Browsing Han Publications by Author "Adang, Eddy"

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Pain Exposure Physical Therapy versus conventional treatment in complex regional pain syndrome type 1-a cost-effectiveness analysis alongside a randomized controlled trial.
Barnhoorn, K. ; Staal, J.B. ; Dongen, R.T.M. van ; Frölke, J.P.M. ; Klomp, F.P. ; Meent, H. van de ; Adang, Eddy ; Nijhuis-van der Sanden, M.W.G.
2018, Article / Letter to editor (Clinical Rehabilitation, vol. 32, iss. 6, (2018), pp. 790-798)
The involvement of physician assistants in inpatient care in hospitals in the Netherlands: a cost-effectiveness analysis
Timmermans, M.C.J. ; Brink, G.T.W.J. van den ; Vught, A.J.A.H. van ; Adang, Eddy ; Berlo, C.L.H. van ; Boxtel, K.V. ; Braunius, W.W. ; Janssen, L. ; Venema, A. ; Wildenberg, F.J. ; Wensing, M. ; Laurant, M.G.H. et al. sine al.
2017, Article / Letter to editor (BMJ Open, (2017))
The impact of substituting general practitioners with nurse practitioners on resource use, production and health-care costs during out-of-hours: a quasi-experimental study
Biezen, M van der ; Adang, Eddy ; Burgt, R. van der ; Wensing, M. ; Laurant, M.G.H.
2016, Article / Letter to editor (BMC Family Practice, vol. 17, (2016))Background: The pressure in out-of-hours primary care is high due to an increasing demand for care and rising health-care costs. During the daytime, substituting general practitioners (GPs) with nurse practitioners (NPs) shows positive results to contribute to these challenges. However, there is a lack of knowledge about the impact during out-of-hours. The current study aims to provide an insight into the impact of substitution on resource use, production and direct health-care costs during out-of-hours. Methods: At a general practitioner cooperative (GPC) in the south-east of the Netherlands, experimental teams with four GPs and one NP were compared with control teams with five GPs. In a secondary analysis, GP care versus NP care was also examined. During a 15-month period all patients visiting the GPC on weekend days were included. The primary outcome was resource use including X-rays, drug prescriptions and referrals to the Emergency Department (ED). We used logistic regression to adjust for potential confounders. Secondary outcomes were production per hour and direct health-care costs using a cost-minimization analysis. Results: We analysed 6,040 patients in the experimental team (NPs: 987, GPs: 5,053) and 6,052 patients in the control team. There were no significant differences in outcomes between the teams. In the secondary analysis, in the experimental team NP care was associated with fewer drug prescriptions (NPs 37.1 %, GPs 43 %, p < .001) and fewer referrals to the ED (NPs 5.1 %, GPs 11.3 %, p = .001) than GP care. The mean production per hour was 3.0 consultations for GPs and 2.4 consultations for NPs (p < .001). The cost of a consultation with an NP was (sic)3.34 less than a consultation with a GP (p = .02). Conclusions: These results indicated no overall differences between the teams. Nonetheless, a comparison of type of provider showed that NP care resulted in lower resource use and cost savings than GP care. To find the optimal balance between GPs and NPs in out-of-hours primary care, more research is needed on the impact of increasing the ratio of NPs in a team with GPs on resource use and health-care costs.
Cost effectiveness of interpersonal community psychiatric treatment for people with long-term severe non-psychotic mental disorders: protocol of a multi-centre randomized controlled trial
Schoonhoven, Lisette ; Teerenstra, Steven ; Adang, Eddy ; Koekkoek, B.W. ; Veen, M. van ; Postulart, Debby ; Achterberg, Theo van ; Mulder, N.
2015, Article / Letter to editor (BMC Psychiatry, vol. 15, iss. 100, (2015))Background This study aims for health gain and cost reduction in the care for people with long-term non-psychotic psychiatric disorders. Present care for this population has a limited evidence base, is often open ended, little effective, and expensive. Recent epidemiological data shows that 43.5% of the Dutch are affected by mental illness during their life. About 80% of all patients receiving mental health services (MHS) have one or more non-psychotic disorders. Particularly for this group, long-term treatment and care is poorly developed. Care As Usual (CAU) currently is a form of low-structured treatment/care. Interpersonal Community Psychiatric Treatment (ICPT) is a structured treatment for people with long-term, non-psychotic disorders, developed together with patients, professionals, and experts. ICPT uses a number of evidence-based techniques and was positively evaluated in a controlled pilot study. Methods/Design Multi-centre cluster-randomized clinical trial: 36 professionals will be randomly allocated to either ICPT or CAU for an intervention period of 12 months, and a follow-up of 6 months. 180 Patients between 18–65 years of age will be included, who have been diagnosed with a non-psychotic psychiatric disorder (depressive, anxiety, personality or substance abuse disorder), have long-term (>2 years) or high care use (>1 outpatient contact per week or >2 crisis contacts per year or >1 inpatient admission per year), and who receive treatment in a specialized mental health care setting. The primary outcome variable is quality of life; secondary outcomes are costs, recovery, general mental health, therapeutic alliance, professional-perceived difficulty of patient, care needs and social contacts. Discussion No RCT, nor cost-effectiveness study, has been conducted on ICPT so far. The empirical base for current CAU is weak, if not absent. This study will fill this void, and generate data needed to improve daily mental health care.
Cost-consequence analysis of "washing without water" for nursing home residents: A cluster randomized trial
Schoonhoven, Lisette ; Gaal, B.G.I. van ; Teerenstra, S. ; Adang, Eddy ; Vleuten, Cees van der ; Achterberg, Theo van
2015, Article / Letter to editor (International Journal of Nursing Studies, vol. 52, iss. 1, (2015), pp. 112-120)Background: No-rinse disposable wash gloves are increasingly implemented in health care to replace traditional soap and water bed baths without proper evaluation of (cost) effectiveness. Objectives: To compare bed baths for effects on skin integrity and resistance against bathing and costs. Design: Cluster randomized trial. Setting: Fifty six nursing home wards in the Netherlands. Participants: Five hundred adult care-dependent residents and 275 nurses from nursing home wards. Methods: The experimental condition 'washing without water' consists of a bed bath with disposable wash gloves made of non-woven waffled fibers, saturated with a no-rinse, quickly vaporizing skin cleaning and caring lotion. The control condition is a traditional bed bath using soap, water, washcloths and towels. Both conditions were continued for 6 weeks. Outcome measures were prevalence of skin damage distinguished in two levels of severity: any skin abnormality/lesion and significant skin lesions. Additional outcomes: resistance during bed baths, costs. Results: Any skin abnormalities/lesions over time decreased slightly in the experimental group, and increased slightly in the control group, resulting in 72.7% vs 77.6% of residents having any skin abnormalities/lesions after 6 weeks, respectively (p= 0.04). There were no differences in significant skin lesions or resistance after 6 weeks. Mean costs for bed baths during 6 weeks per resident were estimated at 218.30 (95%Cl 150.52-286.08) in the experimental group and 232.20 (95%Cl: 203.80-260.60) in the control group (difference 13.90 (95%Cl: 25.61-53.42). Conclusion: Washing without water mildly protects from skin abnormalities/lesions, costs for preparing and performing bed baths do not differ from costs for traditional bed bathing. Thus, washing without water can be considered the more efficient alternative. (C) 2014 Elsevier Ltd. All rights reserved.

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