Research Themes Healthcare improvement science In healthcare place matters and value for patients differs

It is common knowledge that in all modern healthcare systems medical practice varies from place to place and that the care patients get largely depends on the door they knock on. This is also the case in the Netherlands. Our research states that the current situation can be improved and that transparency of healthcare usage, expenditures and outcomes will help to start an improvement cycle with four stages: map (regional differences in use, costs and outcomes), analyze, share, and change.
In this process it is important that the providers are on board and one should give attention to an additional cycle, the so called four stages of grief that always pop up: (i) The data aren’t right; (ii) My patients are sicker; (iii) It may be a problem, but it is not my problem; (iv) Let’s roll up the sleeves and learn what is going on here.
In 2014 and 2015 HcIS researchers together with, and funded by, the National Patient Consumer Federation (NPCF) initiated this value improvement cycle for seven diseases/treatments: Lumbar Disc Surgery, CTS, Gallbladder, Cataract, Knee replacements, Hip replacements, and Groin rupture. At present, we have ‘gone through the full cycle’ for lumbar disc surgery.

Infographics were presented that –besides general information about the diagnosis, its causes, and possible treatments– give a coherent picture of regional differences in healthcare usage, quality, and costs for lumbar disc surgery, and help people think over its consequences.

In 2017 HcIS has completed these steps for 8 diseases / procedures. Reducing unwarranted care is one of the policy goals of the Ministry of Health, Welfare and Sport; HcIS facilitates the stakeholders to achieve the targets that have been agreed upon at a national level by providers, insurers, and NPCF.