maternal physical health as well as mental health. Moreover, the system can send the results and health guidance to smart terminals.

  12. Finding Health Care Services

    Science.gov (United States)

    If you have been diagnosed with cancer, finding a doctor and treatment facility for your cancer care is an important step to getting the best treatment possible. Learn tips for choosing a doctor and treatment facility to manage your cancer care.

  13. Sexual Orientation and Mental and Physical Health Status: Findings From a Dutch Population Survey

    Science.gov (United States)

    Sandfort, Theo G.M.; Bakker, Floor; Schellevis, François G.; Vanwesenbeeck, Ine

    2006-01-01

    Objectives. We sought to determine whether sexual orientation is related to mental and physical health and health behaviors in the general population. Methods. Data was derived from a health interview survey that was part of the second Dutch National Survey of General Practice, carried out in 2001 among an all-age random sample of the population. Of the 19685 persons invited to participate, 65% took part in the survey. Sexual orientation was assessed in persons aged 18 years and older and reported by 98.2% of 9684 participants. The respondents’ characteristics are comparable with those of the Dutch general population. Results. Gay/lesbian participants reported more acute mental health symptoms than heterosexual people and their general mental health also was poorer. Gay/lesbian people more frequently reported acute physical symptoms and chronic conditions than heterosexual people. Differences in smoking, alcohol use, and drug use were less prominent. Conclusions. We found that sexual orientation was associated with mental as well as physical health. The causal processes responsible for these differences by sexual orientation need further exploration. PMID:16670235

  14. Conscientious objection in health care

    Directory of Open Access Journals (Sweden)

    Kuře Josef

    2016-12-01

    Full Text Available The paper deals with conscientious objection in health care, addressing the problems of scope, verification and limitation of such refusal, paying attention to ideological agendas hidden behind the right of conscience where the claimed refusal can cause harm or where such a claim is an attempt to impose certain moral values on society or an excuse for not providing health care. The nature of conscientious objection will be investigated and an ethical analysis of conscientious objection will be conducted. Finally some suggestions for health care policy will be proposed.

  15. Home Health Care Agencies

    Data.gov (United States)

    U.S. Department of Health & Human Services — A list of all Home Health Agencies that have been registered with Medicare. The list includes addresses, phone numbers, and quality measure ratings for each agency.

  16. Adherence and health care costs

    Directory of Open Access Journals (Sweden)

    Iuga AO

    2014-02-01

    Full Text Available Aurel O Iuga,1,2 Maura J McGuire3,4 1Johns Hopkins Bloomberg School of Public Health, 2Johns Hopkins University, 3Johns Hopkins Community Physicians, 4Johns Hopkins University School of Medicine, Baltimore, MD, USA Abstract: Medication nonadherence is an important public health consideration, affecting health outcomes and overall health care costs. This review considers the most recent developments in adherence research with a focus on the impact of medication adherence on health care costs in the US health system. We describe the magnitude of the nonadherence problem and related costs, with an extensive discussion of the mechanisms underlying the impact of nonadherence on costs. Specifically, we summarize the impact of nonadherence on health care costs in several chronic diseases, such as diabetes and asthma. A brief analysis of existing research study designs, along with suggestions for future research focus, is provided. Finally, given the ongoing changes in the US health care system, we also address some of the most relevant and current trends in health care, including pharmacist-led medication therapy management and electronic (e-prescribing. Keywords: patient, medication, adherence, compliance, nonadherence, noncompliance, cost

  17. A chance for change : building an outcome monitoring feedback system for outpatient mental health care

    NARCIS (Netherlands)

    Jong, Kim de

    2012-01-01

    The principal aim of this thesis was to develop an outcome monitoring feedback model for Dutch outpatient mental health care in the Netherlands and to test whether providing feedback to therapists and patients can improve treatment outcomes. Data on patient progress collected in outpatient centers i

  18. Progressivity, horizontal equity and reranking in health care finance: a decomposition analysis for the Netherlands

    NARCIS (Netherlands)

    A. Wagstaff (Adam); E.K.A. van Doorslaer (Eddy)

    1997-01-01

    textabstractThis paper employs the method of Aronson et al. (1994) to decompose the redistributive effect of the Dutch health care financing system into three components: a progressivity component, a classical horizontal equity component and a reranking component. Results are presented for the

  19. Reimbursement of targeted cancer therapies within three different European health care systems

    NARCIS (Netherlands)

    Mihajlovic, Jovan; Dolk, C.; Postma, Maarten

    2014-01-01

    Objectives: To identify differences in the recommendations for targeted cancer therapies (TCT) in three distinctive European health care systems: Serbian, Scottish and Dutch, and to examine the role of cost effectiveness analyses (CEA) in such recommendations. Methods: A list of currently approved T

  20. Use of health care services by ethnic minorities in the Netherlands: do patterns differs?

    NARCIS (Netherlands)

    Uiters, E.; Devillé, W.L.J.M.; Foets, M.; Groenewegen, P.P.

    2006-01-01

    BACKGROUND: This article examines the nature of ethnic differences in health care utilisation by assessing patterns of use in addition to single service utilisation. METHODS: Data were derived from the Second Dutch National Survey of General Practice. A nationally representative sample of 104 genera

  1. Use of health care services by ethnic minorities in The Netherlands : do patterns differ?

    NARCIS (Netherlands)

    Uiters, Ellen; Devillé, Walter L.J.M.; Foets, Marleen; Groenewegen, Peter P.

    2006-01-01

    Background: This article examines the nature of ethnic differences in health care utilisation by assessing patterns of use in addition to single service utilisation. Methods: Data were derived from the Second Dutch National Survey of General Practice. A nationally representative sample of 104 genera

  2. MENTAL-HEALTH INTERVENTION PROGRAMS IN PRIMARY CARE - THEIR SCIENTIFIC BASIS

    NARCIS (Netherlands)

    VANDENBRINK, W; LEENSTRA, A; ORMEL, J; VANDEWILLIGE, G

    1991-01-01

    This study examines the scientific basis for mental health intervention programs in primary care. The validity of five underlying assumptions is evaluated, using the results of a naturalistic study covering a representative sample of 25 Dutch family practices and data from the literature. Our findin

  3. MENTAL-HEALTH INTERVENTION PROGRAMS IN PRIMARY CARE - THEIR SCIENTIFIC BASIS

    NARCIS (Netherlands)

    VANDENBRINK, W; LEENSTRA, A; ORMEL, J; VANDEWILLIGE, G

    1991-01-01

    This study examines the scientific basis for mental health intervention programs in primary care. The validity of five underlying assumptions is evaluated, using the results of a naturalistic study covering a representative sample of 25 Dutch family practices and data from the literature. Our findin

  4. The sexual health care needs after colorectal cancer: the view of patients, partners, and health care professionals.

    Science.gov (United States)

    Traa, Marjan J; De Vries, Jolanda; Roukema, Jan A; Rutten, Harm J T; Den Oudsten, Brenda L

    2014-03-01

    Sexual dysfunction among patients with colorectal cancer is frequently reported. Studies examining patients' sexual health care needs are rare. We examined the sexual health care needs after colorectal cancer treatment according to patients, partners, and health care professionals (HCPs). Factors that impede or facilitate the quality of this care were identified. Participants were recruited from three Dutch hospitals: St. Elisabeth, TweeSteden, and Catharina hospitals. Patients (n = 21), partners (n = 9), and 10 HCPs participated in eight focus groups. It is important to regularly evaluate and manage sexual issues. This does not always occur. Almost all participants reported a lack of knowledge and feelings of embarrassment or inappropriateness as barriers to discuss sexuality. HCPs reported stereotypical assumptions regarding the need for care based on age, sex, and partner status. The HCPs debated on whose responsibility it is that sexuality is discussed with patients. Factors within the organization, such as insufficient re-discussion of sexuality during (long-term) follow-up and unsatisfactory (knowledge of the) referral system impeded sexual health care. The HCPs could facilitate adequate sexual health care by providing patient-tailored information and permission to discuss sex, normalizing sexual issues, and establishing an adequate referral system. It is up to the patients and partners to demarcate the extent of sexual health care needed. Our findings illustrate the need for patient-tailored sexual health care and the complexity of providing/receiving this care. An adequate referral system and training are needed to help HCPs engage in providing satisfactory sexual health care.

  5. Vulnerable Consumers in the Deregulated Dutch Health System

    OpenAIRE

    Booltink, L.; Genugten, M.L. van; Lako, C.J.

    2015-01-01

    Public service deregulation is favoured for motivating providers to offer consumers better price-quality services. Consequently, consumers are enabled to make informed choices and choose for the best service provider. However, recent publications reveal that consumers are not capable of exercising optimal choice behaviour. Despite these concerns, evidence is lacking on the extent to which potentially vulnerable consumers make use of the core element of deregulation—switching health plans. Thi...

  6. Factors influencing perceived sustainability of Dutch community health programs.

    Science.gov (United States)

    Vermeer, A J M; Van Assema, P; Hesdahl, B; Harting, J; De Vries, N K

    2015-09-01

    We assessed the perceived sustainability of community health programs organized by local intersectoral coalitions, as well as the factors that collaborating partners think might influence sustainability. Semi-structured interviews were conducted among 31 collaborating partners of 5 community health programs in deprived neighborhoods in the southern part of the Netherlands. The interview guide was based on a conceptual framework that includes factors related to the context, the leading organization, leadership, the coalition, collaborating partners, interventions and outcomes. Interviews were recorded, transcribed and content analyzed using NVivo 8.0. Participants in each of the programs varied in their perceptions of the sustainability of the program, but those people collaborating in pre-existing neighborhood structures expressed relatively high faith in their continuation. The participating citizens in particular believed that these structures would continue to address the health of the community in the future. We found factors from all categories of the conceptual framework that were perceived to influence sustainability. The program leaders appeared to be crucial to the programs, as they were frequently mentioned in close interaction with other factors. Program leaders should use a motivating and supportive leadership style and should act as 'program champions'. © The Author (2013). Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  7. American Health Care Association

    Science.gov (United States)

    ... Care Association Responds to Ruling on Injunction Delaying CMS Implementation of Arbitration Rule AHCA/NCAL Elects New ... Information Technology Integrity Medicaid Medicare Patient Privacy and Security Survey and Regulatory Therapy Services Workforce Events Calendar ...

  8. 8 ways to cut health care costs

    Science.gov (United States)

    ... health care provider if you can switch to generic medicines. They have the same active ingredient, but ... Trust for America's Health. A Healthy America 2013: Strategies to Move From Sick Care to Health Care ...

  9. Health Care Analysis Using Hadoop

    Directory of Open Access Journals (Sweden)

    Prashant Dhotre

    2015-08-01

    Full Text Available ABSTRACT The Electronic Medical Records EMRs are the primary sources to study the enhancement of health and medical care. The rapid development in science and medical technology has produced various methods to detect verify prevent and treat diseases. This has led to the generation of big health-care data and difficulties in processing and managing data. To capture all the information about a patient and to get a more detailed and complete view for insight into care coordination and management decisions big data technologies can be used. A more detailed and complete picture about patients and populations can be identified along with patients at risk before any health issue arises. Optimal strategies to commercialize treatments and the next generation of health care treatments can be identified and developed by it.

  10. COMMUNITY MEDICINE & PRIMARY HEALTH CARE

    African Journals Online (AJOL)

    ajiboro

    birth attendants, and if there is a proper division of labour amongst the three tiers of the health system. 3 ... Obstetric. Care,. Traditional. Birth. Attendants,. Maternal. Mortality,. Neonatal ..... interview believed that sudden onset of labor and.

  11. Will Boeing Change Health Care?

    Science.gov (United States)

    Stempniak, Marty

    2015-12-01

    Big employers like Boeing and Intel are directly contracting with hospitals in an effort to control health care prices. Some hospital CEOs see direct contracting as the future, while others wonder how they can participate.

  12. Patient's experiences with quality of hospital care: the Dutch Consumer Quality Index Cataract Questionnaire.

    NARCIS (Netherlands)

    Stubbe, J.H.; Brouwer, W.; Delnoij, D.M.J.

    2007-01-01

    BACKGROUND: Patients' feedback is of great importance in health care policy decisions. The Consumer Quality Index Cataract Questionnaire (CQI Cataract) was used to measure patients' experiences with quality of care after a cataract operation. This study aims to evaluate the reliability and the dimen

  13. [Corruption and health care system].

    Science.gov (United States)

    Marasović Šušnjara, Ivana

    2014-06-01

    Corruption is a global problem that takes special place in health care system. A large number of participants in the health care system and numerous interactions among them provide an opportunity for various forms of corruption, be it bribery, theft, bureaucratic corruption or incorrect information. Even though it is difficult to measure the amount of corruption in medicine, there are tools that allow forming of the frames for possible interventions.

  14. [Health and health care in Vietnam].

    Science.gov (United States)

    Flessa, S

    2003-05-01

    The South East Asian state of Vietnam is currently undergoing a transition from a centralised socialism to a so-called socialist market economy strongly promoting the private sector. For the last 17 years economy experienced an impressive growth. If the assumption is true that economic growth is positively correlated with the health status of the population, the strengthened economy of Vietnam must go along with an improved health situation and health care system of this country. The following paper evaluates this assumption. It is demonstrated that there is indeed a strongly positive correlation between health and development in many aspects. However, it becomes obvious that economic growth is definitely accompanied by increasing regional and social disparity challenging the health care policy of Vietnam and her international partners.

  15. [Interprofessional teamwork in health care].

    Science.gov (United States)

    Antoni, Conny H

    2010-01-01

    Providing health care requires the integrative co-operation of physicians, nurses and other professionals in the health care sector. The success of such interprofessional teamwork does not only rely on the team members' task knowledge, but also on their teamwork-related knowledge, their skills and attitudes. In this paper a theoretical framework for team effectiveness is developed and used to identify factors improving team success. Within this context interprofessional team composition is perceived as a characteristic of team diversity, which needs to be perceived as a chance for better patient care in order to be used effectively.

  16. Residential care : Dutch and Italian residents of residential care facilities compared

    NARCIS (Netherlands)

    de Heer-Wunderink, Charlotte; Caro-Nienhuis, Annemarie D.; Sytema, Sjoerd; Wiersma, Durk

    2008-01-01

    Aims - Characteristics of patients living in residential care facilities and the availability of mental hospital- and residential beds in Italy and The Netherlands were compared to assess whether differences in the process of deinstitutionalisation have influenced the composition of their

  17. Babesiosis for Health Care Providers

    Centers for Disease Control (CDC) Podcasts

    2012-04-25

    This podcast will educate health care providers on diagnosing babesiosis and providing patients at risk with tick bite prevention messages.  Created: 4/25/2012 by Center for Global Health, Division of Parasitic Diseases and Malaria.   Date Released: 4/25/2012.

  18. Levinas, justice and health care.

    Science.gov (United States)

    Nortvedt, P

    2003-01-01

    In this paper I argue that the metaphysical ethics of Emmanuel Levinas captures some essential moral intuitions that are central to health care. However, there is an ongoing discussion about the relevance of ethical metaphysics for normative ethics and in particular on the question of the relationship between justice and individualized care. In this paper I take part in this debate and I argue that Levinas' idea of an ethics of the Other that guides politics and justice can shed important light on issues that are central to priorities in health care. In fact, the ethics of Levinas in seeking the foundation of normativity itself, captures the ethical core and central values of health care.

  19. Health promotion innovation in primary health care

    Directory of Open Access Journals (Sweden)

    Alexandra McManus

    2013-01-01

    Full Text Available Previously, the main focus of primary health care practices was to diagnose and treat patients. The identification of risk factors for disease and the prevention of chronic conditions have become a part of everyday practice. This paper provides an argument for training primary health care (PHC practitioners in health promotion, while encouraging them to embrace innovation within their practice to streamline the treatment process and improve patient outcomes. Electronic modes of communication, education and training are now commonplace in many medical practices. The PHC sector has a small window of opportunity in which to become leaders within the current model of continuity of care by establishing their role as innovators in the prevention, treatment and management of disease. Not only will this make their own jobs easier, it has the potential to significantly impact patient outcomes.

  20. Dutch healthcare reform: did it result in performance improvement of health plans? A comparison of consumer experiences over time

    Directory of Open Access Journals (Sweden)

    Rademakers Jany

    2009-09-01

    Full Text Available Abstract Background Many countries have introduced elements of managed competition in their healthcare system with the aim to accomplish more efficient and demand-driven health care. Simultaneously, generating and reporting of comparative healthcare information has become an important quality-improvement instrument. We examined whether the introduction of managed competition in the Dutch healthcare system along with public reporting of quality information was associated with performance improvement in health plans. Methods Experiences of consumers with their health plan were measured in four consecutive years (2005-2008 using the CQI® health plan instrument 'Experiences with Healthcare and Health Insurer'. Data were available of 13,819 respondents (response = 45% of 30 health plans in 2005, of 8,266 respondents (response = 39% of 32 health plans in 2006, of 8,088 respondents (response = 34% of 32 health plans in 2007, and of 7,183 respondents (response = 31% of 32 health plans in 2008. We performed multilevel regression analyses with three levels: respondent, health plan and year of measurement. Per year and per quality aspect, we estimated health plan means while adjusting for consumers' age, education and self-reported health status. We tested for linear and quadratic time effects using chi-squares. Results The overall performance of health plans increased significantly from 2005 to 2008 on four quality aspects. For three other aspects, we found that the overall performance first declined and then increased from 2006 to 2008, but the performance in 2008 was not better than in 2005. The overall performance of health plans did not improve more often for quality aspects that were identified as important areas of improvement in the first year of measurement. On six out of seven aspects, the performance of health plans that scored below average in 2005 increased more than the performance of health plans that scored average and/or above average in

  1. Rural migration and health care

    DEFF Research Database (Denmark)

    Svendsen, Gunnar Lind Haase; Jensen, Marit Vatn

    This literature study focuses on possible links between access to health services and migration in rural areas. Why do people move to or from rural areas or why do they stay? What determines where people settle? And, in this context, do local health care services play an important or minor role......, or no role at all? First, the paper reports on key findings from rural migration studies, in order to shed light on two migration trends: urbanization and counter-urbanization. Then we take a closer look on settlement preferences in rural areas, including the impact of health care facilities. Finally, we end...... up with a more deepgoing review of the relatively small number of studies, which explicitly deal with settlement preferences related to access to health care....

  2. Rural migration and health care

    DEFF Research Database (Denmark)

    Svendsen, Gunnar Lind Haase; Jensen, Marit Vatn

    This literature study focuses on possible links between access to health services and migration in rural areas. Why do people move to or from rural areas or why do they stay? What determines where people settle? And, in this context, do local health care services play an important or minor role......, or no role at all? First, the paper reports on key findings from rural migration studies, in order to shed light on two migration trends: urbanization and counter-urbanization. Then we take a closer look on settlement preferences in rural areas, including the impact of health care facilities. Finally, we end...... up with a more deepgoing review of the relatively small number of studies, which explicitly deal with settlement preferences related to access to health care....

  3. Health Related Quality of Life in a Dutch Rehabilitation Population: Reference Values and the Effect of Physical Activity

    Science.gov (United States)

    Jaarsma, Eva A.; Dijkstra, Pieter U.; Geertzen, Jan H. B.; Dekker, Rienk

    2017-01-01

    Purpose To establish reference values for Health Related Quality of Life (HRQoL) in a Dutch rehabilitation population, and to study effects of patient characteristics, diagnosis and physical activity on HRQoL in this population. Method Former rehabilitation patients (3169) were asked to fill in a questionnaire including the Dutch version of the RAND-36. Differences between our rehabilitation patients and Dutch reference values were analyzed (t-tests). Effects of patient characteristics, diagnosis and movement intensity on scores on the subscales of the RAND-36 were analyzed using block wise multiple regression analyses. Results In total 1223 patients (39%) returned the questionnaire. HRQoL was significantly poorer in the rehabilitation patients compared to Dutch reference values on all subscales (phealth change (p = 0.197). Longer time between questionnaire and last treatment was associated with a smaller health change (p = 0.035). Higher age negatively affected physical functioning (phealth change (p = 0.001). Diagnosis affected outcomes on all subscales except role limitations physical, and mental health (p ranged health (p ranged HRQoL is poorer in rehabilitation patients compared to Dutch reference values. Physical components of HRQoL are affected by diagnosis. In rehabilitation patients an association between movement intensity and HRQoL was found. For clinical purposes, results of this study can be used as reference values for HRQoL in a rehabilitation setting. PMID:28060949

  4. DOD Health Care: Domestic Health Care for Female Servicemembers

    Science.gov (United States)

    2013-01-01

    and rubella); • medical readiness laboratory tests, such as a human immunodeficiency virus test and results current within the past 24 months...established in order to provide for medical recovery from childbirth and to allow additional time to prepare family care plans and child care. However...164.530(c). The Department of Health and Human Services does not consider restructuring of hospitals and doctors’ offices, such as providing

  5. Medical wage slave or worthy professional? The Dutch medical profession and the health funds 1900-1941

    NARCIS (Netherlands)

    L.A. van der Valk (Loes)

    2010-01-01

    textabstractSummary The development of mutual and commercial health insurance, and state health insurance programs in particular, typically provoked much criticism from the professionals involved with them. Moreover, the efforts of the Dutch medical association, the NMG, to influence state proposals

  6. Effects of the Dutch skills for life program on the health behavior, bullying, and suicidal ideation of secondary school students

    NARCIS (Netherlands)

    Fekkes, M.; Sande, M.C.E. van de; Gravesteijn, J.C.; Pannebakker, F.D.; Buijs, G.J.; Diekstra, R.F.W.; Kocken, P.L.

    2016-01-01

    Purpose – The purpose of this paper is to evaluate the effects of the Dutch “Skills for Life” programme on students’ health behaviours, bullying behaviour and suicidal ideation. Design/methodology/approach – The effectiveness of the “Skills for Life” programme on health behaviour outcomes was

  7. Impact of foods with health logo on ssaturated fat, sodium and sugar intake of young Dutch adults

    NARCIS (Netherlands)

    Temme, E.H.M.; Voet, van der H.; Roodenburg, A.; Bulder, A.; Donkersgoed, van A.; Klaveren, van J.D.

    2011-01-01

    Objective Health logos are introduced to distinguish foods with ‘healthier’ nutrient composition from regular foods. In the present study, we evaluated the effects of changed food compositions according to health logo criteria on the intake of saturated fat, sugar and sodium in a Dutch population of

  8. The Dutch version of the Oral Health Impact Profile (OHIP-NL): translation, reliability and construct validity

    NARCIS (Netherlands)

    M.J. van der Meulen; M.T. John; M. Naeije; F. Lobbezoo

    2008-01-01

    Background The purpose of this study was to make a cross-culturally adapted, Dutch version of the Oral Health Impact Profile (OHIP), a 49-item questionnaire measuring oral health-related quality of life, and to examine its psychometric properties. Methods The original English version of the OHIP was

  9. Coping styles relate to health and work environment of Norwegian and Dutch hospital nurses : A comparative study

    NARCIS (Netherlands)

    Schreuder, Jolanda A. H.; Roelen, Corne A. M.; Groothoff, Johan W.; van der Klink, Jac J. L.; Mageroy, Nils; Pallesen, Stale; Bjorvatn, Bjorn; Moen, Bente E.

