Do conceptualisations of health differ across social strata? A concept mapping study among lay people.

The legitimacy of policies that aim at tackling socioeconomic inequalities in health can be challenged if they do not reflect the conceptualisations of health that are valued in all strata. Therefore, this study analyses how different socioeconomic groups formulate their own answers regarding: what does health mean to you

Implementation of a guideline for local health policy making by regional health services: exploring determinants of use by a web survey.

Previous evaluation showed insufficient use of a national guideline for integrated local health policy by Regional Health Services (RHS) in the Netherlands. The guideline focuses on five health topics and includes five checklists to support integrated municipal health policies. This study explores the determinants of guideline use by regional Dutch health professionals

Examining the Link Between Domestic Violence Victimization and Loneliness in a Dutch Community Sample: A Comparison Between Victims and Nonvictims by Type D Personality

The current study investigated whether differences in loneliness scores between individuals with a distressed personality type (type D personality) and subjects without such a personality varied by domestic violence victimization. Participants (N = 625) were recruited by random sampling from the Municipal Basic Administration of the Dutch city of ‘s-Hertogenbosch and were invited to fill out a set of questionnaires on health status. For this study, only ratings for domestic violence victimization, type D personality, feelings of loneliness, and demographics were used. Statistical analyses yielded main effects on loneliness for both type D personality and history of domestic violence victimization. Above and beyond these main effects, their interaction was significantly associated with loneliness as well. However, this result seemed to apply to emotional loneliness in particular. Findings were discussed in light of previous research and study limitations

Key features of an EU health information system: a concept mapping study

Background: Despite the acknowledged value of an EU health information system (EU–HISys) and the many achievements in this field, the landscape is still heavily fragmented and incomplete. Through a systematic analysis of the opinions and valuations of public health stakeholders, this study aims to conceptualize key features of an EU–HISys. Methods: Public health professionals and policymakers were invited to participate in a concept mapping procedure. First, participants ( N = 34) formulated statements that reflected their vision of an EU–HISys. Second, participants ( N = 28) rated the relative importance of each statement and grouped conceptually similar ones. Principal Component and cluster analyses were used to condense these results to EU–HISys key features in a concept map. The number of key features and the labelling of the concept map were determined by expert consensus. Results: The concept map contains 10 key features that summarize 93 statements. The map consists of a horizontal axis that represents the relevance of an ‘organizational strategy’, which deals with the ‘efforts’ to design and develop an EU–HISys and the ‘achievements’ gained by a functioning EU–HISys. The vertical axis represents the ‘professional orientation’ of the EU–HISys, ranging from the ‘scientific’ through to the ‘policy’ perspective. The top ranking statement expressed the need to establish a system that is permanent and sustainable. The top ranking key feature focuses on data and information quality. Conclusions: This study provides insights into key features of an EU–HISys. The results can be used to guide future planning and to support the development of a health information system for Europe

Key features of an EU health information system: a concept mapping study

Background: Despite the acknowledged value of an EU health information system (EU–HISys) and the many achievements in this field, the landscape is still heavily fragmented and incomplete. Through a systematic analysis of the opinions and valuations of public health stakeholders, this study aims to conceptualize key features of an EU–HISys. Methods: Public health professionals and policymakers were invited to participate in a concept mapping procedure. First, participants ( N = 34) formulated statements that reflected their vision of an EU–HISys. Second, participants ( N = 28) rated the relative importance of each statement and grouped conceptually similar ones. Principal Component and cluster analyses were used to condense these results to EU–HISys key features in a concept map. The number of key features and the labelling of the concept map were determined by expert consensus. Results: The concept map contains 10 key features that summarize 93 statements. The map consists of a horizontal axis that represents the relevance of an ‘organizational strategy’, which deals with the ‘efforts’ to design and develop an EU–HISys and the ‘achievements’ gained by a functioning EU–HISys. The vertical axis represents the ‘professional orientation’ of the EU–HISys, ranging from the ‘scientific’ through to the ‘policy’ perspective. The top ranking statement expressed the need to establish a system that is permanent and sustainable. The top ranking key feature focuses on data and information quality. Conclusions: This study provides insights into key features of an EU–HISys. The results can be used to guide future planning and to support the development of a health information system for Europe

Factors influencing short-term effectiveness and efficiency of the care provided by Dutch general practice mental health professionals

Introduction: This study examined whether factors related to general practice mental health professionals (GP-MHPs), that is, characteristics of the professional, the function, and the care provided, were associated with short-term effectiveness and efficiency of the care provided by GP-MHPs to adults in Dutch general practice.Methods: A prospective cohort study was conducted among 320 adults with anxiety or depressive symptoms who had an intake consultation with GP-MHPs (n = 64). Effectiveness was measured in terms of change in quality-adjusted life years (QALYs) 3 months after intake; and efficiency in terms of net monetary benefit (NMB) at 3-month follow-up. A range of GP-MHP-related predictors and patient-related confounders was considered.Results: Patients gained on average 0.022 QALYs at 3-month follow-up. The mean total costs per patient during the 3-month follow-up period ((sic)3,864; 95% confidence interval [CI]: (sic)3,196-(sic)4,731) decreased compared to that during the 3 months before intake ((sic)5,220; 95% CI: (sic)4,639-(sic)5,925), resulting largely from an increase in productivity. Providing mindfulness and/or relaxation exercises was associated with QALY decrement. Having longer work experience as a GP-MHP (&gt;= 2 years) and having 10-20 years of work experience as a mental health care professional were negatively associated with NMB. Furthermore, a higher number of homework exercises tended to be related to less efficient care. Finally, being self-employed and being seconded from an organization in which primary care and mental health care organizations collaborate were related to a positive NMB, while being seconded from a mental health organization tended towards such a relationship.Conclusions: Findings seem to imply that the care provided by GP-MHPs contributes to improving patients' functioning. Some GP-MHP-related characteristics appear to influence short-term effectiveness and efficiency of the care provided. Further research is needed to confirm and better explain these findings and to examine longer-term effects.</p

Reconsideration of the scheme of the international classification of functioning, disability and health:Incentives from the Netherlands for a global debate

Purpose: The ICF (International Classification of Functioning, Disability and Health) framework (used worldwide to describe 'functioning' and 'disability'), including the ICF scheme (visualization of functioning as result of interaction with health condition and contextual factors), needs reconsideration. The purpose of this article is to discuss alternative ICF schemes. Method: Reconsideration of ICF via literature review and discussions with 23 Dutch ICF experts. Twenty-six experts were invited to rank the three resulting alternative schemes. Results: The literature review provided five themes: 1) societal developments; 2) health and research influences; 3) conceptualization of health; 4) models/frameworks of health and disability; and 5) ICF-criticism (e.g. position of 'health condition' at the top and role of 'contextual factors'). Experts concluded that the ICF scheme gives the impression that the medical perspective is dominant instead of the biopsychosocial perspective. Three alternative ICF schemes were ranked by 16 (62%) experts, resulting in one preferred scheme. Conclusions: There is a need for a new ICF scheme, better reflecting the ICF framework, for further (inter)national consideration. These Dutch schemes should be reviewed on a global scale, to develop a scheme that is more consistent with current and foreseen developments and changing ideas on health