Publications by authors named "Kees Ahaus"

Living kidney donors voluntarily donate one of their kidneys to someone suffering from end-stage kidney disease. Transplantation is a life-saving opportunity for these patients and generally provides an increase in quality of life. A major goal of research and practice related to living kidney donation concerns the safety of the donor.

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Background: The prevalence of patient (and their relatives/friends) aggression and violence against healthcare professionals in general, and physicians in particular, is a recognized problem worldwide. While numerous risk factors for such aggression and violence from patients (and their relatives/friends) have been identified, little is known about which risk factors are perceived as relatively most important in a specific context and among a particular group, and about the potentially differing views on the relative importance. This lack of insight prohibits preventive measures being tailored to address the main risk factors.

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Background: While aiming to optimize patient value, the shift towards Value-Based Health Care (VBHC) in hospitals worldwide has been argued to benefit healthcare professionals as well. However, robust evidence regarding VBHC's workforce implications is lacking. This gap is problematic, as the motivation and health of healthcare professionals are central to the quality of care and crucial amidst contemporary workforce challenges.

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Background: Non-pharmacological dementia research products, such as social and behavioural interventions, are generated in traditional university settings. These often experience challenges to impact practices that they were developed for. The Netherlands established five specialized academic health science centres, referred to as Alzheimer Centres, to structurally coordinate and facilitate the utilization of dementia research knowledge.

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Problem: Women's preferences regarding care delivery during labour and birth remain insufficiently understood. Obtaining a clear understanding of these is important to realise a maternity care system that is future-proof and person-centred.

Background: Dutch maternity care deals with capacity issues due to staff shortages.

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Background: Health economic evaluations require cost data as a key input, and reimbursement policies and systems should incentivize valuable care. Subfertility is a growing global phenomenon, and Dutch per-treatment DRGs alone do not support value-based decision-making because they don't reflect patient-level variation or the impact of technologies on costs across entire patient pathways.

Methods: We present a real-world micro-costing analysis of subfertility patient pathways (n = 4.

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Article Synopsis
  • Real-time access to test results can be both beneficial and stressful for patients, as it requires them to decide whether to view results before consulting a doctor.
  • Through discourse analysis of interviews with 28 patients, three main perspectives on this access were identified: it can cause stress, reduce anxiety, and enhance self-management.
  • The findings highlight the varied opinions on real-time access, suggesting the need for tailored strategies to assist patients in effectively using this feature.
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  • - The study aimed to improve response rates for patient-reported outcome measures (PROMs) among outpatients at a Dutch university hospital, identifying characteristics that influence patient engagement and response behavior.
  • - Researchers analyzed internal hospital strategies using the COM-B model and found that while response rates improved to 56%, challenges like language barriers and effective feedback mechanisms still existed.
  • - The analysis revealed that patients with higher socioeconomic status and those attending in-person consultations were more likely to complete PROMs, highlighting the need for tailored engagement strategies to promote equity in healthcare.
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Background: Despite the increasing use of patient-reported outcome measures (PROMs) for collecting self-reported data among hospital outpatients, clinicians' use of these data remains suboptimal. Insight into this issue and strategies to enhance the use of PROMs are critical but limited.

Objective: This study aimed to examine clinicians' use of PROM data for value-based outpatient consultations and identify efforts to enhance their use of PROMs in a Dutch university hospital.

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Article Synopsis
  • The study aimed to explore patients' views on the ethical principles for fair surgical resource allocation during the COVID-19 pandemic, as healthcare professionals' perspectives had been more highlighted.
  • Researchers conducted a Q-methodology study with 16 patient representatives in the Netherlands, where participants ranked 20 statements on fair allocation and engaged in interviews.
  • Two main perspectives emerged, both supporting utilitarianism: one focused on maximizing individual health outcomes based on clinical needs, while the other considered broader societal contributions alongside health gains.
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Background: While healthcare organizations in several countries are embracing Value-Based Health Care (VBHC), there are limited insights into how to achieve this paradigm shift. This study examines the decade-long (2012-2023) change towards VBHC in a pioneering Dutch university hospital.

Method: Through retrospective, complexity-informed process research, we study how a Dutch university hospital's strategy to implement VBHC evolved, how implementation outcomes unfolded, and the underlying logic behind these developments.

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The implementation of Value-Based Healthcare (VBHC) has spread across international healthcare systems, aiming to improve decision-making by combining information about patient outcomes and costs of care. Time-Driven Activity-Based Costing (TDABC) is introduced as a pragmatic yet accurate method to calculate costs of care pathways. It is often applied to demonstrate value-improving opportunities, such as interventions aimed at service delivery redesign.