    2012-01-01

    Nurses exposed to high nursing stress report no health complaints as long as they have high coping abilities. The purpose of this study was to investigate coping styles in relation to the health status and work environment of Norwegian and Dutch hospital nurses. This comparative study included a ran

  10. Impact of foods with health logo on ssaturated fat, sodium and sugar intake of young Dutch adults

    NARCIS (Netherlands)

    Temme, E.H.M.; Voet, van der H.; Roodenburg, A.; Bulder, A.; Donkersgoed, van A.; Klaveren, van J.D.

    2011-01-01

    Objective Health logos are introduced to distinguish foods with ‘healthier’ nutrient composition from regular foods. In the present study, we evaluated the effects of changed food compositions according to health logo criteria on the intake of saturated fat, sugar and sodium in a Dutch population of

  11. Effects of the Dutch skills for life program on the health behavior, bullying, and suicidal ideation of secondary school students

    NARCIS (Netherlands)

    Fekkes, M.; Sande, M.C.E. van de; Gravesteijn, J.C.; Pannebakker, F.D.; Buijs, G.J.; Diekstra, R.F.W.; Kocken, P.L.

    2016-01-01

    Purpose – The purpose of this paper is to evaluate the effects of the Dutch “Skills for Life” programme on students’ health behaviours, bullying behaviour and suicidal ideation. Design/methodology/approach – The effectiveness of the “Skills for Life” programme on health behaviour outcomes was evalua

  12. Effects of the Dutch Skills for Life Program on the Health Behavior, Bullying, and Suicidal Ideation of Secondary School Students

    Science.gov (United States)

    Fekkes, M.; van de Sande, M. C. E.; Gravesteijn, J. C.; Pannebakker, F. D.; Buijs, G. J.; Diekstra, R. F. W.; Kocken, P. L.

    2016-01-01

    Purpose: The purpose of this paper is to evaluate the effects of the Dutch "Skills for Life" programme on students' health behaviours, bullying behaviour and suicidal ideation. Design/methodology/approach: The effectiveness of the "Skills for Life" programme on health behaviour outcomes was evaluated at three points in time in…

  13. [Animal health and primary health care].

    Science.gov (United States)

    Moro, M

    1983-01-01

    As part of the primary care strategy, the Governments of the Americas have included the agricultural and animal health sectors among the public health activities of the Plan of Action. This means that both sectors--agricultural and veterinary--must be guided in their work by a multidisciplinary and multisectoral approach, with full community participation. Hence, it is certain that both the study of veterinary medicine and the practice of the profession in the Region will have to be reoriented so that they may be more fully integrated with the primary care strategy. The reorientation of animal health activities is the subject of this paper. There can be no doubt that animal health has a vital part to play in improving the quality of human life and that veterinary practice itself offers excellent opportunities for building a sense of personal and community responsibility for the promotion, care, and restoration of health. Through their contact with the rural population while caring for their livestock (an integral part of the rural socioeconomic structures), the veterinarian and animal health assistant establish close bonds of trust not only with farmers, but with their families and the entire community as well; they are thus well placed to enlist community participation in a variety of veterinary public health activities such as zoonoses control, hygiene programs, and so forth. While the goal of the Plan of action is to extend primary care to the entire population, the lack of material and human resources requires that priority attention be given to the needs of the more vulnerable groups, including the extremely poor living in rural and urban areas. These are the groups at greatest risk from the zoonoses still present in the Americas. In the face of these facts, it is clear that primary care in the animal health field should be based on the application in each country of proven, effective, appropriate technology by personnel who, whether new or retrained, are well

  14. Marketing occupational health care.

    Science.gov (United States)

    Norris, M J; Harris, J C

    1981-01-01

    A very basic part of marketing success is determining areas of your business in which you have a competitive advantage. In drafting a marketing plan for the Denver Clinic, the competitive advantages group practices have in the area of occupational health were quickly realized. This competitive edge is presented along with the Denver Clinic's marketing strategies and plans to capitalize on occupational healthcare advantages.

  15. Health Care Wide Hazards

    Science.gov (United States)

    ... Other Hazards (Lack of) PPE Slips/Trips/Falls Stress Tuberculosis Universal Precautions Workplace Violence Use of Medical Lasers Health Effects Use ... Needlesticks Noise Mercury Inappropriate PPE Slips/Trips/Falls ... of Universal Precautions Workplace Violence For more information, see Other Healthcare Wide ...

  16. Health Care Information Systems.

    Science.gov (United States)

    Banks, Jane L.; And Others

    1987-01-01

    The first of eight articles discusses the current state of the sensitive but unclassified information controversy. A series of six articles then explores the use of integrated information systems in the area of health services. Current trends in document management are provided in the last article. (CLB)

  17. Residential care : Dutch and Italian residents of residential care facilities compared

    NARCIS (Netherlands)

    de Heer-Wunderink, Charlotte; Caro-Nienhuis, Annemarie D.; Sytema, Sjoerd; Wiersma, Durk

    2008-01-01

    Aims - Characteristics of patients living in residential care facilities and the availability of mental hospital- and residential beds in Italy and The Netherlands were compared to assess whether differences in the process of deinstitutionalisation have influenced the composition of their residentia

  18. Health promotion and primary health care: examining the discourse.

    Science.gov (United States)

    Ashcroft, Rachelle

    2015-01-01

    The health promotion discourse is comprised of assumptions about health and health care that are compatible with primary health care. An examination of the health promotion discourse illustrates how assumptions of health can help to inform primary health care. Despite health promotion being a good fit for primary health care, this analysis demonstrates that the scope in which it is being implemented in primary health care settings is limited. The health promotion discourse appears largely compatible with primary health care-in theory and in the health care practices that follow. The aim of this article is to contribute to the advancement of theoretical understanding of the health promotion discourse, and the relevance of health promotion to primary health care.

  19. Chiropractic care and public health

    DEFF Research Database (Denmark)

    Johnson, Claire; Rubinstein, Sidney M; Côté, Pierre

    2012-01-01

    through the lifespan, and effective participation in community health issues. The questions that are addressed include: Is spinal manipulative therapy for neck and low-back pain a public health problem? What is the role of chiropractic care in prevention or reduction of musculoskeletal injuries...... in children? What ways can doctors of chiropractic stay updated on evidence-based information about vaccines and immunization throughout the lifespan? Can smoking cessation be a prevention strategy for back pain? Does chiropractic have relevance within the VA Health Care System for chronic pain and comorbid...... of prevention and public health? What role do citizen-doctors of chiropractic have in organizing community action on health-related matters? How can our future chiropractic graduates become socially responsible agents of change?...

  20. Effects of a Dutch work-site wellness-health program: the Brabantia Project.

    Science.gov (United States)

    Maes, S; Verhoeven, C; Kittel, F; Scholten, H

    1998-01-01

    OBJECTIVES: This study examined a project designed to improve the health and wellness of employees of Brabantia, a Dutch manufacturer of household goods, by means of lifestyle changes and changes in working conditions. METHODS: The workers at one Brabantia site constituted the experimental group, and the workers from two other sites formed the control group. Biomedical variables, lifestyles, general stress reactions, and quality of work were measured identically in both groups at baseline and 1, 2, and 3 years later. During this period, there was continuous registration of absenteeism. RESULTS: The interventions brought about favorable short-term changes in terms of health risks, and there were stable effects on working conditions (especially decision latitude) and absenteeism. CONCLUSIONS: A combination of interventions directed at both lifestyles and the work environment can produce extensive and stable effects on health-related variables, wellness, and absenteeism. PMID:9663150

  1. A right to health care.

    Science.gov (United States)

    Eleftheriadis, Pavlos

    2012-01-01

    What does it mean to say that there is a right to health care? Health care is part of a cooperative project that organizes finite resources. How are these resources to be distributed? This essay discusses three rival theories. The first two, a utilitarian theory and an interst theory, are both instrumental, in that they collapse rights to good states of affairs. A third theory, offered by Thomas Pogge, locates the question within an institutional legal context and distinguishes between a right to health care that results in claimable duties and other dimensions of health policy that do not. Pogge's argument relies on a list of "basic needs," which itself, however, relies on some kind of instrumental reasoning. The essay offers a reconstruction of Pogge's argument to bring it in line with a political conception of a right to health care. Health is a matter of equal liberty and equal citizenship, given our common human vulnerability. If we are to live as equal members in a political community, then our institutions need to create processes by which we are protected from the kinds of suffering that would make it impossible for us to live as equal members.

  2. Child rearing in a group setting: beliefs of Dutch, Caribbean Dutch, and Mediterranean Dutch caregivers in center-based child care

    NARCIS (Netherlands)

    S.K. Huijbregts; L. Tavecchio; P. Leseman; P. Hoffenaar

    2009-01-01

    Child care centers in Western countries are becoming increasingly culturally diverse, regarding both professional caregivers, children, and their parents. Child-rearing beliefs, which differ between cultures, are found to affect process quality and children’s developmental outcomes. The first aim of

  3. Assessment of the need for care 15 years after onset of a Dutch cohort of patients with schizophrenia, and an international comparison

    NARCIS (Netherlands)

    Wiersma, D; Giel, R; deJong, A; Nienhuis, FJ; Slooff, CJ

    Assessment of needs for care is crucial in the evaluation of ongoing changes from institutional care to various forms of day- and outpatient treatment, Do patients really do better in the community and are they adequately cared for? The 15-year follow-up of a Dutch incidence cohort of patients with

  4. Phytotherapy in primary health care

    Directory of Open Access Journals (Sweden)

    Gisele Damian Antonio

    2014-06-01

    Full Text Available OBJECTIVE To characterize the integration of phytotherapy in primary health care in Brazil. METHODS Journal articles and theses and dissertations were searched for in the following databases: SciELO, Lilacs, PubMed, Scopus, Web of Science and Theses Portal Capes, between January 1988 and March 2013. We analyzed 53 original studies on actions, programs, acceptance and use of phytotherapy and medicinal plants in the Brazilian Unified Health System. Bibliometric data, characteristics of the actions/programs, places and subjects involved and type and focus of the selected studies were analyzed. RESULTS Between 2003 and 2013, there was an increase in publications in different areas of knowledge, compared with the 1990-2002 period. The objectives and actions of programs involving the integration of phytotherapy into primary health care varied: including other treatment options, reduce costs, reviving traditional knowledge, preserving biodiversity, promoting social development and stimulating inter-sectorial actions. CONCLUSIONS Over the past 25 years, there was a small increase in scientific production on actions/programs developed in primary care. Including phytotherapy in primary care services encourages interaction between health care users and professionals. It also contributes to the socialization of scientific research and the development of a critical vision about the use of phytotherapy and plant medicine, not only on the part of professionals but also of the population.

  5. Phytotherapy in primary health care

    Science.gov (United States)

    Antonio, Gisele Damian; Tesser, Charles Dalcanale; Moretti-Pires, Rodrigo Otavio

    2014-01-01

    OBJECTIVE To characterize the integration of phytotherapy in primary health care in Brazil. METHODS Journal articles and theses and dissertations were searched for in the following databases: SciELO, Lilacs, PubMed, Scopus, Web of Science and Theses Portal Capes, between January 1988 and March 2013. We analyzed 53 original studies on actions, programs, acceptance and use of phytotherapy and medicinal plants in the Brazilian Unified Health System. Bibliometric data, characteristics of the actions/programs, places and subjects involved and type and focus of the selected studies were analyzed. RESULTS Between 2003 and 2013, there was an increase in publications in different areas of knowledge, compared with the 1990-2002 period. The objectives and actions of programs involving the integration of phytotherapy into primary health care varied: including other treatment options, reduce costs, reviving traditional knowledge, preserving biodiversity, promoting social development and stimulating inter-sectorial actions. CONCLUSIONS Over the past 25 years, there was a small increase in scientific production on actions/programs developed in primary care. Including phytotherapy in primary care services encourages interaction between health care users and professionals. It also contributes to the socialization of scientific research and the development of a critical vision about the use of phytotherapy and plant medicine, not only on the part of professionals but also of the population. PMID:25119949

  6. Nanotechnology in health care

    CERN Document Server

    Sahoo, Sanjeeb K

    2012-01-01

    Nanomedicine: Emerging Field of Nanotechnology to Human HealthNanomedicines: Impacts in Ocular Delivery and TargetingImmuno-Nanosystems to CNS Pathologies: State of the Art PEGylated Zinc Protoporphyrin: A Micelle-Forming Polymeric Drug for Cancer TherapyORMOSIL Nanoparticles: Nanomedicine Approach for Drug/Gene Delivery to the BrainMagnetic Nanoparticles: A Versatile System for Therapeutic and Imaging SystemNanobiotechnology: A New Generation of Biomedicine Application of Nanotechnology-Based Drug Delivery and Targeting to LungsAptamers and Nanomedicine in C

  7. Access to Health Care

    Centers for Disease Control (CDC) Podcasts

    2010-11-09

    This podcast is based on the November, 2010 CDC Vital Signs report which indicates that more than one in four adults 18-64 years old (about 50 million) report being uninsured for at least part of the past 12 months, and focuses on the growing number of middle-income adults and those with a chronic illness or disability who have no health insurance.  Created: 11/9/2010 by Centers for Disease Control and Prevention (CDC).   Date Released: 11/9/2010.

  8. Health Care Procedure Considerations and Individualized Health Care Plans

    Science.gov (United States)

    Heller, Kathryn Wolff; Avant, Mary Jane Thompson

    2011-01-01

    Teachers need to maintain a safe, healthy environment for all their students in order to promote learning. However, there are additional considerations when students require health care procedures, such as tube feeding or clean intermittent catheterization. Teachers must effectively monitor their students and understand their roles and…

  9. Social responsibility in health care

    Directory of Open Access Journals (Sweden)

    Tjaša

    2014-06-01

    Full Text Available Research Question (RQ: What is socially responsible behavior in the Slovenian health care system, where we have three main entities which they are actively involved in so called health care system. Purpose: Through the article, I would like for all three entities in the health sector to present, what is socially responsible behavior, which contributes to improving mutual cooperation for each of them and the wider society. Method: The results I achieved by studying domestic and foreign literature, laws and regulations that define social responsibility to the other two entities in the health care and the integration of literature in practice. Results: Each social responsibility within the organization, starting with superiors or managers, whose activities transferred the positive impact of social responsibility on employees and therefore the wider society. Society: By being aware of our role in society or position in the health system, any individual with a positive socially responsible actions have a positive impact on the wider community and to improve the benefits, at least in theoretical terms. Originality: I have not registered any discussions that would include mutual social responsibility - related conduct that contributes to the overall satisfaction of all. Most are present in one entity in health and his social responsibility in the internal and external environment, where they performance. Limitations/Future Research: Accessibility of data nature, from which it was evident social responsibility to other entities in the health system. The lack of literature covering social responsibility in Slovenia.

  10. Psychometric properties of the Exercise Self-efficacy Scale in Dutch Primary care patients with type 2 diabetes mellitus

    DEFF Research Database (Denmark)

    van der Heijden, M M P; Pouwer, F; Pop, V J M

    2014-01-01

    BACKGROUND: Excercise self-efficacy is believed to influence physical activity bahavior. PURPOSE: The purpose of this study is to assess the psychometric aspects of the Exercise Self-efficacy Scale (ESS) in a type 2 diabetes Dutch Primary care sample. METHOD: Type 2 diabetes patients (n = 322; ...-item ESS had sound psychometric properties in a large sample of primary care type 2 diabetes patients. The 13-item ESS could be useful in (intervention) research on physical activity in type 2 diabetes patients....

  11. Innovation in Health Care Delivery.

    Science.gov (United States)

    Sharan, Alok D; Schroeder, Gregory D; West, Michael E; Vaccaro, Alexander R

    2016-02-01

    As reimbursement transitions from a volume-based to a value-based system, innovation in health care delivery will be needed. The process of innovation begins with framing the problem that needs to be solved along with the strategic vision that has to be achieved. Similar to scientific testing, a hypothesis is generated for a new solution to a problem. Innovation requires conducting a disciplined form of experimentation and then learning from the process. This manuscript will discuss the different types of innovation, and the key steps necessary for successful innovation in the health care field.

  12. [Violence on health care workers].

    Science.gov (United States)

    Cannavò, M; Fusaro, N; Colaiuda, F; Rescigno, G; Fioravanti, M

    2017-01-01

    The Emergency Department (ED) is vulnerable for workplace violence, but little is known about this and its consequences. Objectives of this study were presence, characteristics and effects of violence from patients and visitors on health care workers in an Emergency Department (ED). This study was about the Accident and Emergency Department, S. Pertini Hospital, (ASL RMB, Rome, Italy). Data were collected from November 2014 to January 2015 on frequency and type of violent behavior in the past five years experienced by staff members and their level of stress by an ad hoc questionnaire for the evaluation of violent events in health activities (QVS) and a questionnaire on perceived work-related stress (QES). Of the 58 eligible workers, 51 completed the interview. Health care workers were regularly exposed to violence with a consequent severe underreporting to work authorities and only a minor reporting to the police. A diffuse belief that workplace violence is a normal part of the work was also identified. Aggressors were usually patients or their relatives and were mainly males. Health care workers may suffer physical and emotional harm. Emergency Department health care workers are at risk of experiencing workplace violence and should have specific training and support in the management of violent situations focused on early identification, communication strategies, and de-escalation techniques.

  13. Consumer mobility in the Dutch health insurance system: the role of collectives.

    NARCIS (Netherlands)

    Brabers, A.E.M.; Reitsma-van Rooijen, M.; Jong, J.D. de

    2012-01-01

    Background: In the last decades, health care reforms based on introducing managed competition have been implemented in several countries. The policy assumption is that managed competition leads to lower prices and increases the quality of health care. In The Netherlands the system of managed competi

  14. Consumer mobility in the Dutch health insurance system: the role of collectives.

    NARCIS (Netherlands)

    Brabers, A.E.M.; Reitsma-van Rooijen, M.; Jong, J.D. de

    2012-01-01

    Background: In the last decades, health care reforms based on introducing managed competition have been implemented in several countries. The policy assumption is that managed competition leads to lower prices and increases the quality of health care. In The Netherlands the system of managed

  15. Workers' opinions on the effect of contact with health care providers on sickness absence duration.

    Science.gov (United States)

    Steenbeek, Romy

    2014-01-01

    Because of the aging working population and the increasing age of retirement the number of workers with chronic illnesses and disabilities is growing. It is important that workers with health complaints receive efficient health care in order to remain fully or at least partly productive. To explore workers' opinions about the effectiveness of contact with health care providers in shortening sickness absence duration. Data come from a four-wave study from 2005 to 2008 among Dutch workers (n=1,424). Data were obtained on visits to health care providers, sickness absence and workers' opinions on whether and how their absence could have been shortened. A third of the workers were of the opinion that the health care provider (most often the general practitioner, GP) had played a role in preventing sickness absence and 35% were of the opinion that the health care provider had limited their absence. Most often the physical therapist (71%) and mental health therapist (61%) shortened sickness absence duration, in contrast to the occupational physician (OP, 25%) and GP (32%). The effectiveness of the health care providers' treatment was associated with the cause of sickness absence. Approximately 15% of the workers reported that their sickness absence could have been shortened if health care providers had provided the proper treatment and if waiting times had been reduced. Health care providers differ in their potential to shorten sickness absence duration. Health care providers can further reduce sickness absence and health care costs by providing the proper treatment and by reducing waiting times.

  16. Intercultural Health Care and Welfare

    DEFF Research Database (Denmark)

    Nielsen, Ben

    2014-01-01

    Artiklen har fokus på undervisning, planlægning, udvikling og evaluering af et internationalt tværfagligt valgfag Intercultural Health Care and Welfare, der udbydes på Det Sundhedsfaglige og Teknologiske Fakultet på Professionshøjskolen Metropol. Ifølge den tysk-amerikanske professor Iris Varner og...

  17. Relationship marketing in health care.

    Science.gov (United States)

    Wagner, H C; Fleming, D; Mangold, W G; LaForge, R W

    1994-01-01

    Building relationships with patients is critical to the success of many health care organizations. The authors profile the relationship marketing program for a hospital's cardiac center and discuss the key strategic aspects that account for its success: a focus on a specific hospital service, an integrated marketing communication strategy, a specially designed database, and the continuous tracking of results.

  18. COMMUNITY MEDICINE & PRIMARY HEALTH CARE

    African Journals Online (AJOL)

    ajiboro

    availability and affordability of ACTs in Secondary Health Care (SHC) facilities in Lagos State and ... percent (37.5%) of the hospitals did not have the drug in stock at the time of visit and drugs had been out of .... Only one in the community pharmacies as single dose .... funding and international competitive bidding for.

  19. [Integrated health care at Nuremberg].

    Science.gov (United States)

    Männl, V

    2006-01-01

    This paper reports in detail on a project of Integrated Health Care in cardiology at Nuremberg, Germany. Information on the structure of the contract, the participants, the agreed claiming of benefits and provision of services are provided as well as relevant figures and contact data.

  20. Health care insolvency and bankruptcy.

    Science.gov (United States)

    Handelsman, L; Speiser, M; Maltz, A; Kirpalani, S

    1998-08-01

    Bankruptcy is an event that is often considered a business' worst nightmare. Debt, lawyers, and the U.S. government can lead to the eventual destruction of a business. This article shows how declaring bankruptcy can be a helpful instrument in continuing a successful venture in the health care marketplace.

  1. primary health care in nigeria

    African Journals Online (AJOL)

    user1

    2014-07-31

    Jul 31, 2014 ... Key Words: Primary Health Care, Strategies for implementation, Constraints, Alma Ata Declaration, Nigeria. 4th June, 2014. Accepted: ... including family planning; immunization against the ... evolved to meet the challenges associated with these diversities. .... and urban areas in Nigeria with the intention of.

  2. The Chinese Health Care System

    DEFF Research Database (Denmark)

    Hougaard, Jens Leth; Østerdal, Lars Peter; Yu, Yi

    In the present paper we describe the structure of the Chinese health care system and sketch its future development. We analyse issues of provider incentives and the actual burden sharing between government, enterprises and people. We further aim to identify a number of current problems and link...

  3. COMMUNITY MEDICINE & PRIMARY HEALTH CARE

    African Journals Online (AJOL)

    ajiboro

    Journal of Community Medicine and Primary Health Care. 26 (1) 96-107 ... obesity. Specific criteria for MetS developed by. 19 of hypertension. .... Triglycerides 150 mg/dL or more or on Christians 329 (96.2%); and lower grade income.

