Tom E D van der Grinten

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BACKGROUND In the Netherlands municipalities are legally required to draw up a Local Health Policy Memorandum every four years. This policy memorandum should be based on (local) epidemiological research as performed by the Regional Health Services. However, it is largely unknown if and in what way epidemiological research is used during local policy(More)
The policy of the Dutch government (now enshrined in legislation) aims at the integration of medical specialists in hospitals and seeks to end the economic and organisational autonomy of the medical specialist. This article suggests that this policy has also acted as an incentive for medical specialists to develop local strategies that often diverge.(More)
In this article we analyze the evolution of market-oriented health care reforms in the Netherlands. We argue that these reforms can be characterized as policy learning within and between competing policy programs. Policy learning denotes the process by which policy makers and stakeholders deliberately adjust the goals, rules, and techniques of a given(More)
Photosynthetic biofilms are capable of immobilizing important concentrations of metals, therefore reducing bioavailability to organisms. But also metal pollution is believed to produce changes in the microalgal species composition of biofilms. We investigated the changes undergone by natural photosynthetic biofilms from the River Meuse, The Netherlands,(More)
This article provides a critical analysis of the impact of health technology assessment (HTA) on priority setting in The Netherlands. It describes the limited steering powers of the Dutch government; its complex interactions with insurers, health-care providers, and patients; and the role of HTA in this context as an attempt to rationalize the debate about(More)
In the light of experience that choices in health care appear to be not so much hindered by a lack of insight into how choices should be made in theory, as uncertainty as to how choices could be made in practice, this paper sets out to deepen our insight into the dynamics of health care policy making within the concrete socio-economic and political context.(More)
Analyses the way hospital organisation models handle the relationship between medical specialists and hospital management. All models that have been developed during the last ten years seek to integrate the medical specialists in the hospital organisation by formally subordinating them to the hospital management. However, recently a new model has come to(More)
Waiting times in specialist medical care are difficult to reduce owing to the fast-growing demand with supply lagging behind. These waiting times were the subject of a conference of this Journal, where experts from different backgrounds assessed the problems and discussed promising ways of coping with them at micro, meso and macro level. In the first(More)
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