Arjen Stoop

Should I stay or should I go? Waiting lists and cross-border care in the Netherlands

The recent ruling of the European Court of Justice in the case Smits-Peerbooms explicitly mentions undue delay as a legitimisation for cross-border care within the EU. In the Netherlands, waiting times are well above the norm set by several health care parties as well as maximally acceptable waiting times elicited in patients. This might indicate that Dutch patients are often entitled to care in other Member States, in the sense that insurers cannot withhold reimbursement of cross-border care in the present situation. However, experiments clearly demonstrate that few Dutch patients are willing to travel abroad. Patients seem to prefer longer waiting in the Netherlands over shorter waiting by going abroad, even those living in border regions. In addition, mobility of patients within the Netherlands is very modest. Given this inertia in patient mobility, in the short run, cross-border care will probably remain an insignificant phenomenon in terms of quantities of patients travelling abroad and therefore the impact of the Smits-Peerbooms rulings is limited.

Using information technology for patient education: realizing surplus value?

Computer-based patient information systems are introduced to replace traditional forms of patient education like brochures, leaflets, videotapes and, to a certain extent, face-to-face communication. In this paper, we claim that though computer-based patient information systems potentially have many advantages compared to traditional means, the surplus value of these systems is much harder to realize than often expected. By reporting on two computer-based patient information systems, both found to be unsuccessful, we will show that building computer-based patient information systems for patient education requires a thorough analysis of the advantages and limitations of IT compared to traditional forms of patient education. When this condition is fulfilled, however, these systems have the potential to improve health status and to be a valuable supplement to (rather than a substitute for) traditional means of patient education.

Elektronische informatie in de wachtkamer

SamenvattingDoel Het verkrijgen van inzicht in de mogelijkheden en behoefte van patiënten inzake elektronische medische informatie in de wachtkamer van de huisarts.Methode Exploratief sociologisch onderzoek in vier huisartspraktijken in Rotterdam door middel van semi-gestructureerde interviews en observaties.Resultaten Patiënten bleken geen behoefte te hebben aan een systeem waarmee zij elektronische medische informatie kunnen raadplegen in de wachtkamer.Conclusie Uitgangspunt van het onderzoek was de veronderstelling dat de wachtkamer een geschikte omgeving is om elektronische medische informatie te raadplegen. Deze veronderstelling is onjuist.