  4. COMMUNITY MEDICINE & PRIMARY HEALTH CARE

    African Journals Online (AJOL)

    4 and optimal use. In Nigeria, despite the The main objective of this study is therefore to .... Islam. Others. 185. 205. 5. 46.8. 51.9. 1.3. Utilization (use) of PHC Services and educational qualifications and of low socio-economic .... other zones except in the south-east region. .... primary health care interventions, the evidence is.

  5. Lower Costs, Better Care- Reforming Our Health Care Delivery

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Affordable Care Act includes tools to improve the quality of health care that can also lower costs for taxpayers and patients. This means avoiding costly...

  6. What Influences Patients' Decisions When Choosing a Health Care Provider? : Measuring Preferences of Patients with Knee Arthrosis, Chronic Depression, or Alzheimer's Disease, Using Discrete Choice Experiments

    NARCIS (Netherlands)

    A.S. Groenewoud (Stef); N.J.A. van Exel (Job); A. Bobinac (Ana); M. Berg (Marc); R. Huijsman (Robbert); E.A. Stolk (Elly)

    2015-01-01

    textabstractObjective: To investigate what influences patients' health care decisions and what the implications are for the provision of information on the quality of health care providers to patients. Data Sources/Study Setting: Dutch patient samples between November 2006 and February 2007. Study D

  7. Exploring a Dutch paradox: an ethnographic investigation of gay men's mental health.

    Science.gov (United States)

    Aggarwal, Sanjay; Gerrets, Rene

    2014-01-01

    Despite the Netherlands' reputation as a world leader with respect to gay rights, homosexual Dutch men have much higher rates of mood disorders, anxiety disorders and suicide attempts than heterosexual Dutch men. Epidemiologists report similar disparities elsewhere in Western Europe and North America. These findings have been the focus of a blossoming psychological literature, inspired by minority stress theory and deploying quantitative methods. Our investigation aims to complement this body of work by adopting an ethnographic approach. Drawing from fieldwork conducted in the Netherlands from 2009 to 2010, we explore sociocultural and contextual factors that have received relatively little attention with respect to gay mental health. In the Netherlands - considered a model for gay equality - how can one understand high rates of psychiatric disorders among gay men? This study points to heteronormativity, complex dynamics involving long-term relationships and processes within gay subcultures as key issues. Notwithstanding their putative socioeconomic, legal and political equality, gay men struggled - at various stages of the life cycle - with internalised norms that they found difficult to fulfil. The desire to embody these ideals, and structural constraints in meeting them, could be potent sources of disappointment and distress.

  8. Managed consumerism in health care.

    Science.gov (United States)

    Robinson, James C

    2005-01-01

    The future of market-oriented health policy and practice lies in "managed consumerism," a blend of the patient-centric focus of consumer-driven health care and the provider-centric focus of managed competition. The optimal locus of incentives will vary among health services according to the nature of the illness, the clinical technology, and the extent of discretion in utilization. A competitive market will manifest a variety of comprehensive and limited benefit designs, broad and narrow contractual networks, and single-and multispecialty provider organizations.

  9. Health care technology as a policy issue

    NARCIS (Netherlands)

    Banta, H.D.

    1994-01-01

    Health care technology has become an increasingly visible issue in many countries, primarily because of the rising costs of health care. In addition, many questions concerning quality of care are being raised. Health care technology assessment has been seen as an aid in addressing questions

  10. Health Care Challenges in Iran

    Directory of Open Access Journals (Sweden)

    M Davari

    2005-10-01

    Full Text Available All health systems across the world have faced new challenges, which is primarily referable to increasing the cost of health care services as well as growing demands for new and expensive health technologies. The aim of this study is to analyse the main challenges facing the Iranian health system. A review of available governmental and relevant publications about Iranian health care system was undertaken to assess the direction of future healthcare policy. Electronic news agencies, newspapers, and parliament’s electronic news also reviewed to realise policy-makers points of view about the health system. Healthcare services in Iran have had a great success in primary healthcare services in last 25 years, which is mainly attributable to National Health Networks policy. Between 1979 and 2003, average life expectancy at birth increased from 57 to 70 and infant mortality rate fell from 104 to 26 per thousand live births. Active vaccination system, very good distribution and coverage, free end point services, family planning, maternal teaching, and primary referral system are of strong advantages of health networks in Iran. However, the healthcare system is now subject to a range of new pressures that must be addressed. Many of these pressures are common to all health services (rising consumer demands and expectations for expensive new technologies, changing disease patterns, and resources shortage, but some are largely specific to Iran. Financial fairness contribution of the population to health system, responsiveness of health system, overusing new technologies, inadequate integration of health services, and inequitable distribution of the resources are of the main challenges of health system in Iran. In addition, considering demographic changes of the Iranian population in recent decades, which made Iranian population young, potential pressures due to an aging population will reveal in coming years. Many of these pressures relate to policies and

  11. Preserving community in health care.

    Science.gov (United States)

    Emanuel, E J; Emanuel, L L

    1997-02-01

    There are two prominent trends in health care today: first, increasing demands for accountabilty, and second, increasing provision of care through managed care organizations. These trends promote the question: What form of account-ability is appropriate to managed care plans? Accountability is the process by which a party justifies its actions and policies. Components of accountability include parties that can be held or hold others accountable, domains and content areas being assessed, and procedures of assessment. Traditionally, the professional model of accountability has operated in medical care. In this model, physicians establish the standards of accountability and hold each other accountable through professional organizations. This form of accountability seems outdated and inapplicable to managed care plans. The alternatives are the economic and the political models of accountability. In the economic model, medicine becomes more like a commodity, and "exit" (consumers changing providers for reasons of cost and quality) is the dominant procedure of accountability. In the political model, medicine becomes more like a community good, and "voice" (citizens communicating their views in public forums or on policy committees, or in elections for representatives) is the dominant procedure of accountability. The economic model's advantages affirm American individualism, make minimal demands on consumers, and use a powerful incentive, money. Its disadvantages undermine health care as a nonmarket good, undermine individual autonomy, undermine good medical practice, impose significant demands on consumers to be informed, sustain differentials of power, and use indirect procedures of accountability. The political model's advantages affirm health care as a matter of justice, permit selecting domains other than price and quality for accountability, reinforce good medical practice, and equalize power between patients and physicians. Its disadvantages include inefficiency in

  12. Financing the health care Internet.

    Science.gov (United States)

    Robinson, J C

    2000-01-01

    Internet-related health care firms have accelerated through the life cycle of capital finance and organizational destiny, including venture capital funding, public stock offerings, and consolidation, in the wake of heightened competition and earnings disappointments. Venture capital flooded into the e-health sector, rising from $3 million in the first quarter of 1998 to $335 million two years later. Twenty-six e-health firms went public in eighteen months, raising $1.53 billion at initial public offering (IPO) and with post-IPO share price appreciation greater than 100 percent for eighteen firms. The technology-sector crash hit the e-health sector especially hard, driving share prices down by more than 80 percent for twenty-one firms. The industry now faces an extended period of consolidation between e-health and conventional firms.

  13. Food-related lifestyle and health attitudes of Dutch vegetarians, non-vegetarian consumers of meat substitutes, and meat consumers

    NARCIS (Netherlands)

    Hoek, A.C.; Luning, P.A.; Stafleu, A.; Graaf, de C.

    2004-01-01

    The aim was to investigate socio-demographic characteristics, and attitudes to food and health of vegetarians, non-vegetarian consumers of meat substitutes, and meat consumers in The Netherlands. The sample used for this study (participants > or =18 years) was taken from the Dutch National Food

  14. Food-related lifestyle and health attitudes of Dutch vegetarians, non-vegetarian consumers of meat substitutes, and meat consumers

    NARCIS (Netherlands)

    Hoek, A.C.; Luning, P.A.; Stafleu, A.; Graaf, C. de

    2004-01-01

    The aim was to investigate socio-demographic characteristics, and attitudes to food and health of vegetarians, non-vegetarian consumers of meat substitutes, and meat consumers in the Netherlands. The sample used for this study (participants ≥18 years) was taken from the Dutch National Food

  15. Does age modify the relationship between morbidity severity and physical health in English and Dutch family practice populations?

    NARCIS (Netherlands)

    Kadam, U.T.; Schellevis, F.G.; Lewis, M.; Windt, D.A.W.M. van der; Vet, H.C. de; Bouter, L.M.; Croft, P.R.

    2009-01-01

    PURPOSE: To investigate the co-influences of age and morbidity severity on physical health in adult family practice populations. METHODS: Morbidity data in a 12-month period for 7,833 older English consulters aged 50 years and over and 6,846 Dutch consulters aged 18 years and over was linked to thei

  16. Food-related lifestyle and health attitudes of Dutch vegetarians, non-vegetarian consumers of meat substitutes, and meat consumers

    NARCIS (Netherlands)

    Hoek, A.C.; Luning, P.A.; Stafleu, A.; Graaf, de C.

    2004-01-01

    The aim was to investigate socio-demographic characteristics, and attitudes to food and health of vegetarians, non-vegetarian consumers of meat substitutes, and meat consumers in The Netherlands. The sample used for this study (participants > or =18 years) was taken from the Dutch National Food C

  17. Quality of life in endometriosis: evaluation of the Dutch-version Endometriosis Health Profile-30 (EHP-30)

    NARCIS (Netherlands)

    Burgt, T.J. van de; Hendriks, J.C.M.; Kluivers, K.B.

    2011-01-01

    The Dutch version of the Endometriosis Health Profile-30 (EHP-30) showed a high return rate and data completeness, low floor and ceiling effects, as well as good internal consistency, test-retest reliability and construct validity. The questionnaire is a reliable and valid instrument for the measure

  18. The Difficult Balance Between Entertainment and Education: A Qualitative Evaluation of a Dutch Health-Promoting Documentary Series

    NARCIS (Netherlands)

    Renes, R.J.; Mutsaers, K.; Woerkum, van C.

    2011-01-01

    The development, content and potential health promoting effect of the Dutch documentary series, Voor dik & dun (“For thick and thin”) were investigated. This series was based on the entertainment–education (EE) strategy and designed to prevent overweight. Qualitative data were collected from thr

  19. The effect of urban-area unemployment on the mental health of citizens differs between Slovak and Dutch cities

    NARCIS (Netherlands)

    Behanova, Martina; Nagyova, Iveta; Katreniakova, Zuzana; van Ameijden, Erik J. C.; van Dijk, Jitse P.; Reijneveld, Sijmen A.

    2013-01-01

    Conclusive evidence on the association of mental health problems (MHP) with area unemployment is lacking in regard to Central European cities. We obtained data on residents aged 19-64 from Slovak and Dutch cities from the FP7 EURO-URHIS 2 project. Multilevel logistic regression showed that the

  20. What is the health care product?

    Science.gov (United States)

    France, K R; Grover, R

    1992-06-01

    Because of the current competitive environment, health care providers (hospitals, HMOs, physicians, and others) are constantly searching for better products and better means for delivering them. The health care product is often loosely defined as a service. The authors develop a more precise definition of the health care product, product line, and product mix. A bundle-of-elements concept is presented for the health care product. These conceptualizations help to address how health care providers can segment their market and position, promote, and price their products. Though the authors focus on hospitals, the concepts and procedures developed are applicable to other health care organizations.

  1. Health Care Access among Latinos: Implications for Social and Health Care Reforms

    Science.gov (United States)

    Perez-Escamilla, Rafael

    2010-01-01

    According to the Institute of Medicine, health care access is defined as "the degree to which people are able to obtain appropriate care from the health care system in a timely manner." Two key components of health care access are medical insurance and having access to a usual source of health care. Recent national data show that 34% of Latino…

  2. Factors influencing consumer satisfaction with health care.

    Science.gov (United States)

    Deshpande, Satish P; Deshpande, Samir S

    2014-01-01

    The purpose of this study was to examine factors that impact consumer satisfaction with health care. This is a secondary analysis of the Center for Studying Health System Change's 2010 Health Tracking Household Survey. Regression analysis was used to examine the impact of treatment issues, financial issues, family-related issues, sources of health care information, location, and demographics-related factors on satisfaction with health care. The study involved 12280 subjects, 56% of whom were very satisfied with their health care, whereas 66% were very satisfied with their primary care physician. Fourteen percent of the subjects had no health insurance; 34% of the subjects got their health care information from the Web. Satisfaction with primary care physician, general health status, promptness of visit to doctor, insurance type, medical cost per family, annual income, persons in family, health care information from friends, and age significantly impacted satisfaction with health care. The regression models accounted for 23% of the variance in health care satisfaction. Satisfaction with primary care physicians, health insurance, and general health status are the 3 most significant indicators of an individual's satisfaction with health care.

  3. Consumer evaluation of complaint handling in the Dutch health insurance market

    Directory of Open Access Journals (Sweden)

    Wendel Sonja

    2011-11-01

    Full Text Available Abstract Background How companies deal with complaints is a particularly challenging aspect in managing the quality of their service. In this study we test the direct and relative effects of service quality dimensions on consumer complaint satisfaction evaluations and trust in a company in the Dutch health insurance market. Methods A cross-sectional survey design was used. Survey data of 150 members of a Dutch insurance panel who lodged a complaint at their healthcare insurer within the past 12 months were surveyed. The data were collected using a questionnaire containing validated multi-item measures. These measures assess the service quality dimensions consisting of functional quality and technical quality and consumer complaint satisfaction evaluations consisting of complaint satisfaction and overall satisfaction with the company after complaint handling. Respondents' trust in a company after complaint handling was also measured. Using factor analysis, reliability and validity of the measures were assessed. Regression analysis was used to examine the relationships between these variables. Results Overall, results confirm the hypothesized direct and relative effects between the service quality dimensions and consumer complaint satisfaction evaluations and trust in the company. No support was found for the effect of technical quality on overall satisfaction with the company. This outcome might be driven by the context of our study; namely, consumers get in touch with a company to resolve a specific problem and therefore might focus more on complaint satisfaction and less on overall satisfaction with the company. Conclusions Overall, the model we present is valid in the context of the Dutch health insurance market. Management is able to increase consumers' complaint satisfaction, overall satisfaction with the company, and trust in the company by improving elements of functional and technical quality. Furthermore, we show that functional and

  4. Translation, validation, and norming of the Dutch language version of the SF-36 Health Survey in community and chronic disease populations

    NARCIS (Netherlands)

    Aaronson, N.K.; Muller, M.; Cohen, P.D.A.; Essink-Bot, M.-L.; Fekkes, M.; Sanderman, R.; Sprangers, M.A.G.; Velde, A. te; Verrips, E.

    1998-01-01

    The primary objectives of this research were to translate, validate, and generate normative data on the SF-36 Health Survey for use among Dutch- speaking residents of the Netherlands. Translation of the SF-36 into Dutch followed the stepwise, iterative procedures developed by the IQOLA Project. Foll

  5. Effect of third molar surgery on oral health-related quality of life in the first postoperative week using Dutch version of oral health impact profile-14

    NARCIS (Netherlands)

    van Wijk, A.; Kieffer, J.M.; Lindeboom, J.H.

    2009-01-01

    Purpose: The present study investigated the effect of third molar surgery on oral health-related quality of life, related to pain and clinical variables, in the first postoperative week using the Dutch version of the 14-item Oral Health Impact Profile. Materials and Methods: A total of 50 patients,

  6. Improvements in the quality of co-ordination of nursing care following implementation of the Resident Assessment Instrument in Dutch nursing homes.

    NARCIS (Netherlands)

    Achterberg, W.P.; Holtkamp, C.C.M.; Kerkstra, A.; Pot, A.M.; Ooms, M.E.; Ribbe, M.W.

    2001-01-01

    Aim: To study the effect of implementation of the Resident Assessment Instrument (RAI) on the quality of co-ordination of nursing care in Dutch nursing homes. Background: The Resident Assessment Instrument (RAI) was designed to improve the quality of care and quality of life in nursing homes. Until

  7. Improvements in the quality of co-ordination of nursing care following implementation of the Resident Assessment Instrument in Dutch nursing homes.

    NARCIS (Netherlands)

    Achterberg, W.P.; Holtkamp, C.C.M.; Kerkstra, A.; Pot, A.M.; Ooms, M.E.; Ribbe, M.W.

    2001-01-01

    Aim: To study the effect of implementation of the Resident Assessment Instrument (RAI) on the quality of co-ordination of nursing care in Dutch nursing homes. Background: The Resident Assessment Instrument (RAI) was designed to improve the quality of care and quality of life in nursing homes. Until

  8. Health care organization drug testing.

    Science.gov (United States)

    Brooks, J P; Dempsey, J

    1992-09-01

    Health care managers are being required to respond to the growing concerns of the public about alcohol and drug use in the health care workplace. To this end, the following recommendations are offered. A drug testing policy should be developed with input from and support of employees and unions. "For cause" testing should be used because it results in more definitive results and better employee acceptance. Unless there are compelling reasons for random testing, "for cause" testing is the preferable method. All levels of employees and the medical staff should be subject to the drug-testing policy. Rehabilitation rather than punishment should be emphasized in dealing with employees with alcohol and drug problems.

  9. The Chinese Health Care System

    DEFF Research Database (Denmark)

    Hougaard, Jens Leth; Østerdal, Lars Peter; Yu, Yi

    In the present paper we describe the structure of the Chinese health care system and sketch its future development. We analyse issues of provider incentives and the actual burden sharing between government, enterprises and people. We further aim to identify a number of current problems and link...... these to a discussion of future challenges in the form of an aging population, increased privatization and increased inequity...

  10. Microenterprise in health care and health education.

    Science.gov (United States)

    Edler, A A

    1998-01-01

    Over the last decade, development aid has increasingly used a more collaborative model, with donors and recipients both contributing ideas, methods and goals. Though many examples of collateral aid projects exist in agriculture, business administration and banking, few have found their way into health care and health education, a typically donor-dominated model. The following case report describes a collateral project in health care education. This case report analyzes data-inducing project proposals, personal interviews and project reports obtained through standard archival research methods. The setting for this joint project was the collaboration between international nongovernmental (NGO) aid foundations and the faculty of a major sub-Saharan African Medical School's Department of Anesthesia. The initial goal of this project was to improve record keeping for all anesthetic records, both in the operating theatres and outside. Analysis of the data was performed using ethnographic methods of constant comparative analysis. The purpose of the analysis was to critically evaluate both the goals and their results in the Department of Anesthesiology. The findings of this analysis suggested that results included not only quality assurance and improvement programs in the department but also advances in the use of critical incidents as teaching tools, hospital-wide drug and equipment utilization information and the initiation of an outreach program to district hospitals throughout the country for similar projects.

  11. Microenterprise in health care and health education.

    Science.gov (United States)

    Edler, A. A.

    1998-01-01

    Over the last decade, development aid has increasingly used a more collaborative model, with donors and recipients both contributing ideas, methods and goals. Though many examples of collateral aid projects exist in agriculture, business administration and banking, few have found their way into health care and health education, a typically donor-dominated model. The following case report describes a collateral project in health care education. This case report analyzes data-inducing project proposals, personal interviews and project reports obtained through standard archival research methods. The setting for this joint project was the collaboration between international nongovernmental (NGO) aid foundations and the faculty of a major sub-Saharan African Medical School's Department of Anesthesia. The initial goal of this project was to improve record keeping for all anesthetic records, both in the operating theatres and outside. Analysis of the data was performed using ethnographic methods of constant comparative analysis. The purpose of the analysis was to critically evaluate both the goals and their results in the Department of Anesthesiology. The findings of this analysis suggested that results included not only quality assurance and improvement programs in the department but also advances in the use of critical incidents as teaching tools, hospital-wide drug and equipment utilization information and the initiation of an outreach program to district hospitals throughout the country for similar projects. PMID:10604789

  12. Maternal health care utilisation in Teso District

    African Journals Online (AJOL)

    antenatal clinic visits, the level of utilisation of maternal health care, to identify the main service .... number of antenatal care visits which have impact .... to or experience with modern health services may ..... diet/nutrition ..... Human Fertility.

  13. Passion in today's health care leaders.

    Science.gov (United States)

    Piper, Llewellyn E

    2005-01-01

    Passion in today's health care leaders is essential as health care organizations face increasing demands for survival. Leaders in health care have been educated, selected, promoted, and retained based on their analytical and creativity skills. Today's health care leaders must also have emotional intelligence. Emotional intelligence is primal for passion. Emotional intelligence, which leads to passion, is crucial to the survivability of today's health care organizations. In order for health care organizations to go from good to great, the leader must inspire followers through passion. This article encourages health care leaders to gain awareness of emotional intelligence and to use emotional intelligence as part of their leadership to inspire passion. Through passion, leaders and followers become more motivated to accomplish the health care mission of serving others.

  14. The Cultural Geography of Health Care Delivery.

    Science.gov (United States)

    Gesler, Wilbert M.

    1987-01-01

    This article shows how health care delivery is related to cultural or human geography. This is accomplished by describing health care delivery in terms of 12 popular themes of cultural geography. (JDH)

  15. Medicaid Adult Health Care Quality Measures

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Affordable Care Act (Section 1139B) requires the Secretary of HHS to identify and publish a core set of health care quality measures for adult Medicaid...

  16. [The coordination of care in health centres].

    Science.gov (United States)

    Ribardière, Olivia

    2016-06-01

    Health centres are structurally designed to facilitate the coordination of care. However, evolutions in society have resulted in forms of consumption of health care which are not necessarily compatible with efficient care coordination. On a local level, teams are nevertheless organising and structuring themselves to offer the right form of care, to the right patient and at the right time.

  17. Psychometric evaluation of the Dutch version of the mental health recovery measure (MHRM).

    Science.gov (United States)

    van Nieuwenhuizen, Chijs; Wilrycx, Greet; Moradi, Mozhgan; Brouwers, Evelien

    2014-03-01

    During the past decade, the mental health consumer movement has drawn the attention of mental health providers, researchers and policy makers to the concept of recovery. Traditionally, recovery primarily refers to the remission of symptoms. Nowadays, recovery is also regarded in a sense that all individuals, even those with severe psychiatric disabilities, can improve. Accordingly, recovery for people with severe mental illness refers to hope and optimism, empowerment, regained control and increased self-esteem, illness self-management and engagement in meaningful daily activities (Corrigan, Giffort, Rashid, Leary & Okeke, 1999; Jacobson & Greenley, 2001; Leamy, Bird, le Boutillier, Williams & Slade, 2011; van Gestel-Timmermans, Brouwers, van Assen, Bongers & van Nieuwenhuizen, 2012). Little empirical research, however, has been done and instruments to measure recovery are scarce. In the current study, the psychometric properties of the Dutch version of the Mental Health Recovery Measure (MHRM) are explored. Convergent and divergent validity of the MHRM was assessed using standardized measures of hope (Hope Herth Index (HHI)), recovery-promoting professional competence (Recovery Promoting Relationships Scale (RPRS)) and general physical health and well-being (RAND Measure of Health-Related Quality of Life (RAND-36)). A factor analysis was conducted and Cronbach's α of the MHRM scales was assessed. The construct validity was assessed by computing the intercorrelations of the MHRM, HHI, RPRS and RAND-36. Data were available for 212 patients: 70 patients completed the MHRM, HHI and RAND 36 and 142 filled out the MHRM and RPRS. Exploratory factor analysis resulted in an interpretable three-factor solution. Cronbach's α ranged from 0.86 to 0.94. The convergent validity of the instrument was satisfactory; the divergent validity was less clear. This study offers evidence to suggest that the Dutch version of the MHRM is a reliable measure (in terms of internal

  18. The right to preventive health care.

    Science.gov (United States)

    Conly, Sarah

    2016-08-01

    The right to health care is a right to care that (a) is not too costly to the provider, considering the benefits it conveys, and (b) is effective in bringing about the level of health needed for a good human life, not necessarily the best health possible. These considerations suggest that, where possible, society has an obligation to provide preventive health care, which is both low cost and effective, and that health care regulations should promote citizens' engagement in reasonable preventive health care practices.

