Perspectives of older patients on the preventability of their unplanned emergency department return visit within 30 days in the Netherlands: a multicentre mixed methods study.

Objective: Older adults are prone to unplanned emergency department (ED) return visits (URVs). Knowledge about patient perspectives on the preventability and reasons for these URVs is limited and lacks a representable ED study population. This study aims to determine the proportion of URVs and to explore the preventability and underlying causes as perceived by a wide range of older adults and their caregivers.

Stakeholders' perspectives on capturing societal cost savings from a quality improvement initiative: A qualitative study.

Background: Besides improving the quality of care, quality improvement initiatives often also intend to produce cost savings. An example is prehabilitation, which can reduce complication rates and the length of stay in the hospital. However, the process from utilization reductions to actual societal cost savings remains uncertain in practice.

Understanding regional variation in euthanasia using geomedical frameworks: a critical ethical reflection.

Considerable geographical variation in the uptake of euthanasia has been reported: some municipalities in the Netherlands have a 25 times higher euthanasia rate than other municipalities. Current 'geomedical' frameworks for interpreting practice variation in health care utilization seem inadequately tailored to understand regional variation in morally controversial procedures such as euthanasia. The aim of this conceptual article is threefold: i) to add relevant medical ethical principles to current frameworks; ii) to provide a four-step ethical-geomedical model for the interpretation of geographical differences in the utilization of health care in general and for ethically controversial treatments in specific; iii) to gain better understanding of the existing geographical variation in the incidence of euthanasia by using this framework in our analysis.

Patient, caregiver and professional views on preventable emergency admissions of older patients, a multi-method study in three Dutch hospitals.

Background: Older adults are too often hospitalized from the emergency department (ED) without needing hospital care. Knowledge about rates and causes of these preventable emergency admissions (PEAs) is limited. This study aimed to assess the proportion of PEAs, the level of agreement on perceived preventability between physicians and patients, and to explore their underlying causes as perceived by patients, their relatives, and the admitting physician.