Dutch Health Outlook 2013

100 Pages·2013·20.16 MB·English

Dutch Health Outlook 2013
-Since 2013- -The First Edition-
“From Bench to Bed”
Monitoring Applied Research,
Innovation and Valorization
-Developer- -Academic partners- -Partners-
1
see also www.healthoutlook.nl
The Dutch Health Outlook is created under the supervision of Prof. dr. Fred van Eenennaam and Ir. Maarten Koomans. It is supported by the International Academic Advisory Council
Acknowledgement
1 Albert Schweitzer ziekenhuis, Dordrecht
2 Amphia Ziekenhuis, Breda
Thanks to all participating hospitals and its data collectors.
3 Atrium Medisch Centrum, Heerlen
4 Canisius-Wilhelmina Ziekenhuis, Nijmegen
5 Catharina Ziekenhuis, Eindhoven
6 Deventer Ziekenhuis, Deventer
7 Gelre ziekenhuizen, Apeldoorn
8 HagaZiekenhuis, Den Haag
9 Isala klinieken, Zwolle
10 Jeroen Bosch Ziekenhuis, ‘s Hertogenbosch
11 Kennemer Gasthuis, Haarlem
12 Maasstad Ziekenhuis, Rotterdam
13 Martini Ziekenhuis, Groningen
14 Máxima Medisch Centrum, Eindhoven
15 Meander Medisch Centrum, Amersfoort
16 Medisch Centrum Alkmaar
17 Medisch Centrum Haaglanden, Den Haag
18 Medisch Centrum Leeuwarden
19 Medisch Spectrum Twente, Enschede
20 Onze Lieve Vrouwe Gasthuis, Amsterdam
21 Reinier de Graaf Groep, Delft
22 Rijnstate, Arnhem
23 Sint Franciscus Gasthuis, Rotterdam
24 Sint Lucas Andreas Ziekenhuis, Amsterdam
25 SpaaPranrteic iZpaietinkge hnohspuiitasl,s H 20o1o3fddorp
26 St. Antonius Ziekenhuis, Nieuwegein
27 SWt.e E wloiuslad blikeet tho tZhainekk toe anllh wuhios m, aTdiel bit uporsgsible. The help and insights of many (cluster) experts was essential in
sceree altsion gw wthwe.h e2althoutlook.nl
Dutch Health Outlook 2013. For all experts involved please refer to page(s) 98 and 99.
28 VieCuri Medisch Centrum, Venlo
Summary (1/3)
The first Health Outlook aims to attract, and provide insights to applied research and its performance…
Aims
Context
Providing
Attract applied research
affordable
Applied Research Hospitals* should attract applied research and need to be
and high
aware of the importance of applied research to supporting, connecting and
improving the innovative Life Sciences & Health cluster, and their own quality care.
contribution to applied research.
Health
Showcase the applied research performance
Applied Research Hospitals should showcase to the Netherlands, to their
industry and international clusters that the Dutch hospitals are performing well
on applied research.
Provide insights into the applied research
Applied Research Hospitals should provide insights in applied research since Wealth
this proves a valuable tool for all healthcare stakeholders, as individual
hospitals can use the results to compare and optimize their outcomes.
* From now on, applied research hospitals will be called “hospitals“. University Medical Centers (UMCs) are not included in this report.
This study was conducted on 16 out of 28 STZ hospitals. In this report the words “applied research hospitals” and “ (total) STZ hospitals” are used interchangeably.
3
see also www.healthoutlook.nl
Summary (2/3)
Dutch Life Sciences & Health Outlook 2013:
…by collecting and comparing data of 16 applied research hospitals, in order to build a database for the future
which will show progress, be comparable with international clusters…
Data Key Conclusions
OUTPUT
 No. of publications: 3057 publications cited
 Lead time of clinical trials: 65 days • Applied research hospitals seem to vary heavily in
 No. of their ability to be relevant in applied research that
 new products: 21* connects with industry and patients.
 new protocols: 144** Size, level of expertise, support and connection with
 new guidelines: 159**
industry and openness seem to matter.
 new treatments : 101**
• Hospitals that outperform collaborate above average
SIZE with the industry.
Outperformance on output: publications, innovation and
 Size of clinical trials: 7745 patients* efficiency.
 Inflow of patients from
outside catchment area: 12 % admissions
• Publishing and performing applied research are
10.4 % outpatient visits
clearly part of the core business of applied research
hospitals.
INPUT In particular clinical trials in phase 3 and medical devices.
 Industry investments: 630 research projects**
 Hospital R&D investments: 10,8 m€**
*Extrapolation based on number of publication cited. ** Extrapolation based on number of empFlooyre edse.t aFiloerd m doartea ipnlfeoarmsea tsioene scehea pctehra p3ter 4
4
see also www.healthoutlook.nl
Summary (3/3)
… and stimulate and improve applied research by sharing (next) best practices in 4 overall themes.
Key (next) Best Practices
A) Attract and invest in expertise and create internal structures
• BP 4: Stimulate an active policy and support the research committee and LTC (Local Ethics Committee) that enforces guidelines and business plans
to optimize research.
• BP 8: Obligate the recording ( protocoleren) of research.
• BP 9: Register new protocols, treatments and guidelines adopted in a common, central database .
• BP 11: Stimulate and build research support structures.
• BP 13: Attract and invest in the expertise of the core staff members .
• BP 16: Coordinate research at a decentralized level too, to stimulate multicenter studies.
B) Invest in industry
• BP 1: Harmonize, discuss and share knowledge on events, to create leverage and enhance innovation.
• BP 3: Invest in a relationship with thei ndustry.
• BP 5: Cooperate with industry and other partners, as universities and connect with their experts and professors.
• BP 12: Create visibility to industry partners, cluster location seems to matter.
C) Create visibility, a research culture and commitment
• BP 6: An education-driven organization will stimulate the preparation of protocols.
• BP 7: Involve specialists in quality management, and create commitment and (double) learning loops.
• BP 15: Invest in a research culture.
• BP 17: Create insight into costs and investments, to be able to allocate the right resources to the right activities.
D) Cooperate with other hospitals
• BP 2: Initiate, cooperate and participate in multidisciplinary studies to have access to knowledge.
• BP 10: Share best practices internally to increase knowledge: exchange of ideas may help the development of new products.
The Key (next) Best Practices are based on: 1) best performing hospitals, 2) literature research, 3) advice from experts, In4t)e rnational Academic Advisory Council, 5) cluster
experiences by researches, 6) other industries. More detailed information about the Key (next) Best Practices can be found cihnapter 4.
5
see also www.healthoutlook.nl
Contents of the Dutch Health Outlook 2013
Key outcomes Dutch Health Outlook 2013
1
Executive summary 8
Background (Shaping – Defining – Measuring) 9
Data and conclusions 20
Next best practices 27
Guide to interpret data
2
A roadmap 32
Monitoring
3
Key performance indicators (Definition– Measuring – Improving)
Output 38
Size 52
Input 59
Appendices
4
A. History, development and structure of the Health Outlook 67
B. About the involved partners 86
C. Bibliography 90
D. Consulted experts and organizations 97
Not included in this version but available for download at www.healthoutlook.nl
E. Key steering indicators 102
F. Monitoring Methodology – extended version 114
The Outlook 2013 has been compiled with the utmost care based upon available data in 2011. Readers are advised to contact theauthors of the report to avoid potential misinterpretations of
the reported results. Authors welcome suggestions for improvement for the Outlook 2014 (please contact
Should you like to make a decision based on:
Applied research Improving Health Cluster Outperformance
See page no 15, 16, 22
See page no 41, 44, 47, 50, 55, 58, 62, 65 See page no 11, 13, 14, 15 See page no 25, 28 -30,
Measuring KPIs & KSIs Core business
Source SS df MS Number of obs = 10889
F( 18, 10870) =25427.59
Model 208692.045 18 11594.0025 Prob > F = 0.0000
ReSseied puaagle n o 4 04, 9453,6 4.63, 0429,5 514 , 15078, 7610, 6 4.455961593 R-squared =S e e0 p.a9g7e 6n8o 39-65 See page no 22, 26, 40, 54
Adj R-squared = 0.9768
Total 213648.347 10888 19.6223684 Root MSE = .67525

