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The Netherlands can pride itself on its close-knit system of outpatient primary healthcare. It can be attributed in part to medical researchers who work with politicians and social scientists in the Netherlands to build a healthcare system that adapts to meet the developing needs of the population. Various Dutch research institutes do their part in researching the quality of ‘neighbourhood healthcare’. Their focus is on prevention.
The Netherlands School of Primary Care Research (CaRE) is a collaboration of four research institutes: the CAPHRI School for Public Health and Primary Care (Maastricht University), the EMGO Institute for Research in Extramural Medicine (VU University Amsterdam), the Centre for Evidence-Based Practice (Radboud University Nijmegen) and the NIVEL Institute for Health Services Research (Utrecht University). Their joint objective is to develop scientific evidence based knowledge on primary health care and implement this knowledge in practice.
CaRE aims to maximise research effectiveness by combining relevant fields of research and coordinating joint activities by the participating institutes. CaRE research focuses on outpatient care, primary care and health policy.
Maastricht University is internationally known as a centre of excellence for healthcare innovation. Its CAPHRI research school primarily focuses on improving primary care: the type of healthcare that affects everyone’s day-to-day lives. CAPHRI researches the entire process from prevention to aftercare and rehabilitation. The quality of healthcare is viewed from the perspective of patients, professionals and society overall. The development of the Balance Meter effectively illustrates the research that CAPHRI does.
While nearly every institute related to healthcare is involved in efforts to help people stop smoking, CAPHRI has taken matters a step further by developing an anti-smoking vaccine. The vaccine prevents nicotine from reaching the brain, thus preventing the release of addictive positive sensation stimulants like dopamine. Recent trials have proven that the NicVax is safe and may stimulate the human immune system to produce antibodies to nicotine.
Many researchers are convinced that evidence-based healthcare is the key to improving primary care. The focus here is healthcare based on the very best scientific information available. Experts in the field work together in the Nijmegen Centre for Evidence Based Practice (NCEBP). Demand for their work has increased since research has shown that there are patients who are unable to receive optimal or even sufficient healthcare, and patients who receive unnecessary care that may even cause harm.
The NCEBP takes a multidisciplinary approach in its attempt to find answers to two fundamental questions. The first is what we consider to constitute ‘effective, efficient and acceptable healthcare and prevention’. The second question is how guarantees can be put in place to ensure that every patient receives that care. In cooperation with experts from such fields as medical science, epidemiology, social science, economics, nursing, medical services and ethics, the NCEBP is able to research disease prevention and efficient treatment for health problems such as cancer, cardiopulmonary disease, mental illness, neurological disorders, infectious disease and fertility problems.
The EMGO Institute for Health and Care Research at VU University Amsterdam researches chronic illness and aging. Its research is grouped into four thematic areas: diabetes and obesity, mental health, quality of care, and musculoskeletal disorders. Research at EMGO is intended to lead to improvements in public and primary healthcare, rehabilitation and other long-term care.
The societal relevance of the research becomes clear in view of the realisation that overweight
and obesity have taken on nearly epidemic proportions in a growing number of communities. One consequence of this development is the growing number of adults and children with Type 2 diabetes. Scientists from EMGO research programmes aim to change the lifestyle of these groups. Depression, anxiety disorders and musculoskeletal disorders are among the most common and most expensive health problems in the Netherlands.
A longitudinal study has been running in Amsterdam for over thirty years now, examining the link between physical activity, nutrition and the occurrence of musculoskeletal disorders. The final research domain, long-term care, is increasingly important due to aging: more and more people need long-term care. EMGO researches causes and progression, preventive measures, treatment and effective care for these patient groups.
In cooperation with the health and safety department of ABN AMRO, CAPHRI developed the Balance Meter, a web-based screening device that predicts long-term absence through illness. The figures clearly show that such tools are no frivolous luxury: 5% of employees are responsible for 95% of the costs of illness-related absence in the long term. A survey among 12,000 employees proves the effectiveness of the Balance Meter. Employees identified as ‘very high risk’ by the screening tool have an eight to 16 times higher chance of long-term illness-related absence. Employees who showed an elevated risk of long-term absence based on a prediction by the Balance Meter received guidance from health and safety services at an early stage. Absence through illness ultimately proved to be 35% lower than absenteeism among employees who did not receive such guidance.