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Variation in healthcare expenditures from consultations provided by mental healthcare nurses explained by demand and supply-side factors in the Netherlands.

Kortekaas, R. (2018) Variation in healthcare expenditures from consultations provided by mental healthcare nurses explained by demand and supply-side factors in the Netherlands.

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Abstract:Since 2012, the position of the mental healthcare nurse (MHN) was introduced in primary care in the Netherlands with the aim to reduce costs and increase quality of care. The main function of the MHN is to provide basic mental healthcare in general practices. It is plausible that MHNs differ in their procedure, which is known as practice style variation. This is unwarranted since it may cause inequality or inefficiency of care. The objective of this thesis was to explain variation by studying healthcare expenditures from the demand and supply side regarding care provided by MHNs. This quantitative retro-perspective cohort study analysed data from 39,241 patients and 176 MHNs for the years 2016 and 2017. The annual healthcare expenditures per patient are significantly different: Noord-Brabant has a median of €50.80 (N=11,929 patients), whereas Limburg has a median of €41.56 (N=27,312). The variation is explained for 4.0% by demand factors, i.e. patient-related variables, and 4.6% is explained by supply factors, i.e. MHN-specific variables. Consequently, there was some proof to support the practice style hypothesis. Patient characteristics that were found to relate significantly to annual healthcare expenditures from consultations of MHNs are age, gender and degree of urbanisation. The results are robust.
Item Type:Essay (Master)
Clients:
Topicus, Deventer, Nederland
Faculty:BMS: Behavioural, Management and Social Sciences
Subject:74 (human) geography, cartography, town and country planning, demography, 83 economics, 85 business administration, organizational science
Programme:Business Administration MSc (60644)
Link to this item:http://purl.utwente.nl/essays/76905
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