Abstract
This thesis explores how value-based healthcare (VBHC) can enhance the cost-effectiveness of treatment of inflammatory bowel disease (IBD). The thesis is divided into five parts, beginning with a general introduction to VBHC, followed by an analysis of the methodological challenges in implementing VBHC in healthcare. The thesis also examines complexities in IBD treatment and evaluates interventions to improve cost-effectiveness by balancing effectiveness, costs, and safety.
The section on methodology discusses the challenges of defining and implementing VBHC, particularly in IBD care. The IBD Value study, a collaborative effort involving eight hospitals, aims to evaluate outcomes and costs of IBD treatment through VBHC. The thesis also addresses issues related to data collection and analysis, such as the need for high-quality data and strategies for managing missing data. It presents a software package for electronic health records, and validates the self-administered comorbidity questionnaire to enhance the accuracy of comparisons between treatment outcomes across hospitals.
In the third section, the thesis presents findings on the epidemiology and cost burden of IBD care, highlighting rising patient numbers and the increasing use of biologics. In the fourth section, the Lengthening Adalimumab Dosing Interval (LADI) trial is presented, which found a new dosing regimen to be non-inferior in terms of effectiveness while reducing side effects and costs. In the discussion future research directions are proposed, including the use of nationwide data, machine learning, and predictive models to optimize IBD care and improve clinical decision-making. These findings aim to guide the design of future VBHC studies and address gaps in the field to improve patient outcomes and healthcare efficiency.
The section on methodology discusses the challenges of defining and implementing VBHC, particularly in IBD care. The IBD Value study, a collaborative effort involving eight hospitals, aims to evaluate outcomes and costs of IBD treatment through VBHC. The thesis also addresses issues related to data collection and analysis, such as the need for high-quality data and strategies for managing missing data. It presents a software package for electronic health records, and validates the self-administered comorbidity questionnaire to enhance the accuracy of comparisons between treatment outcomes across hospitals.
In the third section, the thesis presents findings on the epidemiology and cost burden of IBD care, highlighting rising patient numbers and the increasing use of biologics. In the fourth section, the Lengthening Adalimumab Dosing Interval (LADI) trial is presented, which found a new dosing regimen to be non-inferior in terms of effectiveness while reducing side effects and costs. In the discussion future research directions are proposed, including the use of nationwide data, machine learning, and predictive models to optimize IBD care and improve clinical decision-making. These findings aim to guide the design of future VBHC studies and address gaps in the field to improve patient outcomes and healthcare efficiency.
| Original language | English |
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| Award date | 29 Jan 2025 |
| Place of Publication | Rotterdam |
| Publication status | Published - 29 Jan 2025 |