Landelijke Basisregistratie Ziekenhuiszorg

Met ingang van 1 januari 2014 is de Landelijke Basisregistratie Ziekenhuiszorg (LBZ) in werking getreden. Hiermee zijn de Landelijke Medische Registratie (LMR) en de Landelijke Ambulante Zorg Registratie (LAZR) verleden tijd. De Landelijke Basisregistratie Ziekenhuiszorg (LBZ) is de registratie van medische, administratieve en financiële gegevens van patiënten die een klinische opname, dagopname of langdurige observatie achter de rug hebben of poliklinisch behandeld werden

Enquête Jaarcijfers Ziekenhuizen

Jaarlijkse enquête onder de algemene ziekenhuizen en UMC’s in Nederland naar kengetallen productie, personeel en kosten

Landelijke Medische Registratie (LMR)

Het jaar 2013 is het laatste LMR registratiejaar geweest. Met ingang van 1 januari 2014 is de LMR registratie definitief vervangen door de LBZ-registratie. De voorgaande LMR-jaren zijn met terugwerkende kracht tot 1992 geconverteerd naar de Landelijke Basisregistratie Ziekenhuiszorg (LBZ). Medische en administratieve gegevens van patiënten die klinisch of in dagverpleging opgenomen zijn geweest in een ziekenhuis in Nederland (inclusief in ziekenhuis geborenen, klinisch of dagverpleging maar exclusief poliklinische ziekenhuiszorg)

Landelijke Ambulante Zorg Registratie

Gegevensverzameling in deze vorm met ingang van 01/01/2014 gestopt, nu Landelijke Basisregistratie Ziekenhuiszorg (LBZ). Administratieve gegevens van patiënten die ambulant behandeld zijn op een (buiten-)polikliniek van een ziekenhuis in Nederland

Choosing cooperation over competition; hospital strategies in response to selective contracting

Summary With the introduction of market competition in health care, the Dutch government enabled health insurers to contract hospital care selectively. The assumption is that “selective contracting” will stimulate efficiency, effectiveness, and innovation and will diminish overcapacity. In 2010, the first Dutch health insurers started experimenting with “selective contracting” by setting a minimum treatment volume per year for complex treatments. In an explorative, multiple case study among 15 hospitals in five regions, we found that instead of competing, hospitals started to cooperate and strengthen their networks. The government intended to remove redundant hospital capacity and improve quality by stimulating specialization and concentration. Our study showed that specialization was indeed stimulated, which may have increased quality of care. However, facilitated by the absence of a countervailing power (government or insurer), hospitals in our cases negotiated to the effect of preserving hospital capacity. Within the current political debate between supporters of competition and advocates of a national health service, the importance and role of the (medical) networks should be taken into account. Otherwise, the outcomes of health care governance will be different than intended by either party

Redesigning healthcare: The 2.4 billion euro question?

Although it has been possible to transfer electrocardiograms via a phone line for more than 100 years, use of internet-based patient monitoring and communication systems in daily care is uncommon. Despite the introduction of numerous health-monitoring devices, and despite most patients having internet access, the implementation of individualised healthcare services is still limited. On the other hand, hospitals have invested heavily in massive information systems offering limited value for money and connectivity. However, the consumer market for personal healthcare devices is developing rapidly and with the current healthcare-related investments by tech companies it can be expected that the way healthcare is provided will change dramatically. Although a variety of initiatives under the banner of ‘e-Health’ are deployed, most are characterised by either industry-driven developments without proven clinical effectiveness or individual initiatives lacking the embedding within the traditional organisations. However, the introduction of numerous smart devices and internet-based technologies facilitates the fundamental redesign of healthcare based on the principle of achieving the best possible care for the individual patient at the lowest possible cost. Conclusion The way healthcare is delivered will change, but to what degree healthcare professionals together with patients will be able to redesign healthcare in a structured manner is still a question

Low varicella-related consultation rate in the Netherlands in primary care data

Background: In the Netherlands, a relatively low varicella disease burden compared to other European countries is observed within routine surveillance. To validate this, we estimated the varicella-related consultation rate using The Integrated Primary Care Information database. Methods: In this retrospective cohort study, varicella patients in 2006–2008 were identified by the International Classification of Primary Care (A72) and free text in the electronic medical records, and manually reviewed to be categorised as ‘varicella’ or ‘probable varicella’. The incidence of GP-consultation, specialist referral, emergency department contact and hospitalisation due to varicella was calculated, standardised to the Dutch population. Results: We identified 1881 varicella cases (2348 including probable cases), 14 patients were hospitalised. The overall incidence of GP-consultation due to varicella per 100,000 person-years was at least 281 (95%CI 268–294) and when probable cases were also included at maximum 354 (95%CI 340–369). The overall incidence of specialist referral, emergency department contact and hospitalisation per 100,000 person-years was 3.9 (95%CI 2.7–5.6), 2.5 (95%CI 1.5–4.0) and 2.0 (95%CI 1.2–3.4) respectively. Conclusions: This study confirms the relatively low disease burden due to varicella in the Netherlands. In this study, using primary care data, similar incidences of GP consultation and referral to secondary care due to varicella were found as in routine surveillance. The lower varicella-related consultation rate might be linked to more conservative GP consultation behaviour in the Netherlands, and the relatively young age of infection. This is highly relevant for the decision-making process whether or not to introduce universal childhood varicella vaccination in the Netherlands. (aut.ref.

Heat and emergency room admissions in the Netherlands

Background: Due to a global warming-related increase in heatwaves, it is important to obtain detailed understanding of the relationship between heat and health. We assessed the relationship between heat and urgent emergency room admissions in the Netherlands.Methods: We collected daily maximum temperature and relative humidity data over the period 2002–2007. Daily urgent emergency room admissions were divided by sex, age group and disease category. We used distributed lag non-linear Poisson models, estimating temperature-admission associations. We estimated the relative risk (RR) for urgent hospital admissions for a range of temperatures compared to a baseline temperature of 21 °C. In addition, we compared the impact of three different temperature scenarios on admissions using the RR.Results: There is a positive relationship between increasing temperatures above 21 °C and the RR for urgent emergency room admissions for the disease categories 'Potential heat-related diseases' and 'Respiratory diseases'. This relationship is strongest in the 85+ group. The RRs are strongest for lag 0. For admissions for 'circulatory diseases', there is only a small significant increase of RRs within the 85+ age group for moderate heat, but not for extreme heat. The RRs for a one-day event with extreme heat are comparable to the RRs for multiple-day events with moderate heat.Conclusions: Hospitals should adjust the capacity of their emergency departments on warm days, and the days immediately thereafter. The elderly in particular should be targeted through prevention programmes to reduce harmful effects of heat. The fact that this increase in admissions already occurs in temperatures above 21 °C is different from previous findings in warmer countries. Given the similar impact of three consecutive days of moderate heat and one day of extreme heat on admissions, criteria for activation of national heatwave plans need adjustments based on different temperature scenarios