  19. A baseline assessment by healthcare professionals of Dutch pharmacotherapeutic care for the elderly with polypharmacy.

    NARCIS (Netherlands)

    Bakker, L.; Kemper, P.F.; Wagner, C.; Delwel, G.O.; Bruijne, M.C. de

    2017-01-01

    Background: Polypharmacy is common in the elderly population and is associated with an increased risk of adverse drug events. To diminish this risk, the guideline ‘Polypharmacy in the Elderly’ has been developed in 2012. This study examines, to what extent Dutch pharmacotherapeutic practice amongst

  20. Health care reform and care at the behavioral health--primary care interface.

    Science.gov (United States)

    Druss, Benjamin G; Mauer, Barbara J

    2010-11-01

    The historic passage of the Patient Protection and Affordable Care Act in March 2010 offers the potential to address long-standing deficits in quality and integration of services at the interface between behavioral health and primary care. Many of the efforts to reform the care delivery system will come in the form of demonstration projects, which, if successful, will become models for the broader health system. This article reviews two of the programs that might have a particular impact on care on the two sides of that interface: Medicaid and Medicare patient-centered medical home demonstration projects and expansion of a Substance Abuse and Mental Health Services Administration program that colocates primary care services in community mental health settings. The authors provide an overview of key supporting factors, including new financing mechanisms, quality assessment metrics, information technology infrastructure, and technical support, that will be important for ensuring that initiatives achieve their potential for improving care.

  1. Women's health care: from whom and why?

    NARCIS (Netherlands)

    Brink-Muinen, A. van den

    1997-01-01

    Differences are investigated between female practice populations of female general practitioners providing women's health care and of women and men general practitioners providing regular health care. Women's health care in the Netherlands is provided in the general practice "Aletta" and is based

  2. Reforms of health care system in Romania

    NARCIS (Netherlands)

    Bara, AC; van den Heuvel, WJA; Maarse, JAM; Bara, Ana Claudia; Maarse, Johannes A.M.

    Aim. To describe health care reforms and analyze the transition of the health care system in Romania in the 1989-2001 period. Method. We analyzed policy documents, political intentions and objectives of health care reform, described new legislation, and presented changes in financial resources of

  3. Reforms of health care system in Romania

    NARCIS (Netherlands)

    Bara, AC; van den Heuvel, WJA; Maarse, JAM; Bara, Ana Claudia; Maarse, Johannes A.M.

    2002-01-01

    Aim. To describe health care reforms and analyze the transition of the health care system in Romania in the 1989-2001 period. Method. We analyzed policy documents, political intentions and objectives of health care reform, described new legislation, and presented changes in financial resources of th

  4. Teaching Health Care in Introductory Economics

    Science.gov (United States)

    Cutler, David M.

    2017-01-01

    Health care is one of the economy's biggest industries, so it is natural that the health care industry should play some role in the teaching of introductory economics. There are many ways that health care can appear in such a context: in the teaching of microeconomics, as a macroeconomic issue, to learn about social welfare, and even to learn how…

  5. How to achieve care coordination inside health care organizations

    DEFF Research Database (Denmark)

    Prætorius, Thim; C. Becker, Markus

    2015-01-01

    Understanding how health care organizations can achieve care coordination internally is essential because it is difficult to achieve, but essential for high quality and efficient health care delivery. This article offers an answer by providing a synthesis of knowledge about coordination from...

  6. Beneficence, justice, and health care.

    Science.gov (United States)

    Kelleher, J Paul

    2014-03-01

    This paper argues that societal duties of health promotion are underwritten (at least in large part) by a principle of beneficence. Further, this principle generates duties of justice that correlate with rights, not merely "imperfect" duties of charity or generosity. To support this argument, I draw on a useful distinction from bioethics and on a somewhat neglected approach to social obligation from political philosophy. The distinction is that between general and specific beneficence; and the approach from political philosophy has at times been called equality of concern. After clarifying the distinction and setting out the basis of the equality of concern view, I argue that the result is a justice-based principle of "specific" beneficence that should be reflected in a society's health policy. I then draw on this account to criticize, refine, and extend some prominent health care policy proposals from the bioethics literature.

  7. The relation between quality of co-ordination of nursing care and quality of life in Dutch nursing homes.

    NARCIS (Netherlands)

    Holtkamp, C.C.M.; Kerkstra, A.; Ribbe, M.W.; Campen, C. van; Ooms, M.E.

    2000-01-01

    Quality of life of nursing home residents is a critical consideration in international health care policies and health care decisions. Yet, there is little relevant research to support decisions about client-tailored and effective nursing care for this population. Because of the permanency of their

  8. Integrating care by implementation of bundled payments: results from a national survey on the experience of Dutch dietitians.

    NARCIS (Netherlands)

    Tol, J.; Swinkels, I.C.S.; Struijs, J.N.; Veenhof, C.; Bakker, D.H. de

    2013-01-01

    Introduction: In the Netherlands, bundled payments were introduced as part of a strategy to redesign chronic care delivery. Under this strategy new entities of health care providers in primary care are negotiating with health insurers about the price for a bundle of services for several chronic cond

  9. Integrating care by implementation of bundled payments: results from a national survey on the experience of Dutch dietitians.

    NARCIS (Netherlands)

    Tol, J.; Swinkels, I.C.S.; Struijs, J.N.; Veenhof, C.; Bakker, D.H. de

    2013-01-01

    Introduction: In the Netherlands, bundled payments were introduced as part of a strategy to redesign chronic care delivery. Under this strategy new entities of health care providers in primary care are negotiating with health insurers about the price for a bundle of services for several chronic

  10. Rural health care in Mexico?

    Science.gov (United States)

    Cañedo, L

    1974-09-27

    A very large percentage of Mexico's population living in rural areas lacks resources for health care. Any new effort to provide such care must emphasize the health of the infant population because of the high percentage of infants in the country. Plans made at the national level have not been correlated with the conditions that exist in rural areas. For example, the majority of university programs are oriented toward urban medical practice, and the construction of more schools of medicine to solve the problem of doctors in rural areas is based on a mistaken premise. This problem has not been solved even in developed countries such as the United States where, as in Mexico, graduates in medicine migrate to the cities where optimal conditions are met for practicing the type of medicine for which they have been trained. Furthermore, it is both expensive and illogical to maintain urban doctors in rural areas where they cannot practice their profession for lack of resources; to do so is to deny the purpose of their education (27). Conventional schools of medicine, for reasons of investment and of structure, should teach only very selected groups of students who, on finishing their training, are fully capacitated to practice specialized medicine. A different system is required if we are to provide adequate health care in the rural communities. A system such as that described herein, adapted to the real need of rural communities, would avoid the necessity to create dysfunctional bureaucracies and would not destroy those institutions which have proved useful in the past. This study should be considered as one of the many pilot programs that should be initiated in order to determine the type of program that would best solve the problem of health care in rural Mexico. Other programs already being considered at the National Autonomous University of Mexico include the A36 plan of the Faculty of Medicine, now in operation; the work of C. Biro carried out in Netzahualcoyotl City

  11. Implementation of quality of life monitoring in Dutch routine care of adolescents with type 1 diabetes: appreciated but difficult.

    Science.gov (United States)

    Eilander, Minke; de Wit, Maartje; Rotteveel, Joost; Maas-van Schaaijk, Nienke; Roeleveld-Versteegh, Angelique; Snoek, Frank

    2016-03-01

    Monitoring quality of life (QoL) improves well-being and care satisfaction of adolescents with type 1 diabetes. We set out to evaluate the implementation of the program DAWN (Diabetes Attitudes Wishes and Needs) MIND-Youth (Monitoring Individual Needs in Young People With Diabetes) (DM-Y), in which Dutch adolescents' QoL is assessed with the MIND Youth Questionnaire (MY-Q) and its outcomes are discussed. Successful implementation of DM-Y warrants close study of experienced barriers and facilitators as experienced by diabetes care teams as well as adolescents and parents. The study was conducted in 11 self-selected Dutch pediatric diabetes clinics. A mixed methods approach was used. Ten diabetes teams (26 members) were interviewed; 36 team members, 29 adolescents, and 66 parents completed an online survey. Two of 10 teams successfully implemented DM-Y. Whereas 92% of teams valued DM-Y as a useful addition to routine care, most clinics were not able to continue because of logistical problems (lack of time and manpower). Still, all teams had the ambition to make DM-Y integral part of routine care in the nearby future. Seventy-nine percentage of the parents and 41% of the adolescents appreciated the usage of MY-Q, same percentage of adolescents neutral. DM-Y is highly appreciated by teams, as well as adolescents and parents, but for most clinics it is difficult to implement. More effort should be paid to resolve logistic problems in order to facilitate dissemination of DM-Y in care nationwide. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  12. A 'health broker' role as a catalyst of change to promote health: an experiment in deprived Dutch neighbourhoods.

    Science.gov (United States)

    Harting, Janneke; Kunst, Anton E; Kwan, Albert; Stronks, Karien

    2011-03-01

    Urban social entrepreneurs have been suggested to play an essential part in the success of local health promotion initiatives. Up to now, roles like these have only been identified in retrospect. This prospective collaborative study explored the possibilities of institutionalizing a comparable role for a 'health broker' in four Dutch municipalities as an additional investment to promote health in deprived neighbourhoods. The theoretical notions of public and policy entrepreneurs as well as of boundary spanners were adopted as a reference framework. Documents produced by the collaborative project served as input for a qualitative analysis of the developments. We succeeded in implementing a 'health broker' role comparable to that of a bureaucratic public entrepreneur holding a formal non-leadership position. The role was empowered by sharing it among multiple professionals. Although positioned within one sector, the occupants of the new role felt more entitled to cross sectoral borders and to connect to local residents, compared to other within-sector functions. The 'health broker' role had the potential to operate as an 'anchoring point' for the municipal health sector (policy), public health services (practice) and/or the local residents (public). It was also possible to specify potential 'broking points', i.e. opportunities for health promotion agenda setting and opportunities to improve cross-sectoral collaboration, citizen participation and political and administrative support for health promotion efforts. The 'health broker' role we developed and implemented reflects the notion of systematic rather than individual entrepreneurship. Such a collective entrepreneurship may create additional opportunities to gradually strengthen local health promotion efforts.

  13. Racial and Ethnic Disparities in Health and Health Care.

    Science.gov (United States)

    Wheeler, Sarahn M; Bryant, Allison S

    2017-03-01

    A health disparity is defined as an increased burden of an adverse health outcome or health determinant within a specific subset of the population. There are well-documented racial and ethnic disparities throughout health care at the patient, provider, and health care system levels. As the minority populations within the United States grow to record numbers, it is increasingly important to invest in efforts to characterize, understand, and end racial and ethnic disparities in health care. Inequities in health outcomes and care pose real threats to the entire nation's well-being. Eliminating health disparities is fundamental to the well-being, productivity, and viability of the entire nation.

  14. Pharmacists in primary care. Determinants of the care-providing function of Dutch community pharmacists in primary care.

    NARCIS (Netherlands)

    Muijrers, P.E.; Knottnerus, J.A.; Sijbrandij, J.; Janknegt, R.; Grol, R.P.T.M.

    2004-01-01

    OBJECTIVE: To identify determinants of the care-providing function of the community pharmacists (CPs) to explain variations in professional practice. SETTING: The Netherlands 2001. PARTICIPANTS: 328 CPs. METHOD: A cross-sectional questionnaire survey was performed. Questionnaires were used to

  15. Pharmacists in primary care. Determinants of the care-providing function of Dutch community pharmacists in primary care.

    NARCIS (Netherlands)

    Muijrers, P.E.; Knottnerus, J.A.; Sijbrandij, J.; Janknegt, R.; Grol, R.P.T.M.

    2004-01-01

    OBJECTIVE: To identify determinants of the care-providing function of the community pharmacists (CPs) to explain variations in professional practice. SETTING: The Netherlands 2001. PARTICIPANTS: 328 CPs. METHOD: A cross-sectional questionnaire survey was performed. Questionnaires were used to collec

  16. Exploring a Dutch paradox: an ethnographic investigation of gay men's mental health

    NARCIS (Netherlands)

    Aggarwal, S.; Gerrets, R.

    2014-01-01

    Despite the Netherlands' reputation as a world leader with respect to gay rights, homosexual Dutch men have much higher rates of mood disorders, anxiety disorders and suicide attempts than heterosexual Dutch men. Epidemiologists report similar disparities elsewhere in Western Europe and North Americ

  17. Exploring a Dutch paradox: an ethnographic investigation of gay men's mental health

    NARCIS (Netherlands)

    S. Aggarwal; R. Gerrets

    2013-01-01

    Despite the Netherlands' reputation as a world leader with respect to gay rights, homosexual Dutch men have much higher rates of mood disorders, anxiety disorders and suicide attempts than heterosexual Dutch men. Epidemiologists report similar disparities elsewhere in Western Europe and North Americ

  18. Exploring a Dutch paradox: an ethnographic investigation of gay men's mental health

    NARCIS (Netherlands)

    Aggarwal, S.; Gerrets, R.

    2014-01-01

    Despite the Netherlands' reputation as a world leader with respect to gay rights, homosexual Dutch men have much higher rates of mood disorders, anxiety disorders and suicide attempts than heterosexual Dutch men. Epidemiologists report similar disparities elsewhere in Western Europe and North Americ

  19. Developing health care workforces for uncertain futures.

    Science.gov (United States)

    Gorman, Des

    2015-04-01

    Conventional approaches to health care workforce planning are notoriously unreliable. In part, this is due to the uncertainty of the future health milieu. An approach to health care workforce planning that accommodates this uncertainty is not only possible but can also generate intelligence on which planning and consequent development can be reliably based. Drawing on the experience of Health Workforce New Zealand, the author outlines some of the approaches being used in New Zealand. Instead of relying simply on health care data, which provides a picture of current circumstances in health systems, the author argues that workforce planning should rely on health care intelligence--looking beyond the numbers to build understanding of how to achieve desired outcomes. As health care systems throughout the world respond to challenges such as reform efforts, aging populations of patients and providers, and maldistribution of physicians (to name a few), New Zealand's experience may offer a model for rethinking workforce planning to truly meet health care needs.

  20. Health-care access as a social determinant of health.

    Science.gov (United States)

    McGibbon, Elizabeth; Etowa, Josephine; McPherson, Charmaine

    2008-09-01

    The social determinants of health (SDH) are recognized as important indicators of health and well-being. Health-care services (primary, secondary, tertiary care) have not until recently been considered an SDH. Inequities in access to health care are changing this view. These inequities include barriers faced by certain population groups at point of care, such as the lack of cultural competence of health-care providers. The authors show how a social justice perspective can help nurses understand how to link inequities in access to poorer health outcomes, and they call on nurses to break the cycle of oppression that contributes to these inequities.

  1. Physical Health Problems and Barriers to Optimal Health Care Among Children in Foster Care.

    Science.gov (United States)

    Deutsch, Stephanie Anne; Fortin, Kristine

    2015-10-01

    Children and adolescents in foster care placement represent a unique population with special health care needs, often resulting from pre-placement early adversity and neglected, unaddressed health care needs. High rates of all health problems, including acute and/or chronic physical, mental, and developmental issues prevail. Disparities in health status and access to health care are observed. This article summarizes the physical health problems of children in foster care, who are predisposed to poor health outcomes when complex care needs are unaddressed. Despite recognition of the significant burden of health care need among this unique population, barriers to effective and optimal health care delivery remain. Legislative solutions to overcome obstacles to health care delivery for children in foster care are discussed. Copyright © 2015 Mosby, Inc. All rights reserved.

  2. What is Good Quality of Health Care?

    Directory of Open Access Journals (Sweden)

    Magne Nylenna

    2015-03-01

    Full Text Available A diversity of definitions of quality exists, that frequently contain aspects of complexity, relativity and subjectivity. This paper provides an overview of key components in the quality debate within health care, including different perspectives and dimensions of the quality of care. Definitions of the quality of health care reflect the characteristics of health services, and are useful for measurements and quality improvement. Over time the patient perspective of quality has gotten increasing weight, and in quality improvement there has been a shift from individual responsibility for doctors and health care personnel to systems thinking. We argue that the quality approach in health care should be more standardized and that health care-specific definitions of quality should be used when the relationship between physician professionalism and quality is investigated.Keywords: quality, health care, systems thinking, patient perspective, outcome, indicator, measurement, improvement.

  3. Integrated occupational health care at sea

    DEFF Research Database (Denmark)

    Jensen, Olaf Chresten

    2011-01-01

    Workplace Health Promotion is the combined efforts of employers, employees and society to improve the health and well-being of people at work. Integrated maritime health care can be defined as the total maritime health care function that includes the prevention of health risks from harmful...... exposures during life at sea and work place health promotion. SEAHEALTH and some of the shipping companies have already added workplace health promotion to occupational health care programs. The purpose of this article is to reinforce this trend by adding some international perspectives and by providing...

  4. Health care: a brave new world.

    Science.gov (United States)

    Morrisette, Shelley; Oberman, William D; Watts, Allison D; Beck, Joseph B

    2015-03-01

    The current U.S. health care system, with both rising costs and demands, is unsustainable. The combination of a sense of individual entitlement to health care and limited acceptance of individual responsibility with respect to personal health has contributed to a system which overspends and underperforms. This sense of entitlement has its roots in a perceived right to health care. Beginning with the so-called moral right to health care (all life is sacred), the issue of who provides health care has evolved as individual rights have trumped societal rights. The concept of government providing some level of health care ranges from limited government intervention, a 'negative right to health care' (e.g., prevention of a socially-caused, preventable health hazard), to various forms of a 'positive right to health care'. The latter ranges from a decent minimum level of care to the best possible health care with access for all. We clarify the concept of legal rights as an entitlement to health care and present distributive and social justice counter arguments to present health care as a privilege that can be provided/earned/altered/revoked by governments. We propose that unlike a 'right', which is unconditional, a 'privilege' has limitations. Going forward, expectations about what will be made available should be lowered while taking personal responsibility for one's health must for elevated. To have access to health care in the future will mean some loss of personal rights (e.g., unhealthy behaviors) and an increase in personal responsibility for gaining or maintaining one's health.

  5. Challenges for health care development in Croatia.

    Science.gov (United States)

    Ostojić, Rajko; Bilas, Vlatka; Franc, Sanja

    2012-09-01

    The main aim of the research done in this paper was to establish key challenges and perspectives for health care development in the Republic of Croatia in the next two decades. Empirical research was conducted in the form of semi-structured interviews involving 49 subjects, representatives of health care professionals from both, public and private sectors, health insurance companies, pharmaceutical companies, drug wholesalers, and non-governmental organisations (patient associations). The results have shown that key challenges and problems of Croatian health care can be divided into three groups: functioning of health care systems, health care personnel, and external factors. Research has shown that key challenges related to the functioning of health care are inefficiency, financial unviability, inadequate infrastructure, and the lack of system transparency. Poor governance is another limiting factor. With regard to health care personnel, they face the problems of low salaries, which then lead to migration challenges and a potential shortage of health care personnel. The following external factors are deemed to be among the most significant challenges: ageing population, bad living habits, and an increase in the number of chronic diseases. However, problems caused by the global financial crisis and consequential macroeconomic situation must not be neglected. Guidelines for responding to challenges identified in this research are the backbone for developing a strategy for health care development in the Republic of Croatia. Long-term vision, strategy, policies, and a regulatory framework are all necessary preconditions for an efficient health care system and more quality health services.

  6. Dutch audiology.

    Science.gov (United States)

    Grobben, L M; van Ligtenberg, C L

    1977-01-01

    In the Netherlands audiological care is given at different stages. An attempt is made to screen the hearing of all Dutch babies between the ages of 8 and 12 months. At the age of 4 or over, general audiological care is given by the school medical service; referral is first to a family doctor, who may refer to an otolaryngologist. Curative medical care (examination and therapy) is the province of the family doctor and the otolaryngologist. Otolaryngologists and pediatricians can refer patients to one of 19 Audiological Centers distributed around the country, where a number of workers in different disciplines cooperate for habilitation and rehabilitation. These may include an otolaryngologist in charge, a psychologist, a speech and hearing therapist, an audiologist (usually a physicist or university-trained engineer), social worker, technician, ortho-pedagogue, audiology assistant, and teacher. There are at the moment 25 schools for the hard of hearing and 5 institutes for the deaf. These are often found in conjunction with Audiological Centers, the latter providing paramedical assistance to the pupils by agreement. Finally, the Dutch Organization for Preventive Medicine works to prevent hearing loss in noisy industries.

  7. Mental health integration: normalizing team care.

    Science.gov (United States)

    Reiss-Brennan, Brenda

    2014-01-01

    This article examines the impact of integrating mental health into primary health care. Mental Health Integration (MHI) within Intermountain Healthcare has changed the culture of primary health care by standardizing a team-based care process that includes mental health as a normal part of the routine medical encounter. Using a quantitative statistical analysis of qualitative reports (mixed methods study), the study reports on health outcomes associated with MHI for patients and staff. Researchers interviewed 59 patients and 50 staff to evaluate the impact of MHI on depression care. Patients receiving MHI reported an improved relationship with caregivers (P approach to improve outcomes.

  8. Prenatal Care for Adolescents and attributes of Primary Health Care

    Directory of Open Access Journals (Sweden)

    Maria Cristina Barbaro

    2014-01-01

    Full Text Available OBJECTIVE: evaluate prenatal care for adolescents in health units, in accordance with the attributes of Primary Health Care (PHC guidelines. METHOD: quantitative study conducted with health professionals, using the Primary Care Assessment Tool-Brazil to assess the presence and extent of PHC attributes. RESULTS: for all the participating units, the attribute Access scored =6.6; the attributes Longitudinality, Coordination (integration of care, Coordination (information systems and Integrality scored =6.6, and the Essential Score =6.6. Comparing basic units with family health units, the attribute scores were equally distributed; Accessibility scored =6.6, the others attributes scored =6.6; however, in the basic units, the Essential Score was =6.6 and, in the family health units, =6.6. CONCLUSION: expanding the coverage of family health units and the training of professionals can be considered strategies to qualify health care.

