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Biomedical subjects

J C van Es

Publications and source records attributed to J C van Es.

13 recordsLinked to original sources
PubMed2001

[Dutch-Romanian cooperation in the area of family practice].

During the years 1992-2000, there was a cooperative programme between the Romanian general practitioners' association (Societatea Nationala de Medicina Generala) in Romania and the Dutch Foundation for the Advancement of Quality in Healthcare in Romania. A succession of programmes were developed and carried out, which were financed by the Dutch government. The purpose of the cooperative programme was to support the development of Romanian general practice in terms of quality and structure. In the first programme, financed by the Dutch Ministry of Health, Welfare and Sport, about 200 Romanian general practitioners received continuing education. This was followed by a social transformation programme (MATRA) that had two parts: (a) the general practitioners association was supported and advised with respect to improving its organisational efficiency and (b) about 50 carefully selected Romanian general practitioners were trained, in post-academic research, management or teaching. The Romanian authorities accredited these trainees as teachers. The co-operation is being continued in 2001 with the setting up of a sentinel station programme in which 100 Romanian general practitioners collect relevant, representative data on health, illness and practice.

Education, Medical, Graduate↗
PubMed1999

[The SGO Health Research Promotion Program. XIV. Final evaluation].

In the Netherlands, the SGO Health Research Promotion Programme was carried out from 1986 until 1997. The aim of the programme was to strengthen patient-oriented clinical research in specific fields of medicine. Some of the programme sections certainly produced a number of good publications in established national and international journals, but the programme advisory committee's main objective was to bring about a cultural change in the field of health care investigation: awareness of the principle that scientific and notably patient-centred investigation has a place in its own right in research, education and care. This resulted in a large diversity of methods of stimulation ranging from stimulation of co-operation between researchers, training of physician researchers, support of methodology development, stimulation of education and postgraduate training, to establishment of actual institutes for clinical scientific research. Patient-oriented research is the necessary link within the continuum of health research, medical education and care. Changing social and demographic developments ask for continuous innovation of this type of research. Top-down steering, as practised by the SGO, can be necessary and effective to reach this innovation.

Health Policy↗
PubMed1984

Written simulation of patient-doctor encounters. 1. Research instrument for registration of the performance of general practitioners.

A written simulation of patient-doctor encounters is described, involving five patients with vague complaints, an 'instruction' patient with sinusitis and a 'test' patient with acute appendicitis. Nineteen general practitioners were confronted with it. The extent to which the simulation distorted reality and the implications of such distortions were considered in an attempt to assess the content validity. The conclusion was that the simulation gave a realistic impression of the general practitioners' diagnostic and therapeutic approach to patients with vague complaints. The searching procedures in relation to the complaint and the patient's perception of the complaint were adequately depicted, and the therapeutic procedures approximated closely to reality. There was some distortion in the attention paid to psychosocial aspects as these were given more attention in the simulation than they receive in reality.

Acute Disease↗
PubMed1984

Written simulation of patient-doctor encounters. 2. Assessment of the performance of general practitioners.

Two rating procedures were used to judge the performance of 19 general practitioners confronted with a written simulation of patient-doctor encounters. The simulation comprised five patients with vague complaints. A group of three 'expert' general practitioners judged the attention that the doctors paid to somatic aspects or to causes of the complaints. A second group of 18 experts judged the extent to which the therapeutic procedures of the general practitioners might induce a risk of unnecessary harm to the patient. Both rating procedures were shown to be reliable for three of the five simulated patients. A weak correlation between these issues was established for these three patients. The problems of judging the behaviour of the practitioners with the other two patients are discussed. The performance of the general practitioners was relatively constant. Variability between individuals substantially exceeded variability within an individual with respect to the attention given to somatic aspects, but these variabilities were roughly equal with respect to the risk of causing unnecessary harm.

Adult↗
PubMed1984

Written simulation of patient-doctor encounters. 3. Comparison of the performance in the simulation with prescription and referral data in reality.

The performance of 19 general practitioners in a written simulation of patient-doctor encounters was compared with real data on prescription and referral from 'sick-fund' patients. Two issues were studied: the amounts of certain drugs prescribed (analgesics and antirheumatics; hypnotics/sedatives and tranquillizers; neuroleptics and antidepressants) and the number of referrals to specialists. In the simulation, experts assessed the 'risk of unnecessary harm to the patient' induced by the therapeutic procedures of these general practitioners, as described previously. A close correlation was found between the ratings of the risk of unnecessary harm in the simulation and the prescription and referral data in reality for general practitioners who were consistently generous or frugal in prescribing the above drugs and referring the patients to specialists. The tentative conclusion is that the written simulation with its rating procedure discriminates reliably between general practitioners who induce less risk of unnecessary harm from those who are likely to cause harm to the patient.

Analgesics↗