Hoe slaagt de MOL?

Op donderdag 20 juni j l. hield ik mijn oratie als bijzonder hoogleraar Management en organisatie van de ouderenzorg. De hoofdtitei 'Hoe slaagt de MOL?' ontstond uit het besef dat, naast management en organisatie, leiderschap minstens zo belangrijk is. Deze drie termen creëerden als acroniem dat beestje. Kunnen Management, Organisatie en Leiderschap zorgen voor toekomstbestendige ouderenzorg

Hoe slaagt de mol? Management, organisatie & leiderschap voor toekomstige ouderenzorg

Rede, in verkorte vorm uitgesproken bij de aanvaarding van het ambt van bijzonder hoogleraar Management en Organisatie van Ouderenzorg aan het instituut Beleid & Management Gezondheidszorg van de Faculteit der Geneeskunde en Gezondheidswetenschappen, Erasmus Universiteit Rotterdam, op donderdag 20 juni 201

Economic evaluation of care for the chronically ill: A literature review

Financial problems of governments and the consequent urge to set limits on health care growth have increased the importance of economic rationalization. A systematic review of the present body of knowledge might facilitate the need to set priorities in health care policies and research in an ageing society with growing numbers of the elderly and chronically ill. After explaining the purpose and methods of full economic evaluation, we review the literature on 3 major chronic diseases, diabetes mellitus (20 publications), rheumatoid arthritis (15) and chronic obstructive pulmonary disease (COPD) and asthma (8). This review serves 2 objectives: to review the existing literature and to assess its quality. The review reveals a lack of full economic evaluation in this sector of health care. The total number of references to the specified chronic diseases covers 5% of all economic literature and 44% of all references under Index Medicus' heading 'economics', while the burden of illness is substantial, resulting in high indirect costs to the patients themselves and to society. The dominant approach is cost-effectiveness analysis (71%), followed by cost-benefit analysis (20%). Cost-utility analysis is rare (9%), partly because it is still in the phase of development. However, this approach can deal better with the objectives of many interventions in chronic care, i.e. increasing the quality rather than the quantity of life. We make a plea for full economic evaluation of chronic care programmes and for the development of quality of life measures which cover the broad domain of well-being of the chronically ill

Ouderenzorg verenigt zeven generaties

Vier generaties zorgwerkers leveren straks ouderenzorg aan drie generaties zorgvragers. Het is hoog tijd voor generatiemanagement voor een toekomstbestendige ouderenzor

Effects of an integrated care intervention on informal caregivers: Baseline and One Year Post-implementation

__Abstract__ __Introduction:__ In order to face the challenges associated with an aging population, traditional health care models are increasingly being replaced with integrated care models [1]. However, while evidence exists that these models benefit older people, there is a lack of knowledge about how integrated care affects the informal caregiver [2]. In this study, effects of a new integrated model on the caregivers of frail elderly have been investigated. The model is characterized by an umbrella organizational structure involving case management, multidisciplinary teams, protocols, consultations, and patient files. The aim of this study was to investigate the effects of this model on caregivers in terms of perceived health, quality of life, objective and subjective burden. __Theory and Methods:__ A quasi-experimental design with before/after study and control group was used. Data was gathered using questionnaires (instruments: 2 items of the RAND-36 [3], short form objective burden informal care [4], SRB [5], CarerQoL [6] ,Cantril’s Ladder [7]). Analysis encompassed group comparison using paired and unpaired tests and regression analyses with baseline measurements, control variables (sex, age, relation to care-receiver, living together with care-receiver, income, education, having a life partner, employment, durance of care giving) and the intervention as independent variables. Additionally, analyses of subgroups and interaction effects will be performed. __Preliminary results:__ Within and between group differences were found and indicated significant reductions in health (P<0.1) and life ratings (P<0.1) and more financial problems (P<0.05) for the control group. Regression analysis revealed that caregivers in the intervention group were more likely to take on HDL type tasks (P<0.05) and experienced less financial problems (P<0.05). __Conclusion:__ The integrated care intervention increased the likelihood of caregivers performing HDL tasks and reduced their financial problems