Biomedical subjects

Wim Groot

Publications and source records attributed to Wim Groot.

14 recordsLinked to original sources

PubMed2006

Generic versus specific competencies of entry-level public health graduates: employers' perceptions in Poland, the UK, and the Netherlands.

Constant changes in society and the public health domain force public health professionals into new roles and the development of new competencies. Public health professionals will need to be trained to respond to this challenge. The aim of this comparative study among Poland, the UK and the Netherlands is to identify competence needs for Master of Public Health graduates entering the labour market from a European perspective. A self-administered questionnaire was sent to employers in the three countries, rating the importance of competency in public health on a master's level. In all three countries, interpersonal competencies, like team working and communication skills, are rated as highly important. However, employers in the UK and Poland generally rate public health specific competencies as much more important than their Dutch colleagues. It is concluded that while public health specific knowledge is providing a useful starting point for entry-level public health professionals, employers increasingly recognise the value of generic competencies such as communication and team working skills. The results suggest a stronger emphasis on teaching methods that encourage active learning and the integration of skills, which is crucial for enhancing graduates' employability, and foster an open attitude to multidisciplinary working, which is essential in modern health care.

Education, Graduate↗

PubMed2006

Costs of the 'Hartslag Limburg' community heart health intervention.

BACKGROUND: Little is known about the costs of community programmes to prevent cardiovascular diseases. The present study calculated the economic costs of all interventions within a Dutch community programme called Hartslag Limburg, in such a way as to facilitate generalisation to other countries. It also calculated the difference between the economic costs and the costs incurred by the coordinating institution. METHODS: Hartslag Limburg was a large-scale community programme that consisted of many interventions to prevent cardiovascular diseases. The target population consisted of all inhabitants of the region (n = 180.000). Special attention was paid to reach persons with a low socio-economic status. Costs were calculated using the guidelines for economic evaluation in health care. An overview of the material and staffing input involved was drawn up for every single intervention, and volume components were attached to each intervention component. These data were gathered during to the implementation of the intervention. Finally, the input was valued, using Dutch price levels for 2004. RESULTS: The economic costs of the interventions that were implemented within the five-year community programme (n = 180,000) were calculated to be about euro900,000. euro555,000 was spent on interventions to change people's exercise patterns, euro250,000 on improving nutrition, euro50,000 on smoking cessation, and euro45,000 on lifestyle in general. The coordinating agency contributed about 10% to the costs of the interventions. Other institutions that were part of the programme's network and external subsidy providers contributed the other 90% of the costs. CONCLUSION: The current study calculated the costs of a community programme in a detailed and systematic way, allowing the costs to be easily adapted to other countries and regions. The study further showed that the difference between economic costs and the costs incurred by the coordinating agency can be very large. Cost sharing was facilitated by the unique approach used in the Hartslag Limburg programme.

Cardiovascular Diseases↗

PubMed2006

The compensating income variation of cardiovascular disease.

This paper uses longitudinal data from the British Household Panel Survey to calculate the compensating income variation (CIV) of cardiovascular disease. It is found that the CIV decreases with age and is higher for men than for women. For women the estimated CIV is similar to those calculated by Groot et al. (2004). For men the estimates are somewhat higher than earlier reported.

Adult↗

PubMed2006

A meta-analysis demonstrates no significant differences between patient and population preferences.

BACKGROUND AND OBJECTIVES: To summarize and quantify mean differences between directly elicited patient and population health state evaluations (= preferences) and to identify factors explaining these differences. MATERIALS AND METHODS: Two meta-analyses of observational studies comparing directly elicited patient and population preferences for two stratified health state classifications: actual/hypothetical and hypothetical/hypothetical health states. RESULTS: Thirty-three articles comparing directly elicited patient and population preferences were included, yielding 78 independent preference estimates. These preference estimates served as input for the two stratified health state classifications. Data on health state assessments, elicitation methods, assessment method, and population characteristics was extracted by one reviewer, and checked by two other reviewers. These parameters were used to explain sources of heterogeneity. Overall, patients' actual health state preferences were not significantly higher than populations hypothetical health state preferences (summary mean difference [SMD] = -0.01, 95% confidence interval [CI] = -0.01, 0.03). Nor did preferences for hypothetical health states differ between patients and population (SMD -0.00, 95% CI = -0.02, 0.02). Most parameters substantially influenced the SMD, although the magnitude and direction differed for the two strata used (all P-values <.05). CONCLUSIONS: The actual/hypothetical and hypothetical/hypothetical meta-analyses demonstrated no significant differences between patient and population preferences, suggesting that both can be used to allocate scarce resources.