lw Coef. Std. Err. t P>|t| [95% Conf. Interval]

expe .0188156 .0041323 4.55 0.000 .0107154 .0269157
expe2 -.000369 .0001039 -3.55 0.000 -.0005726 -.0001654
hh .2240197 .0003729 600.79 0.000 .2232888 .2247506
7
dip1 .1824788 .0320881 5.69 0.000 .1195804 .2453773 see also www.healthoutlook.nl
dip3 .1814161 .0263996 6.87 0.000 .1296682 .2331641
dip4 .1522206 .0231657 6.57 0.000 .1068115 .1976296
dip5 .0796747 .0175065 4.55 0.000 .0453587 .1139906
dip6 .0779941 .0245033 3.18 0.001 .0299632 .126025
enf3 .0264903 .01663 1.59 0.111 -.0061076 .0590882
enf6 -.0081408 .014602 -0.56 0.577 -.0367635 .0204818
en18 -.027078 .0071182 -3.80 0.000 -.0410309 -.0131251
dso1 .0771048 .3902956 0.20 0.843 -.6879458 .8421553
dso2 .0709971 .3904501 0.18 0.856 -.6943563 .8363505
dso3 .043337 .390496 0.11 0.912 -.7221063 .8087804
dso4 .0843082 .0983582 0.86 0.391 -.1084917 .2771082
dso5 -.028818 .4020896 -0.07 0.943 -.8169869 .7593509
dso6 .0098075 .3915849 0.03 0.980 -.7577703 .7773853
wcj 5.77e-07 3.49e-07 1.66 0.098 -1.06e-07 1.26e-06
_cons -.2098312 .3924445 -0.53 0.593 -.979094 .5594315
1 Key outcomes Dutch Health Outlook 2013
Executive summary
• Background (Shaping – Defining – Measuring)
• Data & Key Conclusions
• Key best practices
8
see also www.healthoutlook.nl
© Rebke Klokke, Utrecht
BACKGROUND
Need for a shift in productivity
SHAPING DEFINING MEASURING
In order to make the Dutch healthcare system sustainable, a shift is needed in its productivity frontier: optimizing
value per Euro spent…
Health Expenditure is outgrowing, resulting in a
pressure to cut costs and in the same time to
delivery better value to patients.
Current
situation
Sources: Blendon et al. (2004), Christensen et al. (2009), and a The Decision Group analysis (2010)
Based upon: Porter (1996). What is Strategy? Harvard Business Review, November-December 1996: 59-78
9
see also www.healthoutlook.nl
BACKGROUND
Enhancing applied research, innovation and development
SHAPING DEFINING MEASURING
…by improving cooperation between the Life Science cluster and the Health cluster and enhancing at the same
time applied research, innovation and valorization.
Applied Research, Innovation and Valorization is the base of the five
recognized leverages of Christensen, to increase productivity.
Sources: Blendon et al. (2004), Christensen et al. (2009), and a The Decision Group analysis (2010)
10
see also www.healthoutlook.nl