  9. The health care costs of smoking

    NARCIS (Netherlands)

    J.J.M. Barendregt (Jan); L.G.A. Bonneux (Luc); P.J. van der Maas (Paul)

    1997-01-01

    textabstractBACKGROUND: Although smoking cessation is desirable from a public health perspective, its consequences with respect to health care costs are still debated. Smokers have more disease than nonsmokers, but nonsmokers live longer and can incur more health costs

  10. Health Care Access Among Deaf People

    National Research Council Canada - National Science Library

    Kuenburg, Alexa; Fellinger, Paul; Fellinger, Johannes

    2016-01-01

    .... The present study reviews literature from 2000 to 2015 on access to health care for deaf people and reveals significant challenges in communication with health providers and gaps in global health...

  11. Health Care Information System (HCIS) Data File

    Data.gov (United States)

    U.S. Department of Health & Human Services — The data was derived from the Health Care Information System (HCIS), which contains Medicare Part A (Inpatient, Skilled Nursing Facility, Home Health Agency (Part A...

  12. Dutch Melanoma Treatment Registry: Quality assurance in the care of patients with metastatic melanoma in the Netherlands.

    Science.gov (United States)

    Jochems, Anouk; Schouwenburg, Maartje G; Leeneman, Brenda; Franken, Margreet G; van den Eertwegh, Alfons J M; Haanen, John B A G; Gelderblom, Hans; Uyl-de Groot, Carin A; Aarts, Maureen J B; van den Berkmortel, Franchette W P J; Blokx, Willeke A M; Cardous-Ubbink, Mathilde C; Groenewegen, Gerard; de Groot, Jan Willem B; Hospers, Geke A P; Kapiteijn, Ellen; Koornstra, Rutger H; Kruit, Wim H; Louwman, Marieke W; Piersma, Djura; van Rijn, Rozemarijn S; Ten Tije, Albert J; Vreugdenhil, Gerard; Wouters, Michel W J M; van der Hoeven, Jacobus J M

    2017-02-01

    In recent years, the treatment of metastatic melanoma has changed dramatically due to the development of immune checkpoint and mitogen-activated protein (MAP) kinase inhibitors. A population-based registry, the Dutch Melanoma Treatment Registry (DMTR), was set up in July 2013 to assure the safety and quality of melanoma care in the Netherlands. This article describes the design and objectives of the DMTR and presents some results of the first 2 years of registration. The DMTR documents detailed information on all Dutch patients with unresectable stage IIIc or IV melanoma. This includes tumour and patient characteristics, treatment patterns, clinical outcomes, quality of life, healthcare utilisation, informal care and productivity losses. These data are used for clinical auditing, increasing the transparency of melanoma care, providing insights into real-world cost-effectiveness and creating a platform for research. Within 1 year, all melanoma centres were participating in the DMTR. The quality performance indicators demonstrated that the BRAF inhibitors and ipilimumab have been safely introduced in the Netherlands with toxicity rates that were consistent with the phase III trials conducted. The median overall survival of patients treated with systemic therapy was 10.1 months (95% confidence interval [CI] 9.1-11.1) in the first registration year and 12.7 months (95% CI 11.6-13.7) in the second year. The DMTR is the first comprehensive multipurpose nationwide registry and its collaboration with all stakeholders involved in melanoma care reflects an integrative view of cancer management. In future, the DMTR will provide insights into challenging questions regarding the definition of possible subsets of patients who benefit most from the new drugs. Copyright © 2016 Elsevier Ltd. All rights reserved.

  13. Technology in health care logistics

    DEFF Research Database (Denmark)

    Jørgensen, Pelle; Wallin, Michael

    In most of the developed countries hospitals are facing a major challenge – they have to provide more health care using the same resources. Due to the demographic trend and the increasing share of the population being in a more health-demanding age, the hospitals will have to deal with more...... presents an analytical model that can analyse the logistical system using a holistic approach, and explore the possibility of using technology to improve the current system. A logistical system is one of the different flows happening at a hospital. Included in the analytical model is a performance...... assessment tool, which has been designed to assess the performance of the logistical system, thereby pinpointing where the system is performing poorly. Additionally the model and tool makes it possible to evaluate various technologies that can be used to improve and optimise the existing system...

  14. Markov Models in health care

    Directory of Open Access Journals (Sweden)

    Renato Cesar Sato

    2010-09-01

    Full Text Available Markov Chains provide support for problems involving decision on uncertainties through a continuous period of time. The greater availability and access to processing power through computers allow that these models can be used more often to represent clinical structures. Markov models consider the patients in a discrete state of health, and the events represent the transition from one state to another. The possibility of modeling repetitive events and time dependence of probabilities and utilities associated permits a more accurate representation of the evaluated clinical structure. These templates can be used for economic evaluation in health care taking into account the evaluation of costs and clinical outcomes, especially for evaluation of chronic diseases. This article provides a review of the use of modeling within the clinical context and the advantages of the possibility of including time for this type of study.

  15. Medicine and health care: implications for health sciences library practice.

    OpenAIRE

    1986-01-01

    The American health care system is experiencing a period of unprecedented change. This paper identifies and discusses the major changes in patient care, research, control of the health care system, and medical education, and their implications for health sciences librarians. These changes have resulted in new demands for effective information delivery and a broader health sciences library clientele. There are both challenges and opportunities for health sciences librarians as they respond to ...

  16. Multiculturalism, Medicine and Health Part I: Multicultural Health Care

    Science.gov (United States)

    Masi, R.

    1988-01-01

    Culturally sensitive health care is not a matter of simple formulas or prescriptions that provide a single definitive answer: rather, it requires understanding of the principles on which health care is based and the manner in which culture may influence those principles. This series of six articles will examine influences that ethnic and cultural background may have on health and health care. Part I outlines the development, importance and relevance of multicultural health care. The author stresses the importance of understanding community needs, cultures and beliefs; the active interest and participation of the patient in his or her own health care; the importance of a good physician-patient relationship; and the benefit of an open-minded approach by physicians and other health-care workers to the delivery of health-care services. PMID:21253247

  17. Equity in health care utilization in Chile

    Science.gov (United States)

    2013-01-01

    One of the most extensive Chilean health care reforms occurred in July 2005, when the Regime of Explicit Health Guarantees (AUGE) became effective. This reform guarantees coverage for a specific set of health conditions. Thus, the purpose of this study is to provide timely evidence for policy makers to understand the current distribution and equity of health care utilization in Chile. The authors analyzed secondary data from the National Socioeconomic Survey (CASEN) for the years 1992–2009 and the 2006 Satisfaction and Out-of-Pocket Payment Survey to assess equity in health care utilization using two different approaches. First, we used a two-part model to estimate factors associated with the utilization of health care. Second, we decomposed income-related inequalities in medical care use into contributions of need and non-need factors and estimated a horizontal inequity index. Findings of this empirical study include evidence of inequities in the Chilean health care system that are beneficial to the better-off. We also identified some key factors, including education and health care payment, which affect the utilization of health care services. Results of this study could help researchers and policy makers identify targets for improving equity in health care utilization and strengthening availability of health care services accordingly. PMID:23937894

  18. Latex allergy in health care

    Directory of Open Access Journals (Sweden)

    Tina Virtič

    2012-11-01

    Full Text Available The increasing use of natural rubber latex medical gloves in the last three decades has caused an increase in latex allergy. The majority of risk groups for allergy development include health care workers, workers in the rubber industry, atopic individuals and children with congenital malformations. Three types of pathological reactions can occur in people using latex medical gloves: irritant contact dermatitis, allergic contact dermatitis and immediate hypersensitivity. The latex allergy is caused by constituent components of latex gloves and added powders; there are also numerous latex allergens involved in cross-reactivity between latex and fruits and vegetables, the so-called latex-fruit syndrome. The diagnosis is based on an accurate history of exposure, clinical presentation and confirmatory in vivo and in vitro tests. Prevention is the easiest, most effective and least expensive way to avoid latex allergy. Powder-free latex gloves with reduced levels of proteins and chemicals, and synthetic gloves for allergic workers must be provided in the work environment. There are already many health care institutions around the world where all latex products have been replaced by synthetic material products.

  19. Achieving better health care outcomes for children in foster care.

    Science.gov (United States)

    Mekonnen, Robin; Noonan, Kathleen; Rubin, David

    2009-04-01

    This article reviews the challenges health care systems face as they attempt to improve health care outcomes for children in foster care. It discusses several of the promising health care strategies occurring outside the perimeter of child welfare and identifies some of the key impasses in working alongside efforts in child welfare reform. The authors posit that the greatest impasse in establishing a reasonable quality of health care for these children is placement instability, in which children move frequently among multiple homes and in and out of the child welfare system. The authors propose potential strategies in which efforts to improve placement stability can serve as a vehicle for multidisciplinary reform across the health care system.

  20. Health Care, Capabilities, and AI Assistive Technologies

    NARCIS (Netherlands)

    Coeckelbergh, Mark

    2010-01-01

    Scenarios involving the introduction of artificially intelligent (AI) assistive technologies in health care practices raise several ethical issues. In this paper, I discuss four objections to introducing AI assistive technologies in health care practices as replacements of human care. I analyse them

  1. Introduction: Studying Health and Health Care in Ghana

    NARCIS (Netherlands)

    van der Geest, S.; Krause, K.

    2014-01-01

    This introduction delineates and discusses the field of social, cultural, and historical studies of health and health care in Ghana. Health and health care are viewed as significant nexuses of social and cultural processes. This overview of studies, mainly from Anglophone medical anthropology, focus

  2. Strengthening of primary health care: Key to deliver inclusive health care

    Directory of Open Access Journals (Sweden)

    Rajiv Yeravdekar

    2013-01-01

    Full Text Available Inequity and poverty are the root causes of ill health. Access to quality health services on an affordable and equitable basis in many parts of the country remains an unfulfilled aspiration. Disparity in health care is interpreted as compromise in ′Right to Life.′ It is imperative to define ′essential health care,′ which should be made available to all citizens to facilitate inclusivity in health care. The suggested methods for this include optimal utilization of public resources and increasing public spending on health care. Capacity building through training, especially training of paramedical personnel, is proposed as an essential ingredient, to reduce cost, especially in tertiary care. Another aspect which is considered very important is improvement in delivery system of health care. Increasing the role of ′family physician′ in health care delivery system will improve preventive care and reduce cost of tertiary care. These observations underlie the relevance and role of Primary health care as a key to deliver inclusive health care. The advantages of a primary health care model for health service delivery are greater access to needed services; better quality of care; a greater focus on prevention; early management of health problems; and cumulative improvements in health and lower morbidity as a result of primary health care delivery.

  3. Using appreciative inquiry to transform health care.

    Science.gov (United States)

    Trajkovski, Suza; Schmied, Virginia; Vickers, Margaret; Jackson, Debra

    2013-08-01

    Amid tremendous changes in contemporary health care stimulated by shifts in social, economic and political environments, health care managers are challenged to provide new structures and processes to continually improve health service delivery. The general public and the media are becoming less tolerant of poor levels of health care, and health care professionals need to be involved and supported to bring about positive change in health care. Appreciative inquiry (AI) is a philosophy and method for promoting transformational change, shifting from a traditional problem-based orientation to a more strength-based approach to change, that focuses on affirmation, appreciation and positive dialog. This paper discusses how an innovative participatory approach such as AI may be used to promote workforce engagement and organizational learning, and facilitate positive organizational change in a health care context.

  4. A real-life observational study of the effectiveness of FACT in a Dutch mental health region

    Directory of Open Access Journals (Sweden)

    Poddighe Giovanni

    2008-12-01

    Full Text Available Abstract Background ACT is an effective community treatment but causes discontinuity of care between acutely ill and currently stable patient groups. The Dutch variant of ACT, FACT, combines both intensive ACT treatment and care for patients requiring less intensive care at one time point yet likely to need ACT in the future. It may be hypothesised that this case mix is not beneficial for patients requiring intensive care, as other patient groups may "dilute" care provision. The effectiveness of FACT was compared with standard care, with a particular focus on possible moderating effects of patient characteristics within the case mix in FACT. Methods In 2002, three FACT teams were implemented in a Dutch region in which a cumulative routine outcome measurement system was in place. Patients receiving FACT were compared with patients receiving standard treatment, matched on "baseline" symptom severity and age, using propensity score matching. Outcome was the probability of being in symptomatic remission of psychotic symptoms. Results The probability of symptomatic remission was higher for SMI patients receiving FACT than for controls receiving standard treatment, but only when there was an unmet need for care with respect to psychotic symptoms (OR = 6.70, p = 0.002; 95% CI = 1.97 – 22.7. Conclusion Compared to standard care, FACT was more rather than less effective, but only when a need for care with respect to psychotic symptoms is present. This suggests that there is no adverse effect of using broader patient mixes in providing continuity of care for all patients with severe mental illness in a defined geographical area.

  5. Telementoring Primary Care Clinicians to Improve Geriatric Mental Health Care.

    Science.gov (United States)

    Fisher, Elisa; Hasselberg, Michael; Conwell, Yeates; Weiss, Linda; Padrón, Norma A; Tiernan, Erin; Karuza, Jurgis; Donath, Jeremy; Pagán, José A

    2017-01-20

    Health care delivery and payment systems are moving rapidly toward value-based care. To be successful in this new environment, providers must consistently deliver high-quality, evidence-based, and coordinated care to patients. This study assesses whether Project ECHO(®) (Extension for Community Healthcare Outcomes) GEMH (geriatric mental health)-a remote learning and mentoring program-is an effective strategy to address geriatric mental health challenges in rural and underserved communities. Thirty-three teleECHO clinic sessions connecting a team of specialists to 54 primary care and case management spoke sites (approximately 154 participants) were conducted in 10 New York counties from late 2014 to early 2016. The curriculum consisted of case presentations and didactic lessons on best practices related to geriatric mental health care. Twenty-six interviews with program participants were conducted to explore changes in geriatric mental health care knowledge and treatment practices. Health insurance claims data were analyzed to assess changes in health care utilization and costs before and after program implementation. Findings from interviews suggest that the program led to improvements in clinician geriatric mental health care knowledge and treatment practices. Claims data analysis suggests that emergency room costs decreased for patients with mental health diagnoses. Patients without a mental health diagnosis had more outpatient visits and higher prescription and outpatient costs. Telementoring programs such as Project ECHO GEMH may effectively build the capacity of frontline clinicians to deliver high-quality, evidence-based care to older adults with mental health conditions and may contribute to the transformation of health care delivery systems from volume to value.

  6. Differences between health care systems and the single European health care market

    Directory of Open Access Journals (Sweden)

    Petra Došenovič Bonča

    2007-12-01

    Full Text Available The following paper analyses the possibilities of forming a single European health care market. This aim is achieved by studying the impact of the differing organisational features of individual European health care systems on the efficiency of health care provision, by examining the relationship between the inputs used to produce health care services and the population’s health status in the analysedcountries and by exploring the link between the quantity of health care services and the health status. The authors hypothesise that the efficiency and organisation of health care systems determine the possibilities of forming an efficient single European health care market. The empirical methodology employed in this paper isdata envelopment analysis (DEA. The results show that differences between health care systems and in the ownership types of health care providers are not so large as to prevent the formation of a single European health care market. However, the formation of a single European health care market would reveal the characteristicsof health care systems in such a way that citizens would be in favour of the public sector in health care and the national health service model.

  7. Discussing dying in the diaspora: attitudes towards advance care planning among first generation Dutch and Italian migrants in rural Australia.

    Science.gov (United States)

    Sinclair, Craig; Smith, Jessica; Toussaint, Yann; Auret, Kirsten

    2014-01-01

    Western cultural practices and values have largely shaped advance care planning (ACP) policies across the world. Low uptake of ACP among ethnic minority groups in Western countries has been interpreted with reference to cultural differences. This paper adopts a life-history approach to explore attitudes towards ACP among older, first-generation Dutch-Australian and Italian-Australian migrants. Thirty people participated in extended ethnographic interviews (N = 17) and group discussions (N = 13) during 2012. Transcripts were thematically analyzed and interpreted using a Foucauldian perspective on knowledge and power. Migration experiences, ongoing contact with the native country and participation in migrant community support networks influenced attitudes towards ACP. Dutch participants framed ACP discussions with reference to euthanasia, and adopted a more individualist approach to medical decision-making. Italian participants often spoke of familial roles and emphasized a family-based decision making style. The importance of migrant identity has been neglected in previous discussions of cultural factors influencing ACP uptake among ethnic minority groups. The unique migration experience should be considered alongside culturally appropriate approaches to decision-making, in order to ensure equitable access to ACP among migrant groups.

  8. Dual loyalty in prison health care.

    Science.gov (United States)

    Pont, Jörg; Stöver, Heino; Wolff, Hans

    2012-03-01

    Despite the dissemination of principles of medical ethics in prisons, formulated and advocated by numerous international organizations, health care professionals in prisons all over the world continue to infringe these principles because of perceived or real dual loyalty to patients and prison authorities. Health care professionals and nonmedical prison staff need greater awareness of and training in medical ethics and prisoner human rights. All parties should accept integration of prison health services with public health services. Health care workers in prison should act exclusively as caregivers, and medical tasks required by the prosecution, court, or security system should be carried out by medical professionals not involved in the care of prisoners.

  9. Dual Loyalty in Prison Health Care

    Science.gov (United States)

    Stöver, Heino; Wolff, Hans

    2012-01-01

    Despite the dissemination of principles of medical ethics in prisons, formulated and advocated by numerous international organizations, health care professionals in prisons all over the world continue to infringe these principles because of perceived or real dual loyalty to patients and prison authorities. Health care professionals and nonmedical prison staff need greater awareness of and training in medical ethics and prisoner human rights. All parties should accept integration of prison health services with public health services. Health care workers in prison should act exclusively as caregivers, and medical tasks required by the prosecution, court, or security system should be carried out by medical professionals not involved in the care of prisoners. PMID:22390510

  10. Integrated primary health care in Australia

    Directory of Open Access Journals (Sweden)

    Gawaine Powell Davies

    2009-10-01

    Full Text Available Introduction: To fulfil its role of coordinating health care, primary health care needs to be well integrated, internally and with other health and related services. In Australia, primary health care services are divided between public and private sectors, are responsible to different levels of government and work under a variety of funding arrangements, with no overarching policy to provide a common frame of reference for their activities. Description of policy: Over the past decade, coordination of service provision has been improved by changes to the funding of private medical and allied health services for chronic conditions, by the development in some states of voluntary networks of services and by local initiatives, although these have had little impact on coordination of planning. Integrated primary health care centres are being established nationally and in some states, but these are too recent for their impact to be assessed. Reforms being considered by the federal government include bringing primary health care under one level of government with a national primary health care policy, establishing regional organisations to coordinate health planning, trialling voluntary registration of patients with general practices and reforming funding systems. If adopted, these could greatly improve integration within primary health care. Discussion: Careful change management and realistic expectations will be needed. Also other challenges remain, in particular the need for developing a more population and community oriented primary health care.

  11. Incentives of Health Care Expenditure

    Directory of Open Access Journals (Sweden)

    Eero Siljander

    2012-12-01

    Full Text Available The incentives of health care expenditure (HCE have been a topic of discussion in the USA (Obama reforms and in Europe (adjustment to debt crisis. There are competing views of institutional versus GDP (unit income elasticity and productivity related factors of growth of expenditure. However ageing of populations, technology change and economic incentives related to institutions are also key drivers of growth according to the OECD and EU’s AWG committee. Simulation models have been developed to forecast the growth of social expenditure (including HCEs to 2050. In this article we take a historical perspective to look at the institutional structures and their relationship to HCE growth. When controlling for age structure, price developments, doctor density and in-patient and public shares of expenditures, we find that fee-for-service in primary care, is according to the results, in at least 20 percent more costly than capitation or salary remuneration. Capitation and salary (or wage remuneration are at same cost levels in primary care. However we did not find the cost lowering effect for gatekeeping which could have been expected based on previous literature. Global budgeting 30 (partly DRG based percent less costly in specialized care than other reimbursement schemes like open contracting or volume based reimbursement. However the public integration of purchaser and provider cost seems to result to about 20 higher than public reimbursement or public contracting. Increasing the number of doctors or public financing share results in increased HCEs. Therefore expanding public reimbursement share of health services seems to lead to higher HCE. On the contrary, the in-patient share reduced expenditures. Compared to the previous literature, the finding on institutional dummies is in line with similar modeling papers. However the results for public expansion of services is a contrary one to previous works on the subject. The median lag length of

  12. The new architects of health care reform.

    Science.gov (United States)

    Schaeffer, Leonard D

    2007-01-01

    Rising health care costs have been an issue for decades, yet federal-level health care reform hasn't happened. Support for reform, however, has changed. Purchasers fear that health care cost growth is becoming unaffordable. Research on costs and quality is questioning value. International comparisons rank the United States low on important health system performance measures. Yet it is not these factors but the unsustainable costs of Medicare and Medicaid that will narrow the window for health care stakeholders to shape policy. Unless the health care system is effectively reformed, sometime after the 2008 election, budget hawks and national security experts will eventually combine forces to cut health spending, ultimately determining health policy for the nation.

  13. Forecasting the health care future. Futurescan 2001 and its implications for health care marketing.

    Science.gov (United States)

    2001-01-01

    In his new book, futurist Russell C. Coile Jr. presents predictions about seven aspects of health care for the next five years. Aided by a panel of health care experts, he analyzes likely developments in health care consumerism, technology, managed care, and other areas that raise a number of issues for health care marketers. Even if only a few of these predictions come true, marketers will be forced to rethink some of their techniques to adapt to this rapidly changing environment.

  14. Ethics, Politics, and Religion in Public Health Care: A Manifesto for Health Care Chaplains in Canada.

    Science.gov (United States)

    Lasair, Simon

    2016-03-01

    Health care chaplaincy positions in Canada are significantly threatened due to widespread health care cutbacks. Yet the current time also presents a significant opportunity for spiritual care providers. This article argues that religion and spirituality in Canada are undergoing significant changes. The question for Canadian health care chaplains is, then: how well equipped are they to understand these changes in health care settings and to engage them? This article attempts to go part way toward an answer.