Consumer Behavior↗

PubMed2006

Duration dependence in sickness absence: how can we optimize disability management intervention strategies?

OBJECTIVE: The optimal timing of interventions during sickness absence remains difficult to determine, because we do not have a clear picture of the presence and type of duration dependence that exists. This study investigates the impact of an intervention by the occupational physician as well as of socioeconomic and work-related factors on duration dependence during sickness absence. METHODS: Analyses were performed at the population level using data from a major longitudinal survey on work incapacity and return to work in The Netherlands. Several models of duration dependence are estimated. RESULTS: Evidence is found for the presence of variable-duration dependence. Characteristics that influence duration dependence of the return-to-work (RTW) rate are identified. CONCLUSIONS: The findings imply that RTW intervention strategies should vary according to differences in workers' susceptibility to positive or negative duration-dependence effects.

Absenteeism↗

PubMed2005

Household health-seeking behaviour in Khartoum, Sudan: the willingness to pay for public health services if these services are of good quality.

In this paper, we analyse the extent of willingness to pay for good quality public health services in relation to the demographic and socio-economic characteristics of respondents. The analysis was carried out by way of a household survey conducted in Khartoum, Sudan in 2001. We studied willingness to pay by means of a contingent valuation method. A logistic regression model was used for the statistical analysis. The results show that the overall percentage of people who are willing to pay for good quality public health services is either 80% or 75% depending on whether respondents already pay for these services (group 1) or not (group 2). They show that although the two groups are willing to pay for good quality public health services, the demographic characteristics that affect the willingness to pay differ between the two groups. The results of the logistic regression analysis for each group are remarkably similar. We conclude that if the quality of services is improved, reasonable fees could be set. This supports the continuity of the policy to recover costs because virtually the majority of the households would be willing to pay reasonable fees.

Adult↗

PubMed2004

Money for health: the equivalent variation of cardiovascular diseases.

This paper introduces a new method to calculate the extent to which individuals are willing to trade money for improvements in their health status. An individual welfare function of income (WFI) is applied to calculate the equivalent income variation of health impairments. We believe that this approach avoids various drawbacks of alternative willingness-to-pay methods. The WFI is used to calculate the equivalent variation of cardiovascular diseases. It is found that for a 25 year old male the equivalent variation of a heart disease ranges from 114,000 euro to 380,000 euro depending on the welfare level. This is about 10,000 euro - 30,000 euro for an additional life year. The equivalent variation declines with age and is about the same for men and women. The estimates further vary by discount rate chosen. The estimates of the equivalent variation are generally higher than the money spent on most heart-related medical interventions per QALY. The cost-benefit analysis shows that for most interventions the value of the health benefits exceeds the costs. Heart transplants seem to be too costly and only beneficial if patients are young.

Age Factors↗

PubMed2004

A direct method for estimating the compensating income variation for severe headache and migraine.

A subjective quality of life measurement method is introduced to calculate the compensating income variation for diseases and handicaps. This approach avoids some of the limitations of existing methods. The method is based on the direct measurement of life satisfaction of individuals. We apply the method to severe headache and migraine. It is found that severe headache and migraine have a large effect on well being and that the compensating income variation for severe headache and migraine is substantial.

Adult↗

PubMed2004

Modelling return-to-work intervention strategies: a method to help target interventions.

The aim of this study is twofold: 1) to investigate the relationship between the probability of receiving an intervention by the occupational physician and the probability of return-to-work (RTW) of sick workers; 2) to explore the use of simultaneous modelling of the intervention and RTW process. Analyses are performed on population level using data from a major longitudinal survey on work incapacity and RTW in the Netherlands. A bivariate probit model is used to estimate the correlation between the probability of intervention and the probability of RTW A bivariate hazard model is applied to explore the joint distribution of the waiting times for the intervention and RTW The results of this study show that the probability of receiving an intervention from the occupational physician is not correlated with the probability of RTW Neither is the timing of both events correlated. The analyses do not indicate that the intervention by the occupational physician provides incentives for sick workers to RTW quicker.

Adult↗

PubMed2003

Scale of reference bias and the evolution of health.

