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  • 1
    Language: English
    In: BMC family practice, 2019, Vol.20 (1), p.137-137
    Description: Background  This study aims to describe barriers and facilitators of the implementation of a combined lifestyle intervention (CLI) in primary care for patients with chronic disease. The aim of CLI to help patients to create a healthy lifestyle and to maintain this healthy lifestyle. During a CLI a patient receives advice and counselling to improve health-related behavior such as physical activity and diet. Special attention was given to the influence of adding a health promoting financial incentive (HPFI) for the participants to the CLI.  Methods  Twenty-four semi-structured interviews within six care groups were performed between July and October 2017. The interviews were transcribed verbatim and coded by two researchers independently.  Results  Respondents mentioned several preferred characteristics of the CLI such as easy accessibility of the intervention site and the presence of health care professionals during exercise sessions. Moreover, factors that could influence implementation (such as attitude of the health care professionals) and preconditions for a successful implementation of a CLI (such as structural funding and good infrastructure) were identified. Overall, positive HPFIs (e.g. a reward) were preferred over negative HPFIs (e.g. a fine). According to the respondents, HPFIs could positively influence the degree of participation, and break down barriers for participating in and finishing the CLI.  Conclusions  Multiple barriers and facilitators for successful implementation of a CLI were identified. For successful implementing CLIs, a positive attitude of all stakeholders is essential and specific preconditions should be fulfilled. With regard to adding a HPFI, more research is needed to identify the attitude of specific target groups towards an HPFI.
    Subject(s): BEHAVIORS ; CARE ; Chronic Disease - economics ; Chronic Disease - therapy ; Chronic diseases ; Chronic illness ; Community health care ; Diabetes ; Diet, Healthy ; Disease prevention ; Economic incentives ; Exercise ; General & Internal Medicine ; Health Behavior ; Health care expenditures ; Health services ; Humans ; Implementation ; Intervention ; Interviews ; Interviews as Topic ; Life Sciences & Biomedicine ; Lifestyle intervention ; Lifestyles ; Medical research ; Medicine, Experimental ; Medicine, General & Internal ; Monetary incentives ; Motivation ; Nutrition research ; Out of pocket costs ; PARTICIPATION ; Patients ; Physical activity ; Physical fitness ; Primary care ; Primary Health Care ; Primary Health Care - methods ; PROGRAM ; Qualitative research ; Reward ; Risk Reduction Behavior ; Science & Technology
    ISSN: 1471-2296
    E-ISSN: 1471-2296
    Source: BioMedCentral Open Access
    Source: Academic Search Ultimate
    Source: Web of Science - Science Citation Index Expanded - 2019〈img src="http://exlibris-pub.s3.amazonaws.com/fromwos-v2.jpg" /〉
    Source: PubMed Central
    Source: Web of Science - Social Sciences Citation Index – 2019〈img src="http://exlibris-pub.s3.amazonaws.com/fromwos-v2.jpg" /〉
    Source: DOAJ Directory of Open Access Journals - Not for CDI Discovery
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  • 2
    Language: English
    In: Health services research, 2017-02, Vol.52 (1), p.93-112
    Description: Objective The introduction of bundled payment for diabetes care in the Netherlands led to the origination of care groups. This study explored to what extent variation in health care costs per patient can be attributed to the performance of care groups. Furthermore, the commonly applied simple mean aggregation was compared with the more advanced generalized linear mixed model (GLMM) to benchmark health care costs per patient between care groups. Data Source Dutch 2009 nationwide insurance claims data of diabetes type 2 patients (104,544 patients, 50 care groups). Study Design Both a simple mean aggregation and a GLMM approach was applied to rank care groups, using two different health care costs variables: total treatment health care costs and diabetes-specific specialist care costs per diabetes patient. Principal Findings Care groups varied slightly in the first and mainly in the second indicator. Care group variation was not explained by composition. Although the ranking methods were correlated, some care groups’ rank positions differed, with consequences on the top-10 and the low-10 positions. Conclusions Differences between care groups exist when an appropriate indicator and a sophisticated aggregation technique is used. Currently applied benchmarking may have unfair consequences for some care groups.