  15. Evolution of US Health Care Reform.

    Science.gov (United States)

    Manchikanti, Laxmaiah; Helm Ii, Standiford; Benyamin, Ramsin M; Hirsch, Joshua A

    2017-03-01

    Major health policy creation or changes, including governmental and private policies affecting health care delivery are based on health care reform(s). Health care reform has been a global issue over the years and the United States has seen proposals for multiple reforms over the years. A successful, health care proposal in the United States with involvement of the federal government was the short-lived establishment of the first system of national medical care in the South. In the 20th century, the United States was influenced by progressivism leading to the initiation of efforts to achieve universal coverage, supported by a Republican presidential candidate, Theodore Roosevelt. In 1933, Franklin D. Roosevelt, a Democrat, included a publicly funded health care program while drafting provisions to Social Security legislation, which was eliminated from the final legislation. Subsequently, multiple proposals were introduced, starting in 1949 with President Harry S Truman who proposed universal health care; the proposal by Lyndon B. Johnson with Social Security Act in 1965 which created Medicare and Medicaid; proposals by Ted Kennedy and President Richard Nixon that promoted variations of universal health care. presidential candidate Jimmy Carter also proposed universal health care. This was followed by an effort by President Bill Clinton and headed by first lady Hillary Clinton in 1993, but was not enacted into law. Finally, the election of President Barack Obama and control of both houses of Congress by the Democrats led to the passage of the Affordable Care Act (ACA), often referred to as "ObamaCare" was signed into law in March 2010. Since then, the ACA, or Obamacare, has become a centerpiece of political campaigning. The Republicans now control the presidency and both houses of Congress and are attempting to repeal and replace the ACA. Key words: Health care reform, Affordable Care Act (ACA), Obamacare, Medicare, Medicaid, American Health Care Act.

  16. Feelings of powerlessness in relation to pain: ascribed causes and reported strategies. A qualitative study among Dutch community nurses caring for cancer patients with pain.

    NARCIS (Netherlands)

    Schepper, A.M.E. de; Francke, A.L.; Huijer-Abu Saad, H.

    1997-01-01

    This qualitative study focused on the causes for the feelings of powerlessness experienced by dutch community nurses in caring for cancer patients with pain. In addition, the study focused on the strategies community nurses employed to cope with feelings of powerlessness. Semistructured interviews r

  17. Lifestyle counseling for type 2 diabetes risk reduction in Dutch primary care: results of the APHRODITE study after 0.5 and 1.5 years

    NARCIS (Netherlands)

    Vermunt, P.W.; Milder, I.E.J.; Wielaard, F.; Vries, de J.H.M.; Oers, van H.; Westert, G.P.

    2011-01-01

    OBJECTIVE To study the overall effect of the Active Prevention in High-Risk Individuals of Diabetes Type 2 in and Around Eindhoven (APHRODITE) lifestyle intervention on type 2 diabetes risk reduction in Dutch primary care after 0.5 and 1.5 years and to evaluate the variability between general

  18. Cost-effectiveness of non-invasive assessment in the Dutch breast cancer screening program versus usual care: A randomized controlled trial

    NARCIS (Netherlands)

    Timmers, J.M.H.; Damen, J.A.A.G.; Pijnappel, R.M.; Verbeek, A.L.M.; Heeten, GJ. den; Adang, E.M.M.; Broeders, M.J.M.

    2014-01-01

    OBJECTIVE: Increased recall rates in the Dutch breast cancer screening program call for a new assessment strategy aiming to reduce unnecessary costs and anxiety. Diagnostic work-up (usual care) includes multidisciplinary hospital assessment and is similar for all recalled women, regardless of the ra

  19. [207-POS]: Termination of pregnancy for hypertensive disorders prior to fetal viability in the Netherlands: A retrospective cohort study in 10 Dutch tertiary care centers

    NARCIS (Netherlands)

    Eerden, L. van; Zeeman, G.G.; Christiaens, G.C.; Vandenbussche, F.P.; Oei, S.G.; Scheepers, H.C.J.; Eyck, J. van; Middledorp, J.M.; Pajkrt, E.; Duvekot, J.J.; Groot, C.J. de; Bolte, A.C.

    2015-01-01

    OBJECTIVES: To ascertain the incidence and demographic data of TOP for hypertensive disorders at the limits of fetal viability. METHODS: We conducted a retrospective cohort study. All terminations for hypertensive disorders between 2000 and 2009 in the ten Dutch tertiary care centers with a gestatio

  20. Team collaboration in Dutch paediatric rehabilitation. Cooperation between parents, rehabilitation professionals and special education professionals in the care for children with cerebral palsy

    NARCIS (Netherlands)

    Nijhuis, Bianca Gertruda Johanna

    2007-01-01

    This thesis describes the collaborative processes in Dutch paediatric teams engaged in the care for children with cerebral palsy (CP). The three main stakeholder groups in these teams are the parents and the professionals in child rehabilitation and special education. Although the need for close

  1. Medical innovation and age-specific trends in health care utilization: findings and implications.

    Science.gov (United States)

    Wong, Albert; Wouterse, Bram; Slobbe, Laurentius C J; Boshuizen, Hendriek C; Polder, Johan J

    2012-01-01

    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 different health care sectors in the Netherlands, for the period 1981-2009. For the hospital sector we also explore the link between these trends and the state of medical technology. Using aggregated data from a Dutch health survey and a nationwide hospital register, regression analysis was used to examine age-specific trends in the probability of utilizing health care. To determine the influence of medical technology, the growth in age-specific probabilities of hospital care was regressed on the number of medical patents while adjusting for confounders related to demographics, health status, supply and institutional factors. The findings suggest that for most health care sectors, the trend in the probability of health care utilization is highest for ages 65 and up. Larger advances in medical technology are found to be significantly associated with a higher growth of hospitalization probability, particularly for the higher ages. Age-specific trends will raise questions on the sustainability of intergenerational solidarity in health care, as solidarity will not only be strained by the ageing population, but also might find itself under additional pressure as the gap in health care utilization between elderly and non-elderly grows over time. For hospital care utilization, this process might well be accelerated by advances in medical technology.

  2. Health Care Access among Deaf People

    Science.gov (United States)

    Kuenburg, Alexa; Fellinger, Paul; Fellinger, Johannes

    2016-01-01

    Access to health care without barriers is a clearly defined right of people with disabilities as stated by the UN Convention on the Rights of People with Disabilities. The present study reviews literature from 2000 to 2015 on access to health care for deaf people and reveals significant challenges in communication with health providers and gaps in…

  3. Special Issue: The Family and Health Care.

    Science.gov (United States)

    Doherty, William J., Ed.; McCubbin, Hamilton I., Ed.

    1985-01-01

    Discusses research and interventions related to family health care. Topics include health promotion; risk behaviors; vulnerability and illness onset; choosing health care systems; stress; caregiving and coping; family counseling; and family responses to Alzheimer's Disease, pediatric cancer, cystic fibrosis, diabetes, and obesity. (JAC)

  4. Global health and primary care research

    NARCIS (Netherlands)

    Beasley, John W.; Starfield, Barbara; van Weel, Chris; Rosser, Walter W.; Haq, Cynthia L.

    2007-01-01

    A strong primary health care system is essential to provide effective and efficient health care in both resource-rich and resource-poor countries. Although a direct link has not been proven, we can reasonably expect better economic status when the health of the population is improved. Research in pr

  5. Global health and primary care research.

    NARCIS (Netherlands)

    Beasley, J.W.; Starfield, B.; Weel, C. van; Rosser, W.W.; Haq, C.L.

    2007-01-01

    A strong primary health care system is essential to provide effective and efficient health care in both resource-rich and resource-poor countries. Although a direct link has not been proven, we can reasonably expect better economic status when the health of the population is improved. Research in pr

  6. Global health and primary care research.

    NARCIS (Netherlands)

    Beasley, J.W.; Starfield, B.; Weel, C. van; Rosser, W.W.; Haq, C.L.

    2007-01-01

    A strong primary health care system is essential to provide effective and efficient health care in both resource-rich and resource-poor countries. Although a direct link has not been proven, we can reasonably expect better economic status when the health of the population is improved. Research in

  7. Health care of youth aging out of foster care.

    Science.gov (United States)

    2012-12-01

    Youth transitioning out of foster care face significant medical and mental health care needs. Unfortunately, these youth rarely receive the services they need because of lack of health insurance. Through many policies and programs, the federal government has taken steps to support older youth in foster care and those aging out. The Fostering Connections to Success and Increasing Adoptions Act of 2008 (Pub L No. 110-354) requires states to work with youth to develop a transition plan that addresses issues such as health insurance. In addition, beginning in 2014, the Patient Protection and Affordable Care Act of 2010 (Pub L No. 111-148) makes youth aging out of foster care eligible for Medicaid coverage until age 26 years, regardless of income. Pediatricians can support youth aging out of foster care by working collaboratively with the child welfare agency in their state to ensure that the ongoing health needs of transitioning youth are met.

  8. Health care law versus constitutional law.

    Science.gov (United States)

    Hall, Mark A

    2013-04-01

    National Federation of Independent Business v. Sebelius, the Supreme Court's ruling on the Patient Protection and Affordable Care Act, is a landmark decision - both for constitutional law and for health care law and policy. Others will study its implications for constitutional limits on a range of federal powers beyond health care. This article considers to what extent the decision is also about health care law, properly conceived. Under one view, health care law is the subdiscipline that inquires how courts and government actors take account of the special features of medicine that make legal or policy issues especially problematic - rather than regarding health care delivery and finance more generically, like most any other economic or social enterprise. Viewed this way, the opinions from the Court's conservative justices are mainly about general constitutional law principles. In contrast, Justice Ruth Bader Ginsburg's dissenting opinion for the four more liberal justices is just as much about health care law as it is about constitutional law. Her opinion gives detailed attention to the unique features of health care finance and delivery in order to inform her analysis of constitutional precedents and principles. Thus, the Court's multiple opinions give a vivid depiction of the compelling contrasts between communal versus individualistic conceptions of caring for those in need, and between health care and health insurance as ordinary commodities versus ones that merit special economic, social, and legal status.

  9. Children with Special Health Care Needs

    Science.gov (United States)

    ... by their families. "These children are at a disadvantage in the health care system, because important medical ... Care For You American College of Emergency Phycisians Copyright © American College of Emergency Physicians 2017 Privacy Policy ...

  10. Distributed leadership in health care

    DEFF Research Database (Denmark)

    Günzel-Jensen, Franziska; Jain, Ajay K.; Kjeldsen, Anne Mette

    2016-01-01

    Management and health care literature is increasingly preoccupied with leadership as a collective social process, and related leadership concepts such as distributed leadership have therefore recently gained momentum. This paper investigates how formal, i.e. transformational, transactional...... and empowering, leadership styles affect employees’ perceived agency in distributed leadership, and whether these associations are mediated by employees’ perceived organizational efficacy. Based on large-scale survey data from a study at one of Scandinavia’s largest public hospitals (N = 1,147), our results show...... that all leadership styles had a significant positive impact on employees’ perceived agency in distributed leadership. Further, organizational efficacy related negatively to employees’ perceived agency in distributed leadership; however a mediatory impact of this on the formal leadership styles...

  11. Spirulina in health care management.

    Science.gov (United States)

    Kulshreshtha, Archana; Zacharia, Anish J; Jarouliya, Urmila; Bhadauriya, Pratiksha; Prasad, G B K S; Bisen, P S

    2008-10-01

    Spirulina is a photosynthetic, filamentous, spiral-shaped and multicellular edible microbe. It is the nature's richest and most complete source of nutrition. Spirulina has a unique blend of nutrients that no single source can offer. The alga contains a wide spectrum of prophylactic and therapeutic nutrients that include B-complex vitamins, minerals, proteins, gamma-linolenic acid and the super anti-oxidants such as beta-carotene, vitamin E, trace elements and a number of unexplored bioactive compounds. Because of its apparent ability to stimulate whole human physiology, Spirulina exhibits therapeutic functions such as antioxidant, anti-bacterial, antiviral, anticancer, anti-inflammatory, anti-allergic and anti-diabetic and plethora of beneficial functions. Spirulina consumption appears to promote the growth of intestinal micro flora as well. The review discusses the potential of Spirulina in health care management.

  12. Understanding a Value Chain in Health Care.

    Science.gov (United States)

    Sharan, Alok D; Schroeder, Gregory D; West, Michael E; Vaccaro, Alexander R

    2015-10-01

    As the US health care system transitions toward a value-based system, providers and health care organizations will have to closely scrutinize their current processes of care. To do this, a value chain analysis can be performed to ensure that only the most efficient steps are followed in patient care. Ultimately this will produce a higher quality or equal quality product for less cost by eliminating wasteful steps along the way.

  13. Perceptions about affordability of care in the Netherlands.

    NARCIS (Netherlands)

    Brabers, A.E.M.; Jong, J.D. de

    2014-01-01

    The search to maintain a sustainable health care system often results in health care users facing increased costs. The burden of collective expenditure is shifted onto individuals, which could have an impact upon the affordability of care. One third of Dutch health care users find health care

  14. Implementing TQM in the health care sector.

    Science.gov (United States)

    Motwani, J; Sower, V E; Brashier, L W

    1996-01-01

    This article examines the issue of implementing TQM/CQI programs in the health care industry by grouping the prescriptive literature into four research streams. Based on the literature, a strategic programming model for implementing TQM/CQI in the health care industry is suggested. Finally, issues relating to TQM in the health care sector, which need to be addressed within each research stream in the future, are provided.

  15. The development of an empirical model for regional public health reporting. A descriptive study in two Dutch pilot regions.

    Science.gov (United States)

    Van Bon-Martens, M J H; Van De Goor, L A M; Achterberg, P W; Van Oers, J A M

    2011-08-01

    To develop and describe an empirical model for regional public health reporting, based on the model and experience of the Dutch national Public Health Status and Forecasts (PHSF) as well as on relevant theories and literature. Three basic requirements were chosen in a preparatory feasibility study: the products to be developed, the project organization of the pilot study, and a regional elaboration of the conceptual model of the national PHSF. Subsequently, from November 2005 to June 2007, a regional PHSF was developed in two Dutch pilot regions, to serve as a base for the empirical model for regional public health reporting. The developed empirical regional PHSF model consists of different products for different purposes and target groups. Regional and Municipal Reports aim to underpin strategic regional and local public health policy. Websites contain up-to-date information, aiming to underpin tactical regional and local public health policy by providing building blocks for translating strategic policy priorities into concrete plans of action. Numerous stakeholders are involved in the development of a regional PHSF. The developed empirical process model for a regional PHSF connects to the theoretical framework in which interaction between researchers and policymakers is an important condition for the use of research data in public health policy. The empirical model for a regional PHSF can be characterized by its 1) products, 2) content and design, and 3) underlying process and organization. This empirical model can be seen as a first step in the direction of a generic model for regional public health reporting.

  16. Study Protocol - an exploratory trial on health promoting schools at Dutch secondary schools

    Directory of Open Access Journals (Sweden)

    Vincent Busch

    2012-07-01

    Full Text Available Background: Recent studies show adolescent health-related behaviours to co-occur synergistically. This paper describes the study design for an exploratory trial on the effects of a comprehensive, whole-school health promoting school intervention. This intervention tackles seven different behavioural domains simultaneously via a combination of education, creating a healthy environment and introducing healthy behavioural policies. Additionally, extensive partnerships are formed between schools, parents, neighbourhoods and youth health authorities to coordinate health promotion efforts. Study design and data collection methods: The intervention will be implemented at two secondary schools. Results will be compared with two control schools (n≈1500. The intervention's effectiveness in changing student behaviours as well as physical and psychosocial health status along with qualitative lessons learned on the integration of youth health care services and school health education practices are the main aimed outcomes of this study. Data are collected via a mixed methods design combining an annual youth health (behaviour monitor with a qualitative process evaluation via interviews with key stakeholders. Data analysis: A multilevel analysis is performed combined with a systematic analysis of qualitative interview data. Conclusions: This study will produce an evaluation of a comprehensive health promoting school intervention that combines an integrated approach of schools, neighbourhoods, families and youth health services to improve adolescent health.

  17. Study Protocol - an exploratory trial on health promoting schools at Dutch secondary schools

    Directory of Open Access Journals (Sweden)

    Vincent Busch

    2012-07-01

    Full Text Available Background: Recent studies show adolescent health-related behaviours to co-occur synergistically. This paper describes the study design for an exploratory trial on the effects of a comprehensive, whole-school health promoting school intervention. This intervention tackles seven different behavioural domains simultaneously via a combination of education, creating a healthy environment and introducing healthy behavioural policies. Additionally, extensive partnerships are formed between schools, parents, neighbourhoods and youth health authorities to coordinate health promotion efforts.Study design and data collection methods: The intervention will be implemented at two secondary schools. Results will be compared with two control schools (n≈1500. The intervention's effectiveness in changing student behaviours as well as physical and psychosocial health status along with qualitative lessons learned on the integration of youth health care services and school health education practices are the main aimed outcomes of this study. Data are collected via a mixed methods design combining an annual youth health (behaviour monitor with a qualitative process evaluation via interviews with key stakeholders.Data analysis: A multilevel analysis is performed combined with a systematic analysis of qualitative interview data.Conclusions: This study will produce an evaluation of a comprehensive health promoting school intervention that combines an integrated approach of schools, neighbourhoods, families and youth health services to improve adolescent health.

  18. Blogging and the health care manager.

    Science.gov (United States)

    Malvey, Donna; Alderman, Barbara; Todd, Andrew D

    2009-01-01

    The use of blogs in the workplace has emerged as a communication tool that can rapidly and simultaneously connect managers with their employees, customers, their peers, and other key stakeholders. Nowhere is this connection more critical than in health care, especially because of the uncertainty surrounding health care reform and the need for managers to have access to timely and authentic information. However, most health care managers have been slow to join the blogging bandwagon. This article examines the phenomenon of blogging and offers a list of blogs that every health care manager should read and why. This article also presents a simplified step-by-step process to set up a blog.

  19. Attending Unintended Transformations of Health Care Infrastructure

    DEFF Research Database (Denmark)

    Wentzer, Helle; Bygholm, Ann

    2007-01-01

    of theories on human-computer interaction and IT-mediated communication, different empirical studies of IT implementation in health care are analyzed. The outcome is an analytical discernment between different relations of communication and levels of interaction with IT in health care infrastructure....... These relations and levels are synthesized into a framework for identifying tensions and potential problems in the mediation of health care with the IT system. These problems are also known as unexpected adverse consequences, UACs, from IT implementation into clinical health care practices. Results: This paper...

  20. Celiac Disease Testing (for Health Care Professionals)

    Science.gov (United States)

    ... Series Urinary Tract Imaging Urodynamic Testing Virtual Colonoscopy Celiac Disease Testing (for Health Care Professionals) Serologic tests for celiac disease provide an effective first step in identifying candidates ...

  1. 76 FR 68198 - Lists of Designated Primary Medical Care, Mental Health, and Dental Health Professional Shortage...

    Science.gov (United States)

    2011-11-03

    ... Administration Lists of Designated Primary Medical Care, Mental Health, and Dental Health Professional Shortage... designated as primary medical care, mental health, and dental health professional shortage areas (HPSAs) as... seven health professional types (primary medical care, dental, psychiatric, vision care,...

  2. Palliative care for terminally ill patients in the Netherlands: Dutch government policy.

    NARCIS (Netherlands)

    Francke, A.L.

    2003-01-01

    There is a broad range of palliative care available in the Netherlands. There are many options for obtaining palliative care at home. The care that terminally ill patients need can also be provided in nursing homes, care homes, hospitals and hospices. Government policy in this field is one of the re

  3. Introduction: Studying Health and Health Care in Ghana

    OpenAIRE

    De Geest, S.; Krause, K

    2014-01-01

    This introduction delineates and discusses the field of social, cultural, and historical studies of health and health care in Ghana. Health and health care are viewed as significant nexuses of social and cultural processes. This overview of studies, mainly from Anglophone medical anthropology, focuses on developments around "traditional" medicine and various themes relating to biomedicine, including hospital ethnography, pharmaceuticals, health insurance, reproductive technology, and HIV/AIDS...

  4. Integrating mental health into primary health care in Zambia: a care provider's perspective

    Directory of Open Access Journals (Sweden)

    Mwanza Jason

    2010-07-01

    Full Text Available Abstract Background Despite the 1991 reforms of the health system in Zambia, mental health is still given low priority. This is evident from the fragmented manner in which mental health services are provided in the country and the limited budget allocations, with mental health services receiving 0.4% of the total health budget. Most of the mental health services provided are curative in nature and based in tertiary health institutions. At primary health care level, there is either absence of, or fragmented health services. Aims The aim of this paper was to explore health providers' views about mental health integration into primary health care. Methods A mixed methods, structured survey was conducted of 111 health service providers in primary health care centres, drawn from one urban setting (Lusaka and one rural setting (Mumbwa. Results There is strong support for integrating mental health into primary health care from care providers, as a way of facilitating early detection and intervention for mental health problems. Participants believed that this would contribute to the reduction of stigma and the promotion of human rights for people with mental health problems. However, health providers felt they require basic training in order to enhance their knowledge and skills in providing health care to people with mental health problems. Recommendations It is recommended that health care providers should be provided with basic training in mental health in order to enhance their knowledge and skills to enable them provide mental health care to patients seeking help at primary health care level. Conclusion Integrating mental health services into primary health care is critical to improving and promoting the mental health of the population in Zambia.

  5. Consumer-driven health care marketing.

    Science.gov (United States)

    Upton, R L

    1997-01-01

    In this article, a health care marketing executive takes an opposing view: That the consumer will not only continue to exercise choice but also, at annual renewal time, veto power. In part, that is because the consumers are feeling the rising cost of health care much more directly than in the past, through ever-higher premiums, deductibles and copayments. As they assumed more of the burden of medical care delivery, consumers are becoming more knowledgeable about and discriminating toward the health care system and provider plans they are offered. They understand--as does their employer--that no longer are all health care plans alike or at parity with each other. The consumer is also demanding greater access to freedom of provider choice, quality of health care coverage.

  6. The Italian health-care system.

    Science.gov (United States)

    France, George; Taroni, Francesco; Donatini, Andrea

    2005-09-01

    Italy's national health service is statutorily required to guarantee the uniform provision of comprehensive care throughout the country. However, this is complicated by the fact that, constitutionally, responsibility for health care is shared between the central government and the 20 regions. There are large and growing differences in regional health service organisation and provision. Public health-care expenditure has absorbed a relatively low share of gross domestic product, although in the last 25 years it has consistently exceeded central government forecasts. Changes in payment systems, particularly for hospital care, have helped to encourage organisational appropriateness and may have contributed to containing expenditure. Tax sources used to finance the Servizio Sanitario Nazionale (SSN) have become somewhat more regressive. The limited evidence on vertical equity suggests that the SSN ensures equal access to primary care but lower income groups face barriers to specialist care. The health status of Italians has improved and compares favourably with that in other countries, although regional disparities persist.

  7. The digital transformation of health care.

    Science.gov (United States)

    Coile, R C

    2000-01-01

    The arrival of the Internet offers the opportunity to fundamentally reinvent medicine and health care delivery. The "e-health" era is nothing less than the digital transformation of the practice of medicine, as well as the business side of the health industry. Health care is only now arriving in the "Information Economy." The Internet is the next frontier of health care. Health care consumers are flooding into cyberspace, and an Internet-based industry of health information providers is springing up to serve them. Internet technology may rank with antibiotics, genetics, and computers as among the most important changes for medical care delivery. Utilizing e-health strategies will expand exponentially in the next five years, as America's health care executives shift to applying IS/IT (information systems/information technology) to the fundamental business and clinical processes of the health care enterprise. Internet-savvy physician executives will provide a bridge between medicine and management in the adoption of e-health technology.

