Can the Use of Health Insurance Claim Data Benefit the Risk-Based Supervision of General Practitioner Practices? An Exploratory Study in the Netherlands.

Background: The Dutch Health and Youth Care Inspectorate has organized a study investigating whether there are benefits to using claim data in the risk-based supervision of general practitioner (GP) practices.

Methods: We identified and selected signals of risks based on interviews with experts. Next, we selected 3 indicators that could be measured in the claim database.

Is there a volume-quality relationship within the independent treatment centre sector? A longitudinal analysis.

Background: The number of independent treatment centres (ITCs) has grown substantially. However, little is known as to whether the volume-quality relationship exists within this sector and whether other possible organisational factors mediate this relationship. The aim of this study is to gain a better understanding of such possible relationships.

What is the impact on the readmission ratio of taking into account readmissions to other hospitals? A cross-sectional study.

Objectives: Readmissions are used widespread as an indicator of the quality of care within hospitals. Including readmissions to other hospitals might have consequences for hospitals. The aim of our study is to determine the impact of taking into account readmissions to other hospitals on the readmission ratio.

Can differences in length of stay between Dutch university hospitals and other hospitals be explained by patient characteristics? A cross-sectional study.

Objectives: The indicator unexpectedly long length of stay (UL-LOS) is used to gain insight into quality and safety of care in hospitals. The calculation of UL-LOS takes patients' age, main diagnosis and main procedure into account. University hospitals have relatively more patients with a UL-LOS than other hospitals.

To what degree can variations in readmission rates be explained on the level of the hospital? a multilevel study using a large Dutch database.

Background: It is not clear which part of the variation in hospital readmissions can be attributed to the standard of care hospitals provide. This is in spite of their widespread use as an indicator of a lower quality of care. The aim of this study is to assess the variation in readmissions on the hospital level after adjusting for case-mix factors.

Re-admission patterns in England and the Netherlands: a comparison based on administrative data of all hospitals.

Background: Examining variation in patterns of re-admissions between countries can be valuable for mutual learning in order to reduce unnecessary re-admissions. The aim of this study was to compare re-admission rates and reasons for re-admissions between England and the Netherlands.

Methods: We used data from 85 Dutch hospitals (1 355 947 admissions) and 451 English hospitals (5 260 227 admissions) in 2014 (96% of all Dutch hospitals and 100% of all English NHS hospitals).

How to identify potentially preventable readmissions by classifying them using a national administrative database.

Importance: Hospital readmissions are being used increasingly as an indicator of quality of care. However, it remains difficult to identify potentially preventable readmissions.

Objectives: To evaluate the identification of potentially preventable hospital readmissions by using a classification of readmissions based on administrative data.

Investigating the Potential Contribution of Patient Rating Sites to Hospital Supervision: Exploratory Results From an Interview Study in the Netherlands.

Background: Over the last decades, the patient perspective on health care quality has been unconditionally integrated into quality management. For several years now, patient rating sites have been rapidly gaining attention. These offer a new approach toward hearing the patient's perspective on the quality of health care.

Influence of Intensified Supervision by Health Care Inspectorates on Online Patient Ratings of Hospitals: A Multilevel Study of More Than 43,000 Online Ratings.

Background: In the Netherlands, hospitals with quality or safety issues are put under intensified supervision by the Dutch Health Care Inspectorate, which involves frequent announced and unannounced site visits and other measures. Patient rating sites are an upcoming phenomenon in health care. Patient reviews might be influenced by perceived quality including the media coverage of health care providers when the health care inspectorate imposes intensified supervision, but no data are available to show how these are related.

Unexpectedly long hospital stays as an indicator of risk of unsafe care: an exploratory study.

Objectives: We developed an outcome indicator based on the finding that complications often prolong the patient's hospital stay. A higher percentage of patients with an unexpectedly long length of stay (UL-LOS) compared to the national average may indicate shortcomings in patient safety. We explored the utility of the UL-LOS indicator.

A pilot study on record reviewing with a priori patient selection.

Objectives: To investigate whether a priori selection of patient records using unexpectedly long length of stay (UL-LOS) leads to detection of more records with adverse events (AEs) compared to non-UL-LOS.

Design: To investigate the opportunities of the UL-LOS, we looked for AEs in all records of patients with colorectal cancer. Within this group, we compared the number of AEs found in records of patients with a UL-LOS with the number found in records of patients who did not have a UL-LOS.

Is the length of stay in hospital correlated with patient satisfaction?

Objective: To investigate the correlation between length of stay (LOS) and patient satisfaction on the level of hospital wards. The underlying hypothesis is that good quality of care leads both to shorter LOS and to patients that are more satisfied.

Design: We used standardized LOS and standardized patient satisfaction data from seven specialisms: internal medicine, cardiology, pulmonology, neurology, general surgery, orthopaedic surgery and obstetrics and gynaecology in the period 2003-2010.

Fifty ways to reduce length of stay: an inventory of how hospital staff would reduce the length of stay in their hospital.

Purpose And Setting: In this study we present a bottom up approach to developing interventions to shorten lengths of stay. Between 1999 and 2009 we applied the approach in 21 Dutch clinical wards in 12 hospitals. We present the complete inventory of all interventions.

Benchmarking and reducing length of stay in Dutch hospitals.

Background: To assess the development of and variation in lengths of stay in Dutch hospitals and to determine the potential reduction in hospital days if all Dutch hospitals would have an average length of stay equal to that of benchmark hospitals.

Methods: The potential reduction was calculated using data obtained from 69 hospitals that participated in the National Medical Registration (LMR). For each hospital, the average length of stay was adjusted for differences in type of admission (clinical or day-care admission) and case mix (age, diagnosis and procedure).