Regulation and organisation of health care

Dit vak wordt in het Engels aangeboden. Omschrijvingen kunnen daardoor mogelijk alleen in het Engels worden weergegeven.

Doel vak

To provide students with theoretical and methodological knowledge to
describe, analyse and evaluate:
- The Dutch healthcare system (relationships between providers,
consumers, financers and state) under different social and political
- Health services (hospitals, primary care arrangements, home care and
- Quality of care

Final attainment levels:
- Students are able to describe and critically analyse health systems at
the national and local level under different social and political
- Students are able to describe and analyse the role and functioning of
the different stakeholders and health services within the healthcare
- Students are able to describe and apply theories and models relevant
for a healthcare system.
- Students are able to describe and analyse a quality of care problem
within Dutch healthcare, to apply relevant theories and instruments
(e.g. stakeholder analysis), describe an appropriate solution and
proposal for evaluation during a practical assignment.

Inhoud vak

- Health systems on the national level: various configurations (of
state, insurance companies, suppliers, and consumers) but comparable
- Health organisation on a local level
- Local markets and strategy
- Professional and bureaucratic organisation regimes
- Quality and safety: professional and organisational systems and
- Methods for stakeholder analysis


The theoretical and methodological concepts will be introduced and
discussed during the lectures and in the literature. These concepts
include organisational and policy theories relevant for describing the
Dutch healthcare system and (local) organisations. Guest lecturers will
apply the theoretical
concepts. They also provide
and illustrate cases concerning organisational problems and challenge
students to analyse the problems in order to develop a sophisticated
problem solving approach. The acquired knowledge has to be applied by
the students during the working groups and in the assignment.

In couples or small groups the students will write a report about a
quality problem in health care. In short, this report includes an
analysis of the current situation, a stakeholder analysis, a proposal
for improvement and an appropriate research plan to evaluate the
proposed intervention for improvement. During the working groups, the
students present their analysis and proposal to each other and the

Contact hours;
Lectures: 50 hours
Self-study: 73 hours
Working groups: 15 hours
Assignment: 35 hours


Students have to complete a written exam and write a report. The final
grade is composed as follows: exam (70%)+ report (30%). Both the exam
and the report need a score of at least 5.5 to successfully complete
this course.
In addition, students have to attend all guest lectures, practicals and
present the progress of their report during the practicals, where they
participate actively.


The following literature will be used and discussed during this course:
Boonstra, A. (2007). Invoering van interorganisatorische ICT in de
gezondheidszorg. Analyse van een casestudie vanuit belangengroepen
perspectief. M&O, 61 (2), 63-86.
Bruijn, J.A. de and Heuvelhof, E.F. ten (2007). Management in Netwerken
– over veranderen in een multi-actorcontext. Den Haag: Boom Lemma
uitgevers. Hoofdstuk 1.
Buse, K., Mays, N., and Walt, G. (2005). Making health policy. London:
Open University Press. Hoofdstuk 1,2,4,5,6,7,9 &10.
Ensign, P.C. (2001). Value chain analysis and competitive advantage:
Assessing strategic linkage and interrelationship. Journal of General
Management, 27(1), 18-42.
Gawande, A. (2013). Slow ideas. The New Yorker: Annals of Medicine.
Glouberman, S. and Mintzberg, H. (2001). Managing the Care of Health and
the Cure of Disease—Part I Differentiation. Health Care Management
Review, 26(1), 56-69.
Hope Hailey, V. and Balogun, J. (2002). Devising context sensitive
approaches to change: The example of Glaxo Wellcome. Long Range
Planning, 35, 153-78
Leistikow, I.P., Tuijn, Y. van der, Diemen, R. van (2015). IGZ promoot
just culture. Medisch Contact, 70(38),1742-4.
Leistikow, I.P., Mulder, S., Vesseur, J. and Robben, P. (2016). Learning
from incidents in healthcare: the journey, not the arrival matters. BMJ
Qual Saf, 0, 1-5.
Minkman, M.M.N. (2012). The current state of integrated care: an
overview. Journal of Integrated Care, 20(6), 346-58.
Mintzberg, H. (1987). Crafting Strategy. Harvard Business Review.
Okma, K.G.H. and Crivelli, L. (2013). Dutch and Swiss ‘consumer-driven
health care’: ideal model or reality? Health Policy, 109 (2),105-12.
Oldenburg, C.S., van den Berg, J.M. and Leistikow, I.P. (2015). All
aboard, getting nationwide indicators on the rails. BMJ Outcomes
(Inaugural collection).
Schein, E.H. (1993). Defining Organizational Culture. In Shafritz, J.M.,
Ott, J.S. and Suk Jang, Y. Classics of organization theory. (Hoofdstuk
7.1). USA: Thomson Wadsworth.
Scholes, K. (1998). Stakeholder Mapping: A Practical Tool for Managers.
In Ambosini, V., Johnson, G. and Scholes, K. Exploring Techniques of
Analysis and Evaluation in Strategic Management (Hoofdstuk 9). Hemel
Hempstead: Prentice Hal.
Schoten, S.M. van, Groenwegen, P.P. and Wagner, C. (2013). De
ontwikkeling van kwaliteitssystemen in Nederlandse ziekenhuizen tussen
1995 en 2011. Tijdschrift voor Gezondheidswetenschappen, 91(8), 489-96.
Wagner, C. (2011). Patiëntveiligheid. In: Wollersheim, H., Bakker,
P.J.M., Bijnen, A.B., Gouma, D.J. and Wagner, C. Kwaliteit en veiligheid
in patiëntenzorg (Hoofdstuk 5.4, 5.5 & 5.8-5.11). Houten: Bohn Stafleu
van Loghum.
Wagner, C. and Wal, G. van der (2005). Voor een goed begrip. Medisch
contact, 60(47),1888-91
Waring, J. (2005). Beyond blame: cultural barriers to medical incident
reporting. Social Science and Medicine, 60 (9), 1927-35.
The final list of course literature will be available on Canvas to
the participating students


MSc students Health Sciences

Overige informatie

Involved lecturers:
- Prof. Dr. M.C. de Bruijne
- Dr. H. Merten, contact person for this course:

Guest lecturers:
- Guest lecturers will be announced through the course schedule
NB This course will be in Dutch.
Students are expected to be familiar with: Mackenbach en van der Maas,
Volksgezondheid en gezondheidszorg, sixth edition (or later)

Afwijkende intekenprocedure

Use VUnet to enroll for this course

Aanbevolen voorkennis

Students are expected to be familiar with: Mackenbach en van der Maas,
Volksgezondheid en gezondheidszorg, sixth edition (or later editions)

Algemene informatie

Vakcode AM_470809
Studiepunten 6 EC
Periode P2
Vakniveau 500
Onderwijstaal Engels
Faculteit Faculteit der Bètawetenschappen
Vakcoördinator dr. M.C. de Bruijne
Examinator drs. H. Merten
Docenten drs. H. Merten
prof. dr. C. Wagner

Praktische informatie

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