  8. A health services framework of spiritual care.

    Science.gov (United States)

    Daaleman, Timothy P

    2012-12-01

    To introduce a health services framework of spiritual care that addresses the empirical and applied issues surrounding spirituality and nursing practice. Despite over 20 years of study, the concept of spirituality is still under development, which limits application to nursing practice. Three studies using a health services framework are reviewed: (1) a survey study of dying patients and family that describes the providers, types and outcomes of spiritual care; (2) an exploratory study of the process of spiritual care; and (3) a multi-level study of the structure and outcomes of spiritual care in long-term care facilities. Spiritual care recipients identify family or friends (41%), clergy (17%) and health care providers (29%) as spiritual care providers. The most frequently reported type of spiritual care was help in coping with illness (87%). Just over half (55%) were satisfied with the care that they received. The processes of spiritual care involved: (1) presence, (2) opening eyes, and; (3) co-creating, which was a mutual and fluid activity between patients, family members and care providers. In long term care facilities, decedents who received spiritual care were perceived as receiving better overall care in the last month of life, when compared with those decedents who did not receive spiritual care. A health services framework provides a holistic view of spiritual care, one that is consistent with integrated nursing models. By focusing on the structure, process and outcome elements of spiritual care within organisational settings, nursing management can develop feasible approaches to implement, improve and evaluate the delivery of this unique type of care. © 2012 Blackwell Publishing Ltd.

  9. Female farmworkers' health during pregnancy: health care providers' perspectives.

    Science.gov (United States)

    Kelley, Maureen A; Flocks, Joan D; Economos, Jeannie; McCauley, Linda A

    2013-07-01

    Pregnant farmworkers and their fetuses are at increased risk of negative health outcomes due to environmental and occupational factors at their workplaces. Health care providers who serve farm communities can positively affect workers' health through the informed care they deliver. Yet, interviews with rural health care providers reveal limited knowledge about agricultural work or occupational and environmental health risks during pregnancy. Professional associations, government organizations, academic institutions, and practice settings must renew their efforts to ensure that environmental and occupational health education, especially as it relates to women and their children, is incorporated into academic and practice environments.

  10. Challenges for the German Health Care System.

    Science.gov (United States)

    Dietrich, C F; Riemer-Hommel, P

    2012-06-01

    The German Health Care System (GHCS) faces many challenges among which an aging population and economic problems are just a few. The GHCS traditionally emphasised equity, universal coverage, ready access, free choice, high numbers of providers and technological equipment; however, real competition among health-care providers and insurance companies is lacking. Mainly in response to demographic changes and economic challenges, health-care reforms have focused on cost containment and to a lesser degree also quality issues. In contrast, generational accounting, priorisation and rationing issues have thus far been completely neglected. The paper discusses three important areas of health care in Germany, namely the funding process, hospital management and ambulatory care, with a focus on cost control mechanisms and quality improving measures as the variables of interest. Health Information Technology (HIT) has been identified as an important quality improvement tool. Health Indicators have been introduced as possible instruments for the priorisation debate.

  11. The effect of becoming BVDV-free on fertility and udder health in Dutch dairy herds.

    Science.gov (United States)

    Berends, I M G A; Swart, W A J M; Frankena, K; Muskens, J; Lam, T J G M; van Schaik, G

    2008-04-17

    The aim of the study was to investigate the effect of BVDV-free certification of dairy herds on fertility and udder health. Cases were defined as dairy herds that had at least one BVDV-antigen positive animal, subsequently gained the BVDV-free status by participating in the BVDV-control programme of the Animal Health Service (AHS) and maintained this status for at least 2 years. Controls had an unknown status for BVDV and two controls were matched to one case by region and herd size. Data concerning fertility and milk production of all herds were provided by The Dutch Royal Cattle Syndicate (NRS). After validation, data of 79,607 cows of 392 case herds and 124,831 cows of 730 control herds were analysed on ten fertility and three udder health parameters. For the analyses all observations were aggregated at herd level. To account for the matching, differences for fertility parameters were calculated between each of the two pairs of case-control within a matching code. The analyses were performed with these differences as dependent variables. Mixed models and GEE models were used for the statistical analyses of fertility and udder health. Case herds had a significantly lower abortion rate in the BVDV-free period than controls herds (10.3% versus 11.6%, P<0.01) while there was no significant difference for the other fertility parameters. There was no effect on mastitis prevalence or bulk-milk SCC but the mastitis incidence significantly decreased for case herds in the BVDV-free period (cases 0.6 % lower than controls, P<0.05). In our study the effect of getting the BVDV-free status may have been underestimated for several reasons like an unknown status for control herds, not knowing when an acute infection occurred in case herds and not knowing the management for both cases and controls. Interestingly, both significant variables, being abortions and mastitis incidence, are parameters that are more difficult to influence by the farmer than the other parameters (e

  12. Toward a 21st-century health care system: Recommendations for health care reform

    NARCIS (Netherlands)

    K. Arrow (Kenneth); A. Auerbach (Alan); J. Bertko (John); L.P. Casalino (Lawrence Peter); F.J. Crosson (Francis); A. Enthoven (Alain); E. Falcone; R.C. Feldman; V.R. Fuchs (Victor); A.M. Garber (Alan); M.R. Gold (Marthe Rachel); D.A. Goldman; G.K. Hadfield (Gillian); M.A. Hall (Mark Ann); R.I. Horwitz (Ralph); M. Hooven; P.D. Jacobson (Peter); T.S. Jost (Timothy Stoltzfus); L.J. Kotlikoff; J. Levin (Jonathan); S. Levine (Sharon); R. Levy; K. Linscott; H.S. Luft; R. Mashal; D. McFadden (Daniel); D. Mechanic (David); D. Meltzer (David); J.P. Newhouse (Joseph); R.G. Noll (Roger); J.B. Pietzsch (Jan Benjamin); P. Pizzo (Philip); R.D. Reischauer (Robert); S. Rosenbaum (Sara); W. Sage (William); L.D. Schaeffer (Leonard Daniel); E. Sheen; B.N. Silber (Bernie Michael); J. Skinner (Jonathan Robert); S.M. Shortell (Stephen); S.O. Thier (Samuel); S. Tunis (Sean); L. Wulsin Jr.; P. Yock (Paul); G.B. Nun; S. Bryan (Stirling); O. Luxenburg (Osnat); W.P.M.M. van de Ven (Wynand); J. Cooper (Jim)

    2009-01-01

    textabstractThe coverage, cost, and quality problems of the U.S. health care system are evident. Sustainable health care reform must go beyond financing expanded access to care to substantially changing the organization and delivery of care. The FRESH-Thinking Project (www.fresh-thinking.org) held a

  13. Toward a 21st-century health care system: Recommendations for health care reform

    NARCIS (Netherlands)

    K. Arrow (Kenneth); A. Auerbach (Alan); J. Bertko (John); L.P. Casalino (Lawrence Peter); F.J. Crosson (Francis); A. Enthoven (Alain); E. Falcone; R.C. Feldman; V.R. Fuchs (Victor); A.M. Garber (Alan); M.R. Gold (Marthe Rachel); D.A. Goldman; G.K. Hadfield (Gillian); M.A. Hall (Mark Ann); R.I. Horwitz (Ralph); M. Hooven; P.D. Jacobson (Peter); T.S. Jost (Timothy Stoltzfus); L.J. Kotlikoff; J. Levin (Jonathan); S. Levine (Sharon); R. Levy; K. Linscott; H.S. Luft; R. Mashal; D. McFadden (Daniel); D. Mechanic (David); D. Meltzer (David); J.P. Newhouse (Joseph); R.G. Noll (Roger); J.B. Pietzsch (Jan Benjamin); P. Pizzo (Philip); R.D. Reischauer (Robert); S. Rosenbaum (Sara); W. Sage (William); L.D. Schaeffer (Leonard Daniel); E. Sheen; B.N. Silber (Bernie Michael); J. Skinner (Jonathan Robert); S.M. Shortell (Stephen); S.O. Thier (Samuel); S. Tunis (Sean); L. Wulsin Jr.; P. Yock (Paul); G.B. Nun; S. Bryan (Stirling); O. Luxenburg (Osnat); W.P.M.M. van de Ven (Wynand); J. Cooper (Jim)

    2009-01-01

    textabstractThe coverage, cost, and quality problems of the U.S. health care system are evident. Sustainable health care reform must go beyond financing expanded access to care to substantially changing the organization and delivery of care. The FRESH-Thinking Project (www.fresh-thinking.org) held a

  14. Health care services, information systems & sustainability.

    Science.gov (United States)

    Hovenga, Evelyn J S

    2010-01-01

    This chapter gives an educational overview of: * many competing characteristics within national health systems * national primary information and knowledge flows between health care entities * the role of information technologies in assisting health organizations become sustainable enterprises * the business of maintaining healthy populations for any nation * desirable e-health strategy objectives.

  15. Integrating Community Health Workers (CHWs) into Health Care Organizations.

    Science.gov (United States)

    Payne, Julianne; Razi, Sima; Emery, Kyle; Quattrone, Westleigh; Tardif-Douglin, Miriam

    2017-04-08

    Health care organizations increasingly employ community health workers (CHWs) to help address growing provider shortages, improve patient outcomes, and increase access to culturally sensitive care among traditionally inaccessible or disenfranchised patient populations. Scholarly interest in CHWs has grown in recent decades, but researchers tend to focus on how CHWs affect patient outcomes rather than whether and how CHWs fit into the existing health care workforce. This paper focuses on the factors that facilitate and impede the integration of the CHWs into health care organizations, and strategies that organizations and their staff develop to overcome barriers to CHW integration. We use qualitative evaluation data from 13 awardees that received Health Care Innovation Awards from the Centers of Medicare and Medicaid Innovation to enhance the quality of health care, improve health outcomes, and reduce the cost of care using programs involving CHWs. We find that organizational capacity, support for CHWs, clarity about health care roles, and clinical workflow drive CHW integration. We conclude with practical recommendations for health care organizations interested in employing CHWs.

  16. [Measuring health literacy can improve communication in health care].

    Science.gov (United States)

    Nørgaard, Ole; Sørensen, Kristine; Maindal, Helle Terkildsen; Kayser, Lars

    2014-01-06

    A tool for measuring health literacy is desirable when tailoring health care services to individual patients. Existing tools measure the functional aspects of health literacy whereas newly developed tools have a broader scope and measure people's knowledge, motivation and competences to access, understand, appraise and apply health information. Two novel, international health literacy questionnaires have been translated and are being validated in a Danish context. The final questionnaires may assist Danish health professionals in shaping communication with patients and reduce health disparities.

  17. Gender and communication style in general practice: differences between women's health care and regular health care.

    NARCIS (Netherlands)

    Brink-Muinen, A. van den; Bensing, J.M.; Kerssens, J.J.

    1998-01-01

    Objectives: differences were investigated between general practitioners providing women's health care (4 women) and general practitioners providing regular health care (8 women and 8 men). Expectations were formulated on the basis of the principles of women's health care and literature about gender

  18. Can health care teams improve primary care practice?

    Science.gov (United States)

    Grumbach, Kevin; Bodenheimer, Thomas

    2004-03-10

    In health care settings, individuals from different disciplines come together to care for patients. Although these groups of health care personnel are generally called teams, they need to earn true team status by demonstrating teamwork. Developing health care teams requires attention to 2 central questions: who is on the team and how do team members work together? This article chiefly focuses on the second question. Cohesive health care teams have 5 key characteristics: clear goals with measurable outcomes, clinical and administrative systems, division of labor, training of all team members, and effective communication. Two organizations are described that demonstrate these components: a private primary care practice in Bangor, Me, and Kaiser Permanente's Georgia region primary care sites. Research on patient care teams suggests that teams with greater cohesiveness are associated with better clinical outcome measures and higher patient satisfaction. In addition, medical settings in which physicians and nonphysician professionals work together as teams can demonstrate improved patient outcomes. A number of barriers to team formation exist, chiefly related to the challenges of human relationships and personalities. Taking small steps toward team development may improve the work environment in primary care practices.

  19. Journal of Community Medicine and Primary Health Care

    African Journals Online (AJOL)

    Journal of Community Medicine and Primary Health Care. ... of research findings, reviews, theories and information on all aspects of public health. ... health planning and management, health policy, health care financing, public health nutrition, ...

  20. Online Health Care Communication in Denmark

    DEFF Research Database (Denmark)

    Andersen, Kim Normann; Agger Nielsen, Jeppe; Kim, Soonhee

    2013-01-01

    This paper brings forward five propositions on the use of online communication in health care, its potential impacts on efficiency and effectiveness in health care, and which role government should play in moving forward the use of online communication. In the paper, each of the five propositions...

  1. Catastrophic payments for health care in Asia

    NARCIS (Netherlands)

    E.K.A. van Doorslaer (Eddy); O.A. O'Donnell (Owen); R.P. Rannan-Eliya (Ravi); A. Somanathan (Aparnaa); S.R. Adhikari (Shiva Raj); C.C. Garg (Charu); D. Harbianto (Deni); A.N. Herrin (Alejandro); M.N. Huq (Mohammed); S. Ibragimova (Shamsia); A. Karan (Anup); T-J. Lee (Tae-Jin); G.M. Leung (Gabriel); J-F.R. Lu (Jui-fen Rachel); C.W. Ng (Ng); B.R. Pande (Badri Raj); R. Racelis (Rachel); S. Tao (Tao); K. Tin (Keith); K. Tisayaticom (Kanjana); L. Trisnantoro (Laksono); C. Vasavid (Vasavid); Y. Zhao (Yuxin)

    2007-01-01

    textabstractOut-of-pocket (OOP) payments are the principal means of financing health care throughout much of Asia. We estimate the magnitude and distribution of OOP payments for health care in fourteen countries and territories accounting for 81% of the Asian population. We focus on payments that ar

  2. Total quality management in behavioral health care.

    Science.gov (United States)

    Sluyter, G V

    1998-01-01

    The literature on total quality management or continuous quality improvement in the behavioral health care field is just beginning to emerge. Although most of the evidence on its effectiveness remains anecdotal, it seems clear that it can work in behavioral health care organizations with strong leadership support and a long-term commitment.

  3. Segmenting the mental health care market.

    Science.gov (United States)

    Stone, T R; Warren, W E; Stevens, R E

    1990-03-01

    The authors report the results of a segmentation study of the mental health care market. A random sample of 387 residents of a western city were interviewed by telephone. Cluster analysis of the data identified six market segments. Each is described according to the mental health care services to which it is most sensitive. Implications for targeting the segments are discussed.

  4. Child Health and Access to Medical Care

    Science.gov (United States)

    Leininger, Lindsey; Levy, Helen

    2015-01-01

    It might seem strange to ask whether increasing access to medical care can improve children's health. Yet Lindsey Leininger and Helen Levy begin by pointing out that access to care plays a smaller role than we might think, and that many other factors, such as those discussed elsewhere in this issue, strongly influence children's health.…

  5. Catastrophic payments for health care in Asia

    NARCIS (Netherlands)

    E.K.A. van Doorslaer (Eddy); O.A. O'Donnell (Owen); R.P. Rannan-Eliya (Ravi); A. Somanathan (Aparnaa); S.R. Adhikari (Shiva Raj); C.C. Garg (Charu); D. Harbianto (Deni); A.N. Herrin (Alejandro); M.N. Huq (Mohammed); S. Ibragimova (Shamsia); A. Karan (Anup); T-J. Lee (Tae-Jin); G.M. Leung (Gabriel); J-F.R. Lu (Jui-fen Rachel); C.W. Ng (Ng); B.R. Pande (Badri Raj); R. Racelis (Rachel); S. Tao (Tao); K. Tin (Keith); K. Tisayaticom (Kanjana); L. Trisnantoro (Laksono); C. Vasavid (Vasavid); Y. Zhao (Yuxin)

    2007-01-01

    textabstractOut-of-pocket (OOP) payments are the principal means of financing health care throughout much of Asia. We estimate the magnitude and distribution of OOP payments for health care in fourteen countries and territories accounting for 81% of the Asian population. We focus on payments that ar

  6. Implementing the learning health care system.

    NARCIS (Netherlands)

    Verheij, R.; Barten, D.J.; Hek, K.; Nielen, M.; Prins, M.; Zwaanswijk, M.; Bakker, D. de

    2014-01-01

    Background: As computerisation of primary care facilities is rapidly increasing, a wealth of data is created in routinely recorded electronic health records (EHRs). This data can be used to create a true learning health care system, in which routinely available data are processed and analysed in ord

  7. Transdisciplinarity in Health Care: A Concept Analysis.

    Science.gov (United States)

    Van Bewer, Vanessa

    2017-05-26

    To analyze the concept of transdisciplinarity and provide an enhanced definition of transdisciplinarity in health care. The term transdisciplinarity is increasingly prevalent in health care research and has been identified as important to improving the effectiveness and efficiency in health care. However, the term continues to be misappropriated and poorly understood by researchers and clinicians alike which hinders its potential use and impact. Walker and Avant's (2005) method of concept analysis was used as a framework for the study of the concept. The databases PubMed, CINAHL, Academic Search Premier, PsycInfo and ERIC were used searching the terms transdisciplinarity, transdisciplinary, interdisciplinary and interdisciplinarity. Transdisciplinarity in health care involves transcending of disciplinary boundaries, a sharing of knowledge, skills and decision-making, a focus on real-world problems and the inclusion of multiple stakeholders including patients, their families and their communities. An enhanced definition of transdisciplinarity in health care emerged from this concept analysis that may provide clarity and direction for health care providers. Nurses, and other health care providers, can look to this definition to understand transdisciplinary health care teams as opposed to multidisciplinary, and interdisciplinary ones. © 2017 Wiley Periodicals, Inc.

  8. Does lean cure variability in health care?

    NARCIS (Netherlands)

    Roemeling, Oskar; Land, Martin; Ahaus, C

    2016-01-01

    Purpose – This research investigates the roles that employee-initiated Lean improvement projects play in health care. Lean ideas are introduced to improve flow in health care. Although variability is detrimental to flow performance, it is unclear whether Lean initiatives set out to reduce this varia

  9. Why Health Care Needs Design Research

    DEFF Research Database (Denmark)

    Knutz, Eva; Ammentorp, Jette; Kofoed, Poul-Erik

    2015-01-01

    . Furthermore, the data reveal that pediatric patients display a radically different play pattern than children who are not in hospital. The inquiry takes an interdisciplinary approach; it has obvious health care-related objectives and seeks to meet the urgent need for new methods within health care to optimize...

  10. Primary care NPs: Leaders in population health.

    Science.gov (United States)

    Swartwout, Kathryn D

    2016-08-18

    A 2012 Institute of Medicine report calls primary and public healthcare workers to action, tasking them with working together to improve population health outcomes. A Practical Playbook released in 2014 enables this public health/primary care integration. Primary care NPs are in an excellent position to lead the charge and make this integration happen.

  11. Online Health Care Communication in Denmark

    DEFF Research Database (Denmark)

    Andersen, Kim Normann; Agger Nielsen, Jeppe; Kim, Soonhee

    2013-01-01

    This paper brings forward five propositions on the use of online communication in health care, its potential impacts on efficiency and effectiveness in health care, and which role government should play in moving forward the use of online communication. In the paper, each of the five propositions...

  12. Appropriate reserves in the health care sector

    NARCIS (Netherlands)

    Feenstra, D.W.; Helden, G.J. van

    1999-01-01

    Organizations in the health care sector are increasingly managed and judged on the basis of economic criteria. At the same time they are faced with growing risks which necessitate ‘appropriate’ reserves. Various major risks are mentioned in this paper. Health care organizations are allowed to form p

  13. Baseline health care for refugees in The Netherlands.

    Science.gov (United States)

    Hondius, A J; van Willigen, L H

    1989-01-01

    In the Netherlands there are some 20,000 refugees from different parts of the world (e.g. Vietnam, Latin America). Most of them have experienced a form of organized violence. The somatic and psychosocial complaints of the refugees are comparable to those of Dutch war victims. They are mostly of an aspecific kind and making a diagnosis can be difficult because of the culturally different presentation of ill being. In order to help general practitioners in making a diagnosis the Refugee Health Centre (CGV) has made a classification of complaints according to whether or not they have a specific cause. It is clear from the literature that there are different opinions about the causes of the somatic complaints. As far as the psychic complaints are concerned it is remarkable that in our pilot study (n = 135) only 6% of the examined refugees suffer from a classical picture of the post-traumatic stress disorder; in a number of cases the picture is limited to some components only. Psychosocial complaints of refugees are subdivided and described. The philosophy of the CGV-treatment is to give assistance as much as possible in the refugee's neighbourhood; so that the clinician(s) will become part of the refugee's new social network. Another very important aspect of the assistance given is preventing medicalization of psychological problems. The basis of help is a recognition of the problems and complaints of the refugee. The structure of the Dutch health care, built up in 'lines', is very often very confusing for a refugee; this confusion can cause communication difficulties between refugee and clinician. To develop methods of treatment, definition and registration of complaints and problems can be a first step.

  14. Changing trends in health care tourism.

    Science.gov (United States)

    Karuppan, Corinne M; Karuppan, Muthu

    2010-01-01

    Despite much coverage in the popular press, only anecdotal evidence is available on medical tourists. At first sight, they seemed confined to small and narrowly defined consumer segments: individuals seeking bargains in cosmetic surgery or uninsured and financially distressed individuals in desperate need of medical care. The study reported in this article is the first empirical investigation of the medical tourism consumer market. It provides the demographic profile, motivations, and value perceptions of health care consumers who traveled abroad specifically to receive medical care. The findings suggest a much broader market of educated and savvy health care consumers than previously thought. In the backdrop of the health care reform, the article concludes with implications for health care providers.

  15. Increased health care utilisation in international adoptees

    DEFF Research Database (Denmark)

    Graff, Heidi Jeannet; Siersma, Volkert Dirk; Kragstrup, Jakob;

    2015-01-01

    after adoption. Our study aimed to theassess health-care utilisation of international adoptees inprimary and secondary care for somatic and psychiatricdiagnoses in a late post-adoption period. Is there an increaseduse of the health-care system in this period, evenwhen increased morbidity in the group...... of allservices in primary care, while in secondary care only fewareas showed an increased long-term morbidity. Conclusion: International adoptees use medical servicesin primary care at a higher rate than non-adoptees someyears after adoption. Excess use of services in secondarycare is also present, but only......Introduction: Several studies have documented thatinternational adoptees have an increased occurrence ofhealth problems and contacts to the health-care systemafter arriving to their new country of residence. This maybe explained by pre-adoption adversities, especially for theperiod immediately...