    Subject(s): Age Factors ; Aged ; Agglomeration ; Aggregation ; bundled payment ; Care group ; Composition ; Cost analysis ; Cost and Resource Use ; Costs ; Diabetes ; Diabetes mellitus ; Diabetes mellitus (non-insulin dependent) ; Diabetes Mellitus, Type 2 - economics ; Diabetes Mellitus, Type 2 - therapy ; Diabetes therapy ; Differences ; Economic aspects ; GLMM ; Health care ; Health care costs ; Health Care Costs - statistics & numerical data ; Health care expenditures ; Health costs ; Health insurance ; Health promotion ; Humans ; Insurance ; Male ; Medical care, Cost of ; Medical research ; Medicine, Experimental ; Netherlands ; Patient care ; Patient Care Bundles - economics ; Patient Care Bundles - statistics & numerical data ; Patients ; Ranking ; Reimbursement, Incentive - statistics & numerical data ; Sex Factors ; Statistical models ; Studies ; Type 2 diabetes ; Type 2 diabetes mellitus ; Variation ; Vektis
    ISSN: 0017-9124
    E-ISSN: 1475-6773
    Source: Hellenic Academic Libraries Link
    Source: Academic Search Ultimate
    Source: PubMed Central
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  • 3
    Language: English
    In: Gerontology and geriatric medicine, 2015, Vol.1, p.2333721415607833-2333721415607833
    Description: Objective: To explore the value of day services at green care farms (GCFs) in terms of social participation for people with dementia. Method: Semi-structured interviews were conducted with people with dementia who attended day services at a GCF (GCF group, n = 21), were on a waiting list (WL) for day services at a GCF (WL group, n = 12), or attended day services in a regular day care facility (RDCF group, n = 17) and with their family caregivers. Results: People with dementia in the GCF and WL group were primarily males, with an average age of 71 and 76 years, respectively, who almost all had a spousal caregiver. People with dementia in the RDCF group were mostly females with an average age of 85 years, most of whom had a non-spousal caregiver. For both the GCF and RDCF groups, it was indicated that day services made people with dementia feel part of society. The most important domains of social participation addressed by RDCFs were social interactions and recreational activities. GCFs additionally addressed the domains “paid employment” and “volunteer work.” Conclusion: GCFs are valuable in terms of social participation for a particular group of people with dementia. Matching characteristics of adult day services (ADS) centers to the preferences and capacities of people with dementia is of importance. Diversity in ADS centers is therefore desirable.
    Subject(s): adult day care ; adult day services ; Animal Production Systems ; civic engagement ; dementia ; Dierlijke Productiesystemen ; Gezondheid en Maatschappij ; green care farms ; Health and Society ; Leerstoelgroep Dierlijke productiesystemen ; social participation ; WASS
    ISSN: 2333-7214
    E-ISSN: 2333-7214
    Source: PubMed Central
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  • 4
    Language: English
    In: Gerontology and geriatric medicine, 2015, Vol.1
    Description: Objective: To explore the value of day services at green care farms (GCFs) in terms of social participation for people with dementia. Method: Semi-structured interviews were conducted with people with dementia who attended day services at a GCF (GCF group, n = 21), were on a waiting list (WL) for day services at a GCF (WL group, n = 12), or attended day services in a regular day care facility (RDCF group, n = 17) and with their family caregivers. Results: People with dementia in the GCF and WL group were primarily males, with an average age of 71 and 76 years, respectively, who almost all had a spousal caregiver. People with dementia in the RDCF group were mostly females with an average age of 85 years, most of whom had a non-spousal caregiver. For both the GCF and RDCF groups, it was indicated that day services made people with dementia feel part of society. The most important domains of social participation addressed by RDCFs were social interactions and recreational activities. GCFs additionally addressed the domains “paid employment” and “volunteer work.” Conclusion: GCFs are valuable in terms of social participation for a particular group of people with dementia. Matching characteristics of adult day services (ADS) centers to the preferences and capacities of people with dementia is of importance. Diversity in ADS centers is therefore desirable.
    Subject(s): Animal Production Systems ; Dierlijke Productiesystemen ; Gezondheid en Maatschappij ; Health and Society ; Leerstoelgroep Dierlijke productiesystemen ; WASS
    ISSN: 2333-7214
    E-ISSN: 2333-7214
    Source: PubMed Central
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