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Biomedical subjects

D Hoogendoorn

Publications and source records attributed to D Hoogendoorn.

At least 19 recordsLinked to original sources
PubMed1991

Effects of budgeting on health care services in Dutch hospitals.

BACKGROUND: In 1983 hospital budgeting was introduced in the Netherlands. We studied the effect of the enactment of budgeting on the efficiency and effectiveness of health care. METHODS: In four different age groups, the admission rate, length of stay, type and number of surgical inpatient procedures, and hospital mortality were measured in all short-term hospitals from 1977 through 1988. Data were standardized by age and sex. RESULTS: For the total population, the hospital admission rate and the operation rate decreased after 1982. However, for the subgroup of patients beyond the age of 65 both rates are still on the rise, but the increase in the admission rate for elderly patients has slowed significantly since 1983. The tendency toward a shorter length of stay, together with the diminished admission rates, led to a 22% decrease in standardized hospital days between 1982 and 1988. The severity of the operations increased. Most operations performed on elderly patients were aimed at improving the quality of their lives rather than lengthening their life expectancy. The hospital mortality rate decreased in all age groups. CONCLUSIONS: The findings suggest that modern medicine in the Netherlands has become more efficient and more effective. Better health care for older patients was achieved within the same budget. The tendency toward more efficiency by hospitals has been reinforced since 1983.

Adolescent↗
PubMed1990

[Melanoma of the skin in the national cause-of-death statistics and in the hospital statistics].

In the last 40 years the national mortality from melanoma of the skin, corrected for age, has increased by over 300%. Figures for males are always higher than those for females and this difference tends to grow larger. Since 1960 it has mostly been the mortality in the age groups 30-69 years that increased. The rise in mortality of older persons has been relatively small. Among the patients treated clinically, females are in the majority and increasingly so from year to year. Probability of survival is better for females than for males. Major shifts seem to occur in the localization of the lesion. Lesions are localized relatively less often in the skin of the head. In males, it is the frequency of melanomas of the trunk that is rising, while melanomas of the extremities are markedly increasing in frequency in both males and females.

Adult↗
PubMed1990

[The average costs of an admission to the hospital].

The mean cost of the hospital admission has increased considerably in the last 12 years, to an amount of Dfl. 7,415,- in 1988. However, if the greying of the patient population is taken into account (the elderly on average stay long in hospital), together with the devaluation of the guilder, a clear rise of the mean costs per hospitalization is no longer demonstrable. On the contrary, there is firm evidence to support the view that the cost per hospitalization has actually been decreasing since 1982, the last year before the beginning of budgeting. In addition, a very large amount has been saved due to a considerable decrease of the number of admissions.

Adolescent↗
PubMed1990

[With decreasing mortality does the incidence of acute myocardial infarct decrease also?].

It is unknown how many cases of acute myocardial infarction, fatal or non-fatal, are treated non-clinically. Using various approaches to the available figures from hospital records and statistics of causes of death, it appears possible, however, to conclude that apart from the number of deaths the number of cases, also, has decreased fairly markedly in the last few years.

Adult↗
PubMed1990

[Observations on the current status concerning the epidemic of acute myocardial infarction].

After the mortality from acute myocardial infarction had reached its peak in 1972, a decrease started which by now, taking into account the increase and the greying of the population, already amounts to 33%. Nevertheless, in 1987 as many as 19,168 deaths were still recorded. When after World War II the mortality rose, it was found that the victims included a growing proportion of younger persons. Currently, however, the decrease of mortality in general is most pronounced among the younger age groups. Among the patients treated in hospital, mortality shows an evenly distributed decrease. The admission rates from the populations of commuter municipalities and from rural areas are relatively low, those from medium-sized municipalities with an urban character, relatively high.

Adult↗
PubMed1989

[Frequency and surgical mortality in surgery of the heart and of the intrathoracic large vessels. I. Direct coronary revascularizations].

The number of bypass operations has increased considerably in the last decade. This applies mainly to the multiple bypasses. The number of single bypasses is beginning to decrease. The proportion of the elderly among the patients is rising markedly. The surgical mortality is decreasing strongly, especially among males. It is higher for females than for males. Interestingly, this mortality is not higher for multiple bypasses than for single ones, rather the reverse. The mortality rate of implantation of the internal mammary artery into a coronary vessel is very low. The surgical mortality of bypass operations is lower than, for instance, that of partial gastrectomy or of pulmonary lobectomy.

