Dutch Health Services Research Articles

Stakeholder involvement in the development of a serious game for and with healthcare professionals

Abstract Increasing pressure on the quality, accessibility and affordability of Dutch health services underlines the need for integrated approaches to healthcare that include lifestyle as preventive measure. Integrated healthcare requires coordinated collaboration between healthcare providers, which is facilitated by the concept of Positive Health as a unifying language. To support primary care providers (PCP) in developing knowledge and skills related to lifestyle as prevention, interdisciplinary collaboration and the concept of Positive Health, we are developing education in the form of a serious game: Game2Connect. Co-creation by active involvement of a consortium of educational institutes, healthcare organisations, a game developer, and PCP as end-users of Game2Connect plays a key role in its development. Data from interviews with PCP (on barriers and facilitators for health-promoting and collaborative behaviours), healthcare recipients (on input for case studies) and consortium meetings were incorporated into an initial version of Game2Connect, which is currently being piloted to assess and improve its utility and usability. Pilot sessions included an observed playthrough, followed by a usability questionnaire and a semi-structured group discussion. So far, 2 pilot sessions were held with consortium members (n = 16), and 3 sessions were held with PCP (n = 22). Learning indicators (e.g. PCP clarifying fellow players’ misconceptions) were observed in all sessions. Usability scores indicate high levels of challenge, content relevance, and positive affect, ranging between 3.3-3.6 on a 4-point scale. Qualitative feedback from group discussions resulted in the development of new case studies to appeal to a broader range of PCP, and the adjustment of a goal-setting exercise as a game component to encourage its use. These results suggest that serious gaming may be a viable and engaging method to educate PCP, especially when developed in active collaboration with stakeholders.

EUPHA office column: EUPHA's founding father retires * EUPHA--ASPHER 2009 conference * WHO regional office for Europe column: The impact of the financial crisis on health and health systems

On 18 December 2008, it was a special day for NIVEL. On that day, both directors from NIVEL—Prof. Jozien Bensing and Prof. Jouke van der Zee—retired as directors, but Prof. Jozien Bensing will continue at NIVEL as honorary research fellow Communication and Health Psychology. The whole afternoon was a festive get-together. In the early afternoon, numerous partners of NIVEL gathered to pay their respects. In the late afternoon and evening, personnel and old colleagues were invited to join in a Christmas/farewell celebration. The whole day had a cosy, family feeling to it. The retirement of Jouke as director of NIVEL also has an impact on EUPHA. Jouke was the founding father of EUPHA and has given us enormous support throughout the years—scientifically, organizationally and financially. His idea of organizing an international part to the Dutch Health Services Research Conference days in Ede in December 1989 can be seen as the start of what later became EUPHA. As an anecdote, only one ‘foreign’ participant was present at that meeting, but it meant that everybody had to present everything in English. After the official establishment of EUPHA in 1992, Jouke remained active as the only permanent …

Changes introduce competition into Dutch health service

Changes introduce competition into Dutch health service

The Dutch health services before compulsory health insurance, 1900-1941.

By 1930, almost all the Dutch population had access to basic medical care encompassing general and specialized medical services, hospital care and community services. The system by which this had been accomplished was determined by the fact that central government was unwilling to accept responsibility for health care by stimulating public services or regulating health insurance. In general, the poor were cared for out of municipal medical relief funds while the rest of the working classes were able to participate in voluntary sickness fund insurance schemes. The middle and upper classes had to rely on private practice, yet they found it increasingly difficult to pay for expensive hospital admissions. Moreover, the financial limitations of voluntary insurance, as well as the dominant position of the medical profession vis-à-vis sickness funds, meant that most funds did not cover hospital care or community services. The actual delivery of these services was often in the hands of private organizations but the municipal authorities paid most of the costs, either through direct payment or through subsidies. Before the introduction of compulsory health insurance in 1941, the highly independent Dutch municipalities did not only care for the poor; they also provided hospital care and community services for almost the entire population. This brought about wide geographical variations in the Dutch health services.

One in seven beds could go in the Netherlands

One in seven acute hospital beds in the Netherlands should be lost by 2000 and more space should be given to outpatient departments, said a government advisory body last week. These adjustments in hospital planning reflect changes in the use of the Dutch health service. During the 1980s the average length of hospital stays dropped 2.5% every year, while first visits to outpatient departments shot up from three million to nearly six million a year. Six months ago Health Minister Hans Simons asked the National Board for Hospital Facilities to reconsider the …

Terminal home care in the Netherlands: An overview

Beginning in the late 1980s, after a long period of declining interest in home care for the terminally ill, several projects and experiments were initiated in the Netherlands. This article describes this trend and provides background information on the Dutch health services, a definition of terminal home care, and statistical information about the different types of home care in the Netherlands. Findings from 3 recent studies of these projects and experiments are presented along with the guidelines for providing good terminal home care formulated by the Dutch Health Council in 1991.