This study provides an in-depth understanding of the perceptions of patients with T2DM before use (acceptability) and after use (acceptance) regarding 4 different mobile health apps for diabetes control and self-management. This study was part of the TOPFIT Citizenlab project. TOPFIT Citizenlab is a 3-year research and innovation program in the eastern part of the Netherlands. Citizens, health care professionals (HCPs), and companies have joined forces with researchers to develop and implement technology for health and well-being.
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Purpose – The purposes of this paper are to 1) give an overview of the prevalence of HR practices that are used to retain vital older workers in health organizations, 2) to examine the evaluations of those HR practices, and 3) to determine the wishes for HR practices in three different target groups:older workers, line managers and HR professionals.Design/methodoly/approach - An inventory case study was conducted based on 51 interviews with older workers, line managers and HR professionals working in 15 hospitals and nursing and care organizations.Findings - Our results showed that maintenance HR practices focused on retaining older workers in their current jobs, in comparison with development HR practices, are by far more prevalent. In addition, maintenance and development HR practices, in general, are assessed being successful.Although wishes appeared to be strongly related to development HR practices, maintenance HR practices are mentioned as well.Originality/value - This paper aims to give an overview of the prevalence of HR practices used to retain older workers in health care organizations vital at work, which practices are evaluated as successful from not only line managers’ and HRM perspective, but from the older workers themselves as well.
Background: The substitution of healthcare is a way to control rising healthcare costs. The Primary Care Plus (PC+) intervention of the Dutch ‘Blue Care’ pioneer site aims to achieve this feat by facilitating consultations with medical specialists in the primary care setting. One of the specialties involved is dermatology. This study explores referral decisions following dermatology care in PC+ and the influence of predictive patient and consultation characteristics on this decision. Methods: This retrospective study used clinical data of patients who received dermatology care in PC+ between January 2015 and March 2017. The referral decision following PC+, (i.e., referral back to the general practitioner (GP) or referral to outpatient hospital care) was the primary outcome. Stepwise logistic regression modelling was used to describe variations in the referral decisions following PC+, with patient age and gender, number of PC+ consultations, patient diagnosis and treatment specialist as the predicting factors. Results: A total of 2952 patients visited PC+ for dermatology care. Of those patients with a registered referral, 80.2% (N = 2254) were referred back to the GP, and 19.8% (N = 558) were referred to outpatient hospital care. In the multivariable model, only the treating specialist and patient’s diagnosis independently influenced the referral decisions following PC+. Conclusion: The aim of PC+ is to reduce the number of referrals to outpatient hospital care. According to the results, the treating specialist and patient diagnosis influence referral decisions. Therefore, the results of this study can be used to discuss and improve specialist and patient profiles for PC+ to further optimise the effectiveness of the initiative.
Value-based healthcare (VBHC) kent een aandoening-specifieke aanpak, gericht op een zorgpad na diagnose en start van behandeling. De aanpak is nog sterk ziekenhuiszorg- georiënteerd en zou zich meer op de volledige zorgcyclus moeten richten. In dit project gaan we onderzoeken hoe preventie geïntegreerd kan worden in de VBHC-benadering. Hiervoor gaan we voor hartrevalidatie in kaart brengen hoe uitkomstinformatie, inclusief patiënt-gerapporteerde uitkomsten, ingezet kan worden bij het samen beslissen over gepersonaliseerde zorg en preventie. Het consortium bestaat uit MKB-partner PRO-F (e-health hartrevalidatie), praktijkpartners Medisch Spectrum Twente (Santeon-Ziekenhuis, thoraxcentrum) en Santeon (samenwerkingsverband zeven topklinische ziekenhuizen), Saxion lectoraten Verpleegkunde en Waarde van Reclasseren (maatschappelijke impact) en Hanzehogeschool lector Waardegedreven Zorg. Door middel van literatuuronderzoek en kwalitatief onderzoek wordt verkend waar de kansen liggen voor het integreren van secundaire preventie in de VBHC-benadering in de hartrevalidatie. Aan de hand van drie focusgroepen met patiënten, verpleegkundigen/artsen en experts worden de voor de patiënt relevante zorguitkomsten verhelderd. Op basis hiervan wordt de vertaalslag gemaakt naar gepersonaliseerde zorguitkomsten en hoe e-health oplossingen dit proces kunnen ondersteunen. Hiermee bieden we (1) inzicht in de mogelijkheden voor preventie binnen de VBHC-werkwijze, (2) kennis over hoe gepersonaliseerde zorg en samen beslissen gefaciliteerd kunnen worden, (3) inzicht in de rol die e-health oplossingen kunnen spelen, (4) kennis over de rol van de verpleegkundige in dit vraagstuk, en (5) een kwalitatief beeld van de impact hiervan.