The analysis of subjective measures of well-being-such as self-reports by individuals about their health status is frequently hampered by the problem of scale of reference bias. A particular form of scale of reference bias is age norming. In this study we corrected for scale of reference bias by allowing for individual specific effects in an equation on subjective health. A random effects ordered response model was used to analyze scale of reference bias in self-reported health measures. The results indicate that if we do not control for unobservable individual specific effects, the response to a subjective health state measure suffers from age norming. Age norming can be controlled for by a random effects estimation technique using longitudinal data. Further, estimates are presented on the rate of depreciation of health. Finally, simulations of life expectancy indicate that the estimated model provides a reasonably good fit of the true life expectancy.

Journal Article↗

PubMed2003

Waiting for the doctor: gender differences in the timing of an intervention by the occupational physician.

This study aims to answer the question whether the relatively high inflow risk into disability for women, compared to that for men, is related to a lower chance of being called by the occupational physician during sickness absence. This chance is influenced by sociodemographic, health-related, and work-related factors, as well as by the duration of sickness absence. Using a proportional hazards model, the "risk" of being called by the physician within a certain time period (the so-called hazard rate) is estimated. Kaplan-Meier curves show a gender difference in the hazard rate. Women appear to have a higher chance of being called by the occupational physician (i.e., a shorter waiting time). The influence of the covariates on the hazard rate is estimated using a Weibull model. The Weibull estimations show a negative duration dependence for women, while for men there is no duration dependence. It is concluded that the higher chance for women to be called by the occupational physician is not associated with a gender difference in treatment. Rather, it is the result of a difference in underlying characteristics. Underlying characteristics that significantly predict the waiting time for the occupational physician are in particular related to the labor market position of the employee: educational qualifications, firm size, industry, occupational workload, and job tenure. Other significant predictors are duration and diagnosis.

Absenteeism↗

PubMed2002

Public attitudes towards patient payments in Bulgarian public health care sector: results of a household survey.

This paper analyses the attitudes towards patient payments in the Bulgarian public health care sector. The analysis is based on results of a household survey conducted in the region of Varna (the third largest city in Bulgaria) between May and June 2000. The data are collected through interviews based on a standardised questionnaire and are analysed by non-parametric statistical procedures. The results show that the majority of the respondents accept to pay for public health care services if these services are provided with good quality and quick access. On average, charges for primary and dental care receive higher approval than charges for hospital services. A large percentage of the sample disagrees with charges related to actual service cost or service quality and nearly all respondents consider a ceiling on payments appropriate. According to the majority of the interviewed, the charges should be retained at the place of service provision. The sample shows strong support for an extensive system of exemptions from payments.

Adult↗

PubMed2002

Taking a new course in research on the effectiveness of interventions. A study of physiotherapy interventions for people with musculoskeletal complaints.

Physiotherapy is a commonly employed intervention for people with musculoskeletal complaints. However, due to (methodological) limitations in previous research, the effectiveness of physiotherapy interventions has not yet been proven. The aim of the present study is twofold. First we try to solve some of the methodological problems, of which the most important are selection and endogeneity biases and state dependence. Secondly, the effect of a physiotherapy intervention on recovery from musculoskeletal complaints is investigated. The probability of receiving a physiotherapy intervention is estimated, as well as the probability of recovery as a result of this intervention. A longitudinal design is used. Analyses are performed using secondary data on a populational level. The analytical framework is provided by a Markov model. We use a logit model to estimate transition probabilities of this Markov model. Results show that experience with physiotherapy in the past is an important predictor for receiving physiotherapy in the future. Other predictors of the chance of receiving an intervention are also identified. Furthermore, results indicate that the effect of a physiotherapy intervention on recovery is negative. It is concluded that both the latter effect and the effect of intervention experience can partly be explained by medicalization, in spite of a presence of "severe" cases in the intervention group.

Adolescent↗

PubMedDate not supplied

The importance of quality, access and price to health care consumers in Bulgaria: a self-explicated approach.

One approach to the problem of low patient satisfaction in Bulgaria is to identify attributes of health care services that the consumers value most and to focus on their improvement. Based on data from a household survey, this paper examines the importance that health care consumers attach to quality, access and price. The survey was conducted in 2000 among the population of the region of Varna (the third largest city in Bulgaria). The elicitation of attribute importance was based on a self-explicated method. To analyse the data, an ordered logit regression was performed. The analysis shows that clinical quality is the most valued characteristic by Bulgarian health care consumers compared with social quality, access and price. Given the poor quality of health care provision in Bulgaria, the allocation of revenues to its improvement appears to be essential in order to raise patient satisfaction and to enhance social efficiency.

Bulgaria↗