'Met 50 procent van de informatie 100 procent beslissen', dat doet de zorg al jaren

Deze uitspraak van premier Rutte vonden we best wel legitiem gezien de bijzondere omstandigheden. Wilfried Opheij vroeg zich in zijn blog deze week af of dit “netwerkleiderschap, crisismanagement of floreren van hiërarchische leiders” is. Je zou ook kunnen stellen dat de autoriteiten onder extreme onzekerheid beslissingen moeten nemen

Power, legitimacy and urgency:Unravelling the relationship between Dutch healthcare organisations and their financial stakeholders

Healthcare organisations rely on their financial stakeholders for capital to invest in state-of-the-art buildings, equipment, innovation and the delivery of healthcare services. Nevertheless, relations between healthcare organisations and their financial stakeholders have not been well studied. Here, we studied the relations between Dutch healthcare organisations and two of their main financial stakeholders (banks and health insurers) against the backdrop of system reforms and the financial crisis. We conducted a survey of healthcare executives to evaluate their relations with banks and health insurers in terms of power, legitimacy and urgency. These three attributes are based on the salience model of Mitchel, Agle and Wood (1997). We further tested for differences in power, legitimacy and urgency across organisational sector and size. The results showed that healthcare organisations value banks as legitimate stakeholders with a well-demarcated influence and a clear-cut function. The relationship with health insurers is more complex. Healthcare organisations experience considerable influence from health insurers but question the legitimacy of their claims. Since health insurers play a crucial role in the Dutch healthcare system, these findings question the workability of the relationship between healthcare organisations and health insurers and the position of health insurers in the overall healthcare sector. Our results are relevant to countries with public-private health systems and contribute to the development of the salience model by showing the individual value of stakeholder attributes and the relevance of context

Redesigning mental healthcare delivery

Objective. Many studies have investigated the effect of redesign on operational performance; fewer studies have evaluated th

Symptomatic and Functional Remission in Young Adults with a Psychotic Disorder in a Rehabilitation Focused Team

The aim of this study is to assess symptomatic remission (SR) and functional remission (FR) in a rehabilitation focused program for young adults with a psychotic disorder in the Netherlands, and to investigate which individual and mental health care factors are associated with SR and/or FR, by using Routine Outcome Monitoring data and data on met needs and unmet needs for care. Data of 287 young adults were collected. Almost 40% achieved or maintained SR, 34% FR, and 26% achieved or maintained both. In addition to sociodemographic factors, living independently, paid employment, higher levels of compliance with treatment, and better fulfillment of unmet needs for care in relation to psychological distress, company and daytime activities were associated with better outcomes on SR and/or FR. Our findings underscore that to successfully improve and sustain remission in young adults with a psychotic disorder, it is needed to conduct specific research into the relationship between SR and FR

A Cost-Effectiveness Analysis to Evaluate a System Change in Mental Healthcare in the Netherlands for Patients with Depression or Anxiety

Over the last decade, the Dutch mental healthcare system has been subject to profound policy reforms, in order to achieve affordable, accessible, and high quality care. One of the adjustments was to substitute part of the specialized care for general mental healthcare. Using a quasi-experimental design, we compared the cost-effectiveness of patients in the new setting with comparable patients from specialized mental healthcare in the old setting. Results showed that for this group of patients the average cost of treatment was significantly reduced by, on average, €2132 (p < 0.001), with similar health outcomes as in the old system

Hospital management by product lines

Over the last decennium many reforms of the reimbursement systems have taken .place to improve the economic performance of health service organizations. These environmental changes have stimulated many hospital managers to introduce types of internal management control. Consequently budgeting is a very well known management tool. Less known in Europe is product-line management. The main purpose of this article is to introduce the concept of product-line management. Attention is paid to ways product lines can be defined in hospitals and which elements the implementation of product-line management envelope. Emphasis is laid on the consequences for the organizational structure and the cost information system. Finally, we deal with the advantages and disadvantages of product-line management

Privatisation in Western European Health Care: a comparative study

Since the mid 1970's many countries have at­tempted to develop a strategy for controlling the ratio of growth of public spending. In this strategy privatisation is used as a general in­strument for healing public finance. This paper describes the different types of privatisation in health care which are possible. Further we will analyse in a more quantitative way to what extent privatisation is used in 4 European countries. These countries are the Federal Re­public of Germany, The Netherlands, both representatives of social security based health care systems, and the United Kingdom and Italy, as representatives of countries with a National Health Service. The development of the public health expenditures as

Privatisation in Western European Health Care: a comparative study

Since the mid 1970's many countries have at­tempted to develop a strategy for controlling the ratio of growth of public spending. In this strategy privatisation is used as a general in­strument for healing public finance. This paper describes the different types of privatisation in health care which are possible. Further we will analyse in a more quantitative way to what extent privatisation is used in 4 European countries. These countries are the Federal Re­public of Germany, The Netherlands, both representatives of social security based health care systems, and the United Kingdom and Italy, as representatives of countries with a National Health Service. The development of the public health expenditures as

Power, legitimacy and urgency: Unravelling the relationship between Dutch healthcare organisations and their financial stakeholders

Healthcare organisations rely on their financial stakeholders for capital to invest in state-of-the-art buildings, equipment, innovation and the delivery of healthcare services. Nevertheless, relations between healthcare organisations and their financial stakeholders have not been well studied. Here, we studied the relations between Dutch healthcare organisations and two of their main financial stakeholders (banks and health insurers) against the backdrop of system reforms and the financial crisis. We conducted a survey of healthcare executives to evaluate their relations with banks and health insurers in terms of power, legitimacy and urgency. These three attributes are based on the salience model of Mitchel, Agle and Wood (1997). We further tested for differences in power, legitimacy and urgency across organisational sector and size. The results showed that healthcare organisations value banks as legitimate stakeholders with a well-demarcated influence and a clear-cut function. The relationship with health insurers is more complex. Healthcare organisations experience considerable influence from health insurers but question the legitimacy of their claims. Since health insurers play a crucial role in the Dutch healthcare system, these findings question the workability of the relationship between healthcare organisations and health insurers and the position of health insurers in the overall healthcare sector. Our results are relevant to countries with public-private health systems and contribute to the development of the salience model by showing the individual value of stakeholder attributes and the relevance of context