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International Comparative Research in Health Care

International Comparative Research in Health Care. A straightforward exercise ?. Koen Putman. How are we doing ?. ( Inter ) national research. EU- Funding (CORDIS). Challenges. Securing comparability Accounting for national variations Finding the data.

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International Comparative Research in Health Care

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  1. International Comparative Research in Health Care A straightforwardexercise? Koen Putman

  2. How are we doing?

  3. (Inter)national research

  4. EU-Funding (CORDIS)

  5. Challenges • Securingcomparability • Accounting fornationalvariations • Finding the data In: Burau, CurrSocio, 2012

  6. Health systems dynamics In: van Olmen et al., Health Cult & Society, 2012

  7. Garrido et al., in:HSREPP, 2011

  8. Queen’sMedical Centre City Hospital UZ Pellenberg FachklinikHerzogenaurach RehaClinic Zurzach

  9. Admissionpolicies in SRU In: Putman K et al., J RehabilMed, 2006

  10. Process of care * * * Absolute time in therapeuticactivitiesbetween 7.00am and 5.00 pm * significant differenceaftercorrectionfor case-mix De Wit et al., Stroke, 2005

  11. Time available per patient per week /professional group De Wit et al., Stroke, 2005

  12. use of care afterdischarge (6m) Putman et al., J RehabMed, 2007

  13. Challenges • Securingcomparability • Accounting fornationalvariations • Finding the data In: Burau, CurrSocio, 2012

  14. Selection of patients Kennedy et al., ArchPhysMedRehabil, 2012

  15. Incentives Peltola et al., Cerebrovasc Dis, 2013

  16. Challenges • Securingcomparability • Accounting fornationalvariations • Finding the data In: Burau, CurrSocio, 2012

  17. Finding the data • Assessment traditions and ‘culture’ Systematiccollectionusefulfor research practice(Freeman et al., JNNP, 2005) However: Heterogenity of outcomemeasurement in Europe (Haigh et al., J RehabMed, 2001) example: FIM vsBarthel in strokerehabilitation(Sangha et al. Int J RehabRes, 2005)

  18. “translations” Barthel Index Score Motor FIM Nyein K et al., Clin Rehab 1999

  19. Uniform datasets

  20. Finding the data • Questionnaires • Conceptualequivalenceacross cultures • e.g.: socio-economic status • Pre-study on possibleansweringcategories • e.g.: discharge destination, post-discharge services • Translations of questionnaires

  21. Ethics Chaudhry et al., Clin Trials, 2013

  22. Methodologicalchallenges In: Horn S et al. , ArchPhysMedRehab, 2012

  23. Prioritiesfuture research

  24. Recommendations • Inclusion of evidence in reimbursement regulations on provision of services (Weinrich et al., 2011) • “Chain of care” (Ringelstein et al, 2013) • Quality indicators/national audits (Ringelstein et al, 2013) • Comparativeeffectiveness research

  25. No stereotyping • In Heaven: • the cooks are French, • the policemen are English, • the mechanics are German, • the lovers are Italian • and • the bankers are Swiss. • In Hell: • the cooks are English, • the policemen are German, • the mechanics are French, • the lovers are Swiss • and • the bankers are Italian. • And whatabout the Belgians?

  26. International Comparative Research in Health Care A straightforwardexercise? Koen Putman kputman@vub.ac.be kputman@uclan.ac.uk

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