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At the heart of the Value-Based Health Care concept are patient relevant medical outcomes measures, as the core measures of decision making for patients, medical teams, hospitals, health insurance, funders and the acceptance of new innovations.
In the Netherlands, a significant experience is building on:
-how to get a limited but relevant set of outcome measures
– avoidance of over-registration and under-registration
– dealing with the (often unnecessary) explosions of “quality”, process/functional, patient(family) measurements
– communication on the outcomes and dealing with the balance between evidence –based and clinically relevant indicators
– internal and external validity checks on data and definitions
– a fruitful, internationally open and fair process on determining the outcome sets
– acceptance of the set for its intended purposes
– trying to control the burden of data collection, registration and institutional costs
– cascading the information to those who need to know/can take decisions instead of an ‘all people have all data’ or data fishing exercise.
The international experiences existing partially useful repositories (The Decision Institute, Ichom, The Harvard based team, NHS, Sweden a.o.) on multiple medical conditions from a rich source of disseminating experiences and helping to make efforts more uniform around the world.
The implementation and learning cycles of medical teams, health administrators and decision makers to guide decisions based on outcomes is the key focus of the group for the next period. Prof. Dr. Fred van Eenennaam is actively chairing this chapter and is conducting meta analyses on the methodology and experiences around the world.
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