Zorggebruik en beloning van medisch specialisten

De introductie van het nieuwe zorgstelsel in 2006 had als doel om een efficiëntere zorgverlening en betere kwaliteit van de zorg te realiseren. Regio’s vertonen tijdspersistente verschillen in het aantal behandelingen in ziekenhuizen bij eenzelfde zorgvraag tussen 2006 en 2009. Deze verschillen hangen sterk samen met het aantal artsen en de beloningsstructuur van de specialist. De prikkel tot meer behandelen speelt sterker bij vrij gevestigde specialisten dan bij specialisten in loondienst

Levels of red blood cell fatty acids in patients with psychosis, their unaffected siblings, and healthy controls

Background: Two recent meta- Analyses showed decreased red blood cell (RBC) polyunsaturated fatty acids (FA) in schizophrenia and related disorders. However, both these meta- Analyses report considerable heterogeneity, probably related to differences in patient samples between studies. Here, we investigated whether variations in RBC FA are associated with psychosis, and thus may be an intermediate phenotype of the disorder. Methods: For the present study, a total of 215 patients (87% outpatients), 187 siblings, and 98 controls were investigated for multiple FA analyses. Based on previous studies, we investigated docosahexaenoic acid (DHA), docosapentaenoic acid (DPA), arachidonic acid (AA), linoleic acid (LA), nervonic acid (NA), and eicasopentaenoic acid (EPA). On an exploratory basis, a large number of additional FA were investigated. Multilevel mixed models were used to compare the FA between the 3 groups. Results: Compared to controls, both patients and siblings showed significantly increased DHA, DPA, AA, and NA. LA was significantly higher in siblings compared to controls. EPA was not significantly different between the 3 groups. Also the exploratory FA were increased in patients and siblings. Conclusions: We found increased RBC FA DHA, DPA, AA, and NA in patients and siblings compared to controls. The direction of change is similar in both patients and siblings, which may suggest a shared environment and/or an intermediate phenotype. Differences between patient samples reflectin