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Introduction: Global interest is growing in new value-based models of financing, delivering, and paying for health care services that could produce higher-quality and lower cost outcomes for patients and for society. However, research indicates evidence gaps in knowledge related to alternative payment models (APMs) in early experimentation phases or those contracted between private insurers and their health care provider-partners. The aim of this research was to understand and update the literature related to learning how industry experts design and implement APMs, including specific elements of their models and their choice of stakeholders to be involved in the design and contractual details.

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Article Synopsis
  • - This study examined the changes in length of stay (LoS) for very preterm infants in NICUs and identified what factors influenced these trends over time in the Netherlands from 2008 to 2021.
  • - It found that overall LoS increased by an average of 5.1 days, primarily due to longer stays at level II hospitals, while NICU stays remained stable.
  • - The increase in LoS is linked to more severe complications in extremely preterm infants, suggesting that the health challenges faced by these infants directly impact their duration in care before discharge.
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Background: Recent research within the context of Obstetrics shows the added value of patient participation in in-hospital patient safety. Notwithstanding these benefits, recent research within an Obstetrics department shows that four different negative effects of patient participation in patient safety have emerged. However, the approach to addressing these negative effects within the perspective of patient participation in patient safety is currently lacking.

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Value-based payment aims to shift the focus from traditional volume-driven arrangements to a system that rewards providers for the quality and value of care delivered. Previous research has shown that it is difficult for providers to change their medical and organizational practices to adopt value-based payment, but the role of actors in these reforms has remained underexposed. This paper unravels the motives of non-clinical and clinical professionals to maintain institutionalized payment practices when faced with value-based payment.

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Patient well-being after an organ transplant is a major outcome determinant and survival of the graft is crucial. Before surgery, patients are already informed about how they can influence their prognosis, for example by adhering to treatment advice and remaining active. Overall, effective selfmanagement of health-related issues is a major factor in successful long-term graft survival.

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Article Synopsis
  • - Informal caregivers for people with dementia often face decreased quality of life and need better implementation strategies for evidence-based interventions (EBIs) to enhance their caregiving experience and outcomes.
  • - A scoping review of studies related to implementation science for home- and community-based EBIs involved searching multiple databases and analyzing various frameworks to assess implementation strategies, outcomes, and influencing factors.
  • - Of the 67 studies reviewed, training and education strategies were most common, with high rates of acceptability, penetration, and appropriateness reported, indicating positive reception and integration of these interventions.
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  • This study evaluates the feasibility of out-of-hospital coaching for severe COPD patients by specialized nurses, focusing on aspects such as cost-effectiveness, implementation, and recipient acceptability.
  • It involved 170 patients over six months, collecting data on health management and hospitalization rates, finding a 24% reduction in hospitalizations and improvements in health status and anxiety.
  • The coaching service was well-received by patients and coaches, indicating its effectiveness and support for both primary and hospital care systems.
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Article Synopsis
  • Value-based healthcare aims to assess care outcomes against the costs of delivery, but providers struggle with cost measurement and often lack data, preventing them from improving value despite pressures.
  • This protocol outlines a study focusing on fertility care that will utilize a sequential design to determine total care costs and identify opportunities for process improvement, using methods like time-driven, activity-based costing.
  • The study has ethical approval and will generate insights for both researchers and medical leaders by combining various data sources to measure costs and outcomes in complex care paths.
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Introduction: In recent years, Value-Based Healthcare (VBHC) has been gaining traction, particularly in hospitals. A core VBHC element is patient value, i.e.

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Background: Patient Reported Outcome Measures (PROMs) are increasingly used in routine clinical practice to facilitate patients in sharing and discussing health-related topics with their clinician. This study focuses on the implementation experiences of healthcare professionals and patients during the early implementation phase of the newly developed Dutch set of dialysis PROMs and aims to understand the process of early implementation of PROMs from the users' perspectives.

Methods: This is a qualitative study among healthcare professionals (physicians and nursing staff: n = 13) and patients (n = 14) of which 12 were receiving haemodialysis and 2 peritoneal dialysis.

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Article Synopsis
  • The study examines patient preferences for when to receive their online test results via hospital portals, noting varying disclosure times from immediate to a possible 28-day delay.
  • Out of 4,592 participants, most preferred a 1-day delay for lab results and a 7-day delay for radiology/pathology results, while 43 patients changed their initial preferences.
  • Interviews revealed that many patients value transparency and quick access to information, with some seeking shorter delays for reassurance, while others preferred longer delays to reduce anxiety about unexpected or difficult news.
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The COVID-19 pandemic hit long-term care, and particularly nursing homes hard. We aimed to explore how crisis management goals and tasks evolve during such a prolonged crisis, using the crisis management tasks as identified by Boin and 't Hart as a starting point. This longitudinal, qualitative study comprises 47 interviews with seven Dutch nursing home directors and a focus group.

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