  16. Trends in prescribing for heart failure in Dutch primary care from 1996 to 2000

    NARCIS (Netherlands)

    Pont, LG; Sturkenboom, MCJM; van Gilst, WH; Denig, P; Haaijer-Ruskamp, FM

    2003-01-01

    Purpose The aim of this study is to explore trends in primary care prescribing for chronic heart failure (CHF) over a 5-year period (1996-2000). Methods This study consisted of repeated cross-sectional surveys in a dynamic cohort from the Integrated Primary Care Information (IPCI) primary care datab

  17. [Evaluation of the effectiveness of health care].

    Science.gov (United States)

    Strnad, L

    1990-01-01

    During the last two decades, the economic aspects of health care acquired an outstanding attentiveness in all developed countries. Simultaneously, the methods have been searched for a more intensive and perfect application of internal health sources, i.e. manpower, materials and money. New approaches in evaluating health care efficacy (conception of health provision as a branch of national economy) have been made. In accord with them, the efficiency of either individual or partial health actions such as health care programs, preventive measures, diagnostical and curative procedures etc.) is measured. All these questions are the up to date topic for Health care of Czechoslovakia which now is far to dispose of sources comparable with the majority of economically developed countries in Europe. At present, they are approximately similar in supplying 1 person health care needs with 500-1000 dol. a year and even more in several countries, whereas Czechoslovakia spends about 200 dol. on health needs of 1 inhabitant a year. This fact is closely connected with relatively low efficacy of our economy incapable to produce the sufficient sources for providing health care on one hand, and on the other it is due both to the budgetary politics as practiced now and the conception of national product division. The shortage in Health care sources is manifested mainly in retardation of material and technical base of health service altogether with low levelled renumeration of health workers consequential in psychologic, social and political problems. The consequences of this condition are reflected negatively in a level of health service provision. This is as far important as the czechoslovac population health status viewed from the so-called strategic health indices (averaged life expectancy, specific mortality, occurrence of cardiovascular diseases and malignancies etc.) is not favourable due to a number of factors, and its improvement will require considerable efforts from both the

  18. Cognitive systems engineering in health care

    CERN Document Server

    Bisantz, Ann M; Fairbanks, Rollin J

    2014-01-01

    Cognitive Engineering for Better Health Care Systems, Ann M. Bisantz, Rollin J. Fairbanks, and Catherine M. BurnsThe Role of Cognitive Engineering in Improving Clinical Decision Support, Anne Miller and Laura MilitelloTeam Cognitive Work Analysis as an Approach for Understanding Teamwork in Health Care, Catherine M. BurnsCognitive Engineering Design of an Emergency Department Information System, Theresa K. Guarrera, Nicolette M. McGeorge, Lindsey N. Clark, David T. LaVergne, Zachary A. Hettinger, Rollin J. Fairbanks, and Ann M. BisantzDisplays for Health Care Teams: A Conceptual Framework and Design Methodology, Avi ParushInformation Modeling for Cognitive Work in a Health Care System, Priyadarshini R. PennathurSupport for ICU Clinician Cognitive Work through CSE, Christopher Nemeth, Shilo Anders, Jeffrey Brown, Anna Grome, Beth Crandall, and Jeremy PamplinMatching Cognitive Aids and the "Real Work" of Health Care in Support of Surgical Microsystem Teamwork, Sarah Henrickson Parker and Shawna J. PerryEngageme...

  19. Future developments in health care performance management

    Directory of Open Access Journals (Sweden)

    Crema M

    2013-11-01

    Full Text Available Maria Crema, Chiara Verbano Department of Management and Engineering, University of Padova, Vicenza, Italy Abstract: This paper highlights the challenges of performance management in health care, wherein multiple different objectives have to be pursued. The literature suggests starting with quality performance, following the sand cone theory, but considering a multidimensional concept of health care quality. Moreover, new managerial approaches coming from an industrial context and adapted to health care, such as lean management and risk management, can contribute to improving quality performance. Therefore, the opportunity to analyze them arises from studying their overlaps and links in order to identify possible synergies and to investigate the opportunity to develop an integrated methodology enabling improved performance. Keywords: health care, lean management, clinical risk management, quality, health care processes

  20. Digital signature technology for health care applications.

    Science.gov (United States)

    Wang, H A; Wang, Y Z; Wang, S

    2001-03-01

    The personal computer and the Internet have provided many useful services to both health care professionals and the general public. However, security remains a key factor that could limit their further growth potential. We reviewed and assessed the potential use of the cryptographic technique to resolve security issues. We also analyzed services available in the current market environment and determined their viability in supporting health care applications. While the cryptographic application has a great potential in protecting security of health care information transmitted over the Internet, a nationwide security infrastructure is needed to support deployment of the technology. Although desirable, it could be cost prohibitive to build a national system to be dedicated for the health care purpose. A hybrid approach that involves the government's development of a dedicated security infrastructure for health care providers and the use of commercial off-the-shelf products and services by the general public offers the most cost-effective and viable approach.

  1. Market competition in health care markets in the Netherlands: some lessons for England?

    Science.gov (United States)

    den Exter, André P; Guy, Mary J

    2014-01-01

    This article seeks to establish what lessons might be available to the English health care sector following enactment of the Health and Social Care Act 2012 from the Dutch experience of introducing market competition into health care via a mandatory health insurance scheme implemented by for-profit insurance companies. The existence of the Beveridge NHS model in England, and a Bismarckian insurance system in The Netherlands perhaps suggest that a comparison of the two countries is at best limited, and reinforced by the different Enthoven-inspired competitive models each has adopted. However, we contend that there are positive and negative issues arising from introducing competition into health care-, e.g. concerns about equity and benefits of efficiencies-which go beyond national boundaries and different systems and reflect the global paradigm shift towards the use of market forces in previously non-market areas such as health. The article examines the situation in England following the HSCA 2012 and The Netherlands following the 2006 reforms before analysing two areas of common ground: the focus in both countries on competition on quality (as opposed to price) and integrated care, which is assuming ever greater significance. We suggest that our combined insights (as a health lawyer and competition lawyer respectively) coupled with a comparative approach create a novel contribution to current calls for a wider public debate about the real role of markets in health care over and above simple characterisation as a force for good or bad.

  2. Redistributive effects in public health care financing.

    Science.gov (United States)

    Honekamp, Ivonne; Possenriede, Daniel

    2008-11-01

    This article focuses on the redistributive effects of different measures to finance public health insurance. We analyse the implications of different financing options for public health insurance on the redistribution of income from good to bad health risks and from high-income to low-income individuals. The financing options considered are either income-related (namely income taxes, payroll taxes, and indirect taxes), health-related (co-insurance, deductibles, and no-claim), or neither (flat fee). We show that governments who treat access to health care as a basic right for everyone should consider redistributive effects when reforming health care financing.

  3. [Health advocacy in child care: literature review].

    Science.gov (United States)

    Andrade, Raquel Dully; Mello, Débora Falleiros; Silva, Marta Angélica Iossi; Ventura, Carla Aparecida Arena

    2011-01-01

    This narrative literature review aimed to identify the publications about health law, in the ambit of child health care. The databases LILACS and MEDLINE were searched, between 2004 and 2009. Thirteen articles were analyzed, and three themes were identified: Emphasis on knowledge, abilities and attitudes for the development of competencies; Partnerships as an imperative; Health and Law: intersectorial relationship. The studies about the practice of health law are relevant to our reality, especially in primary health care, pointing out for the possibilities of its applicability in the role of the nurses acting in the family health strategy, with families and children.

  4. Medicaid Managed Care Model of Primary Care and Health Care Management for Individuals with Developmental Disabilities

    Science.gov (United States)

    Kastner, Theodore A.; Walsh, Kevin K.

    2006-01-01

    Lack of sufficient accessible community-based health care services for individuals with developmental disabilities has led to disparities in health outcomes and an overreliance on expensive models of care delivered in hospitals and other safety net or state-subsidized providers. A functioning community-based primary health care model, with an…

  5. [Transforming health systems based on primary care].

    Science.gov (United States)

    Durán-Arenas, Luis; Salinas-Escudero, Guillermo; Granados-García, Víctor; Martínez-Valverde, Silvia

    2012-01-01

    Access to health services is a social basic determinant of health in Mexico unlike what happens in developed countries. The demand for health services is focused on primary care, but the design meets only the supply of hospital care services. So it generates a dissonance between the needs and the effective design of health services. In addition, the term affiliation refers to population contributing or in the recruitment process, that has been counted as members of these social security institutions (SS) and Popular Insurance (SP). In the case of Instituto Mexicano del Seguro Social (IMSS) three of four contributors are in contact with health services; while in the SP, this indicator does not exist. Moreover, the access gap between health services is found in the health care packages so that members of the SS and SP do not have same type of coverage. The question is: which model of health care system want the Mexicans? Primary care represents the first choice for increasing the health systems performance, as well as to fulfill their function of social protection: universal access and coverage based on needs, regardless whether it is a public or private health insurance. A central aspect for development of this component is the definition of the first contact with the health system through the creation of a primary health care team, led by a general practitioner as the responsible of a multidisciplinary health team. The process addresses the concepts of primary care nursing, consumption of inputs (mainly medical drugs), maintenance and general services. Adopting a comprehensive strategy that will benefit all Mexicans equally and without discrimination, this primary care system could be financed with a total operating cost of approximately $ 22,809 million by year.

  6. Chinese health care system and clinical epidemiology

    Science.gov (United States)

    Sun, Yuelian; Gregersen, Hans; Yuan, Wei

    2017-01-01

    China has gone through a comprehensive health care insurance reform since 2003 and achieved universal health insurance coverage in 2011. The new health care insurance system provides China with a huge opportunity for the development of health care and medical research when its rich medical resources are fully unfolded. In this study, we review the Chinese health care system and its implication for medical research, especially within clinical epidemiology. First, we briefly review the population register system, the distribution of the urban and rural population in China, and the development of the Chinese health care system after 1949. In the following sections, we describe the current Chinese health care delivery system and the current health insurance system. We then focus on the construction of the Chinese health information system as well as several existing registers and research projects on health data. Finally, we discuss the opportunities and challenges of the health care system in regard to clinical epidemiology research. China now has three main insurance schemes. The Urban Employee Basic Medical Insurance (UEBMI) covers urban employees and retired employees. The Urban Residence Basic Medical Insurance (URBMI) covers urban residents, including children, students, elderly people without previous employment, and unemployed people. The New Rural Cooperative Medical Scheme (NRCMS) covers rural residents. The Chinese Government has made efforts to build up health information data, including electronic medical records. The establishment of universal health care insurance with linkage to medical records will provide potentially huge research opportunities in the future. However, constructing a complete register system at a nationwide level is challenging. In the future, China will demand increased capacity of researchers and data managers, in particular within clinical epidemiology, to explore the rich resources. PMID:28356772

  7. Education and Health Care Policies in Ghana

    Directory of Open Access Journals (Sweden)

    Ziblim Abukari

    2015-10-01

    Full Text Available Education and health care policies in Ghana since independence have been universalist in approach providing free universal health care and free basic and tertiary education until the early 1980s. Precipitated primarily by a severe drought, stagnant economic growth, mismanagement, and political instability, Ghana undertook major economic reforms with prodding from the World Bank and International Monetary Fund in a bid to salvage the economy. These economic measures included cost recovery and cutback spending in education and health sectors. However, in recent years, purposive targeted interventions have been pursued to address inequalities in education and health care. These new programs include the Education Capitation Grant, school feeding program, and the National Health Insurance Scheme (NHIS, which are propelling Ghana toward the achievement of the Millennium Development Goals. The prospects of these programs in addressing disparities in access to education and health care in the country and recommendations for improved delivery are discussed.

  8. Health care for prisoners in Haiti.

    Science.gov (United States)

    May, John P; Joseph, Patrice; Pape, Jean William; Binswanger, Ingrid A

    2010-09-21

    Prisoners have disproportionate health care needs. Meeting those needs in a prison environment is challenging, especially in such resource-poor countries as Haiti. Even so, before the January 2010 earthquake, local and international organizations, in collaboration with the Haitian government, had been making significant progress to provide for the health needs of prisoners. The effort screened and identified prisoners for infectious disease, initiated appropriate care and treatment, and prepared prisoners for release to the community. Not only is it possible to establish an adequate prison health care program in a resource-poor country, it is necessary. Without adequate management of prisoners' health needs, especially for such infectious diseases as HIV and tuberculosis, disease burden increases. Infectious disease can spread among prisoners and impact the public's health. Recovery for postearthquake Haiti, as any nation rebuilding following natural disaster or conflict, requires respect for rule of law. This includes humane detention and the delivery of justice and adequate health care for prisoners.

  9. [Renewing primary health care in the Americas].

    Science.gov (United States)

    Macinko, James; Montenegro, Hernán; Nebot Adell, Carme; Etienne, Carissa

    2007-01-01

    At the 2003 meeting of the Directing Council of the Pan American Health Organization (PAHO), the PAHO Member States issued a mandate to strengthen primary health care (Resolution CD44. R6). The mandate led in 2005 to the document "Renewing Primary Health Care in the Americas. A Position Paper of the Pan American Health Organization/WHO [World Health Organization]," and it culminated in the Declaration of Montevideo, an agreement among the governments of the Region of the Americas to renew their commitment to primary health care (PHC). Scientific data have shown that PHC, regarded as the basis of all the health systems in the Region, is a key component of effective health systems and can be adapted to the range of diverse social, cultural, and economic conditions that exist. The new, global health paradigm has given rise to changes in the population's health care needs. Health services and systems must adapt to address these changes. Building on the legacy of the International Conference on Primary Health Care, held in 1978 in Alma-Ata (Kazakhstan, Union of Soviet Socialist Republics), PAHO proposes a group of strategies critical to adopting PHC-based health care systems based on the principles of equity, solidarity, and the right to the highest possible standard of health. The main objective of the strategies is to develop and/or strengthen PHC-based health systems in the entire Region of the Americas. A substantial effort will be required on the part of health professionals, citizens, governments, associations, and agencies. This document explains the strategies that must be employed at the national, subregional, Regional, and global levels.

  10. Community care in practice: social work in primary health care.

    Science.gov (United States)

    Lymbery, M; Millward, A

    2001-01-01

    This paper examines the establishment of social work within primary health care settings in Great Britain, following the passage of the National Health Service and Community Care Act in 1990. Although the improvement of relationships between social workers and primary health care teams has been promoted for a number of years, the advent of formal policies for community care has made this a priority for both social services and health. This paper presents interim findings from the evaluation of three pilot projects in Nottinghamshire, Great Britain. These findings are analysed from three linked perspectives. The first is the extent to which structures and organisations have worked effectively together to promote the location of social workers within health care settings. The second is the impact of professional and cultural factors on the work of the social worker in these settings. The third is the effect of interpersonal relationships on the success of the project. The paper will conclude that there is significant learning from each of these perspectives which can be applied to the future location of social workers to primary health care.

  11. Subjective experienced health as a driver of health care behavior

    NARCIS (Netherlands)

    Bloem, S.; Stalpers, J.

    2012-01-01

    This paper describes the key role of the subjective experience of health as the driver of health related behavior. Individuals vary greatly in terms of behaviors related to health. Insights into these interindividual differences are of great importance for all parties involved in health care, includ

  12. Make a Move: A Comprehensive Effect Evaluation of a Sexual Harassment Prevention Program in Dutch Residential Youth Care.

    Science.gov (United States)

    van Lieshout, Sanne; Mevissen, Fraukje E F; van Breukelen, Gerard; Jonker, Marianne; Ruiter, Robert A C

    2016-06-27

    Sexual harassment-unwanted sexual comments, advances, or behaviors-and sexual violence are still prevalent worldwide, leading to a variety of physical, cognitive, and emotional problems among those being harassed. In particular, youth in care are at risk of becoming perpetrators (and victims) of sexual harassment. However, in general, there are very few interventions targeting this at-risk group, and no such programs exist in the Netherlands. To this end, a group intervention program-Make a Move-targeting determinants of sexual harassment was developed. This program was implemented and evaluated among boys (N = 177) in Dutch residential youth care (20 institutions). A pre-test, post-test, and 6-month follow-up design including an intervention and a waiting list control group with randomized assignment of institutions (cluster randomized trial) was used to measure the effects of the intervention on determinants of sexual harassment. Multilevel (mixed) regression analysis with Bonferroni correction for multiple testing (α = .005) showed no significant effects of Make a Move on determinants of sexual harassment (ps > .03, Cohen's ds < .44). Results are discussed in light of a three-way explanatory model focusing on intervention content, evaluation, and implementation as potential explanations for not finding any measurable intervention effects.

  13. The Right to Health Care and Health Insurance Law

    OpenAIRE

    井上, 英夫

    1997-01-01

    The purpose of this paper is to consider the legality of decision for medical treatment expenses under Health Insurance Law. The following issues are discussed: The right to health and Connstitution of Japan; The right to health and Medical Social Security Law; History and concept of Health Insurance Law; Health Insurance Law and the right to self-determination and freedom of medical treatment selection; Care of acupuncture and moxa cautery and medical teratment expenses under Health Insuranc...

  14. [Information in health care: the use of SIAB by the professional teams of Family Health Care].

    Science.gov (United States)

    Marcolino, Janaína Souza; Scochi, Maria José

    2010-06-01

    The remarkable expansion of Family Health Care Program and the discussion of issues related to the amount of the collected data stimulated the need for designing an information system that embraced the complex organization of basic health care. So, in 1998, the Basic Health Care Information System (SI4B) was founded. This research aimed to investigate the use of SIAB by the professional teams of the Family Health Care. A questionnaire was applied to 75 professionals belonging to 10 teams which were observed, one week each. The study evidenced that the Family Health Care teams that participated in this research have not used the available information for planning or assessing their health care services, and so, they have missed the opportunity of using the available information for health care local needs.

  15. Cautioning Health-Care Professionals

    Science.gov (United States)

    Schut, Henk; Boerner, Kathrin

    2017-01-01

    Science and practice seem deeply stuck in the so-called stage theory of grief. Health-care professionals continue to “prescribe” stages. Basically, this perspective endorses the idea that bereaved people go through a set pattern of specific reactions over time following the death of a loved one. It has frequently been interpreted prescriptively, as a progression that bereaved persons must follow in order to adapt to loss. It is of paramount importance to assess stage theory, not least in view of the current status of the maladaptive “persistent complex bereavement-related disorder” as a category for further research in DSM-5. We therefore review the status and value of this approach. It has remained hugely influential among researchers as well as practitioners across recent decades, but there has also been forceful opposition. Major concerns include the absence of sound empirical evidence, conceptual clarity, or explanatory potential. It lacks practical utility for the design or allocation of treatment services, and it does not help identification of those at risk or with complications in the grieving process. Most disturbingly, the expectation that bereaved persons will, even should, go through stages of grieving can be harmful to those who do not. Following such lines of reasoning, we argue that stage theory should be discarded by all concerned (including bereaved persons themselves); at best, it should be relegated to the realms of history. There are alternative models that better represent grieving processes. We develop guidelines to enhance such a move beyond the stage approach in both theory and practice. PMID:28355991

  16. Relationship between the presence of baccalaureate-educated RNs and quality of care: a cross-sectional study in Dutch long-term care facilities.

    Science.gov (United States)

    Backhaus, Ramona; van Rossum, Erik; Verbeek, Hilde; Halfens, Ruud J G; Tan, Frans E S; Capezuti, Elizabeth; Hamers, Jan P H

    2017-01-19

    Recent evidence suggests that an increase in baccalaureate-educated registered nurses (BRNs) leads to better quality of care in hospitals. For geriatric long-term care facilities such as nursing homes, this relationship is less clear. Most studies assessing the relationship between nurse staffing and quality of care in long-term care facilities are US-based, and only a few have focused on the unique contribution of registered nurses. In this study, we focus on BRNs, as they are expected to serve as role models and change agents, while little is known about their unique contribution to quality of care in long-term care facilities. We conducted a cross-sectional study among 282 wards and 6,145 residents from 95 Dutch long-term care facilities. The relationship between the presence of BRNs in wards and quality of care was assessed, controlling for background characteristics, i.e. ward size, and residents' age, gender, length of stay, comorbidities, and care dependency status. Multilevel logistic regression analyses, using a generalized estimating equation approach, were performed. 57% of the wards employed BRNs. In these wards, the BRNs delivered on average 4.8 min of care per resident per day. Among residents living in somatic wards that employed BRNs, the probability of experiencing a fall (odds ratio 1.44; 95% CI 1.06-1.96) and receiving antipsychotic drugs (odds ratio 2.15; 95% CI 1.66-2.78) was higher, whereas the probability of having an indwelling urinary catheter was lower (odds ratio 0.70; 95% CI 0.53-0.91). Among residents living in psychogeriatric wards that employed BRNs, the probability of experiencing a medication incident was lower (odds ratio 0.68; 95% CI 0.49-0.95). For residents from both ward types, the probability of suffering from nosocomial pressure ulcers did not significantly differ for residents in wards employing BRNs. In wards that employed BRNs, their mean amount of time spent per resident was low, while quality of care on most wards was

  17. Implementation of integrated care for diabetes mellitus type 2 by two Dutch care groups : A case study

    NARCIS (Netherlands)

    Busetto, Loraine; Luijkx, Katrien; Huizing, Anna; Vrijhoef, H.J.M.

    2015-01-01

    Background Even though previous research has demonstrated improved outcomes of integrated care initiatives, it is not clear why and when integrated care works. This study aims to contribute to filling this knowledge gap by examining the implementation of integrated care for type 2 diabetes by two Du

  18. Overcoming marginalisation? Gender and ethnic segregation in the Dutch construction, health, IT and printing industries.

    NARCIS (Netherlands)

    M. van der Meer; J. Roosblad

    2004-01-01

    It is common knowledge that indigenous men generally have a better position in the labour market than women and ethnic minorities. This study deals with the question why this is the case in certain sectors of the Dutch economy. The text discusses the labour market attainment for women and ethnic min

  19. Overcoming marginalisation? Gender and ethnic segregation in the Dutch construction, health, IT and printing industries

    NARCIS (Netherlands)

    M. van der Meer; J. Roosblad

    2004-01-01

    It is common knowledge that indigenous men generally have a better position in the labour market than women and ethnic minorities. This study deals with the question why this is the case in certain sectors of the Dutch economy. The text discusses the labour market attainment for women and ethnic min

  20. Total quality management in health care.

    Science.gov (United States)

    McDonald, S C

    1994-01-01

    Total quality management (TQM), continuous quality improvement (CQI) and quality control are terms that are becoming very familiar to workers in the health care environment. The purpose of this article is to discuss these terms and the concepts they describe. The origins of TQM and the keen interest in its application to the health care environment today are addressed. In other environments, TQM has shown significant increases in productivity while increasing effectiveness. Its application to the health care environment is the provision of the best possible care through continuously improving service to meet or exceed the needs and expectations of the customer. The customer in the health care environment could be the patient, staff, physician and community serviced by the hospital. Characteristics of the new organizational structure are reviewed. Established techniques and processes are commonly used to identify process-improvement opportunities to assist the manager in continuously evaluating quality trends.