Adult↗
PubMed1989

[Frequency and surgical mortality in surgery of the heart and intrathoracic large vessels. II. Operations other than direct coronary revascularization].

Just as bypass operations, the number of operations for other lesions of the heart and great vessels are increasing. The surgical mortality among infants operated on because of congenital anomalies is high. Despite the rising number of patients in this age group, mortality after surgery for ductus arteriosus and for Fallot's tetralogy is falling. The mortality of certain operations for non-congenital anomalies also shows a tendency to decrease. Hitherto, the mortality rate of cardiac transplantations has been relatively low. Progress of cardiac surgery appears to manifest itself with a decreasing nationwide number of deaths from congenital anomalies of the heart and great vessels.

Adolescent↗
PubMed1989

[Acute rheumatism and glomerulonephritis; current clinical incidence and mortality in The Netherlands].

The marked decline of morbidity and mortality of both rheumatic fever and acute glomerulonephritis reported in 1977 proves to have continued after 1975. After 1976, not a single death from rheumatic fever has been reported in The Netherlands, and in 1985-1987 only three deaths from acute glomerulonephritis were recorded. Nearly all European countries apart from the USSR, as well as Australia, Japan and New Zealand and North America report the same favourable trend, at any rate for rheumatic fever. Its possible causes are discussed. Some regional epidemiological rises in the US so far are no reason for alarm, although they do make it clear that it would be premature to speak of dying-out diseases.

Acute Disease↗
PubMed1989

[Results of current treatment of testicular cancer].

Owing to various new therapeutic possibilities, mortality from cancer of the testis has decreased to approximately one-third since 1968. This decrease was accompanied by a marked rise of the number of hospital admissions.

Adolescent↗
PubMed1989

[A diminishing number of thyroid operations in The Netherlands in 1972-1986].

The numbers of thyroidectomies in The Netherlands decreased by 35% in the period 1972-1986. The decline started in 1977 and was the result of a decrease in the numbers of thyroidectomies for nontoxic diffuse and nodular goitre, and for toxic diffuse and nodular goitre. The numbers of thyroidectomies for malignant and benign thyroid neoplasms remained unchanged. These findings can be explained by a decrease of the indication for surgery in nontoxic nodular goitre due to the introduction of fine needle aspiration cytology and an increase of the application of radioactive iodine in the treatment of toxic diffuse and nodular goitre. The decrease of the number of thyroidectomies for nontoxic goitre in the younger age groups is suggestive of a lower prevalence due to the improvement of the iodine supplementation. The mean hospital stay for thyroidectomy decreased from 19.5 to 10.1 days. The hospital mortality rate after partial thyroidectomies decreased from 6.6% to 0.9%.

Adolescent↗
PubMed1989

[Admissions and bed occupancy at the hospital before and after the beginning of budgeting; a dance of billions].

Hospital budgeting was enacted in 1983 and led to a spectacular decrease of hospital admissions. Admissions of elderly patients were an exception, however; progress in medicine results in ever-increasing possibilities of adequate treatment for this group. The shortening of the average hospital stay, evident since a number of years, continued unchanged after 1982. Taking into account the greying of the patients, the number of hospital days per 100 of the population has decreased by 20% between 1982 and 1987. This descending curve grows increasingly steep. The evolution outlined has probably resulted in a 10-figure reduction.

Adolescent↗
PubMed1989

[Operations before and after the beginning of budgeting; ever better results from medical practice].

The number of operations performed clinically has decreased fairly steeply, mostly since 1982, the start of hospital budgeting. This decrease concerns all age groups except that of 65 and older. It appears that especially the minor operations are performed in the outpatient clinic more often than formerly. In spite of the fact that this renders the clinical operation schedule gradually heavier, the mortality of patients undergoing clinical operations, already low, continues to decrease rather rather markedly. These findings strongly suggest that the progress of modern medicine also particularly benefits the aged.

Adolescent↗