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The VOICE study; Variation in the Organisation of Integrated CarE

Projectomschrijving

VOICE studie: Variatie in de organisatie van integrale geboortezorg

Doel

In Nederlandse Verloskundige Samenwerkingsverbanden (VSV’s) werken verloskundigen, gynaecologen, kraamverzorgenden, kinderartsen en andere zorgverleners samen aan een betere kwaliteit van geboortezorg. Dit doen ze door de zorg zo goed mogelijk op elkaar aan te laten sluiten; dat is integrale zorg. Hoe dit in de praktijk wordt vormgegeven verschilt per VSV. In VOICE onderzoeken we welke elementen van integrale zorg invloed hebben op gezondheid, ervaringen en zorguitgaven.

Aanpak en verwachte resultaten

Dit doen we door de internationale literatuur te bestuderen en door samen met cliëntvertegenwoordigers en zorgverleners de zorg binnen 6 VSV’s nader te bekijken. Vervolgens vragen we bij alle VSV’s uit welke elementen van integrale zorg zijn ingevoerd. Met deze informatie onderzoeken we hoe elementen van integrale zorg samenhangen met uitkomsten van moeder en kind, ervaringen van vrouwen en zorgverleners en zorguitgaven. Hiervoor zullen gegevens over alle zwangerschappen in Nederland gebruikt worden.

Producten

Titel: De VOICE studie
Auteur: Jolanda Liebregts
Titel: De VOICE studie
Auteur: Jolanda Liebregts
Titel: The VOICE study
Auteur: Jolanda Liebregts
Titel: The VOICE study
Auteur: Jolanda Liebregts
Titel: De VOICE studie
Auteur: Jolanda Liebregts
Titel: The VOICE study; a scoping review
Auteur: Jolanda Liebregts
Titel: De VOICE studie
Auteur: Jolanda Liebregts
Titel: Maternity care
Auteur: Jolanda Liebregts, Bahar Goodarzi, Ank de Jonge
Titel: Update VOICE study
Auteur: Jolanda Liebregts

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Samenvatting van de aanvraag

BACKGROUND Currently, there is no overview of how maternity care collaborations (MCCs) are organized and there is little evidence of which elements of integrated care lead to optimal maternal and newborn care. This lack of knowledge hinders progress in the implementation of integrated care in the Netherlands. Much of the required data to fill this knowledge gap is available through DIAPER, which is a rich data-infrastructure where national perinatal data (Perined), claims data (Vektis) and data from the population registers (Statistics Netherlands) are linked at the individual level. However, data on what elements of integrated care are present in each MCC is missing, which is crucial for gaining in-depth insight into the mechanisms underpinning the effects of integrated care elements. In the Variations in the Organisation of Integrated CarE (VOICE) study, the dimensions of the Maternity care networks Integration Questionnaire (MCN-IQ) will be used to identify and systematically examine these elements using an innovative mixed-methods approach. This validated questionnaire is based on the Rainbow Model of Integrated Care (RMIC). The way in which MCCs have organized risk assessment to identify women and baby’s that need specialist care is an important element of integrated care. AIM AND OBJECTIVES The aim of the VOICE study is to identify elements of integrated care that are associated with improved maternal and neonatal outcomes, experiences of women and their partners and professionals and care processes and reduced healthcare spending. The research questions are: 1) What are important elements of integrated care, and which mechanisms underpin the associations between these elements and maternal and neonatal outcomes, care processes, experiences of women and professionals and healthcare spending? 2) What is the prevalence of elements of integrated care among all MCCs and how has this changed over the past ten years? 3) What are effects of elements of integrated care, identified in research question 1, on maternal and neonatal outcomes, care processes, women’s experiences and spending? APPROACH The VOICE study consists of the following steps: A. Conducting a scoping review A scoping review will be conducted to identify elements of integrated maternal and newborn care that are associated with improved maternal and neonatal outcomes, care processes and the experience of women and professionals. B. Cyclic data collection in a community of practice Based on data previously collected via a national questionnaire, six MCCs will be selected with different risk assessment profiles to participate in a community of practice. In collaboration with client representatives and health care professionals, we will gain in-depth insight into how identified elements of integrated care (in step A) are associated with maternal and perinatal outcomes, care processes and experiences of women and professionals. We will analyse documents, conduct focus groups and interviews with client representatives, women and partners and a questionnaire study will be carried out among women and professionals. Particular attention will be paid to include women and partners with low (Dutch or English) literacy skills. Findings will be discussed in best practice meetings. Associations between elements of integrated care and outcomes and care processes in these MCCs will be tested using DIAPER. C. Defining integrated care profiles of all MCCs Based on the findings from step A, measurable elements of integrated maternal and newborn care will be defined. A questionnaire will be sent to representatives of all professional groups to collect information on the presence of and change in elements of integrated care among all MCCs over the past ten years. This information of each of the 71 MCCs will be linked to the DIAPER data. D. Estimating effects of important elements of integrated care The effects of the elements of integrated care will be quantitatively estimated using a quasi-experimental study design (Difference-in-Differences (DiD)). The first step is to generate specific hypotheses based on the mechanisms identified in steps A and B, such as ‘A shared care risk assessment profile leads to a lower rate of a composite adverse neonatal outcome’ For each hypothesis we will select MCCs with the particular integrated care element and compare these with comparable MCCs without this element. Subsequently, the change in outcomes over the years will be compared between women in the index and control group. E. Developing online tools for improving integrated maternal and newborn care in practice We will develop online tools to improve integrated care and to increase awareness about effective elements of integrated care. Examples are guidelines to set up multidisciplinary meetings and ways of organizing client participation. These tools will be disseminated among professionals, client organisations, policy makers and educational institutes.

Kenmerken

Projectnummer:
05430052110002
Looptijd: 54%
Looptijd: 54 %
2022
2026
Onderdeel van programma:
Gerelateerde subsidieronde:
Projectleider en penvoerder:
prof. dr. A de Jonge PhD
Verantwoordelijke organisatie:
Amsterdam UMC Locatie VUmc