Department of Public Health and Primary Care

More information about the projects of Health Economics and Management

Overzicht

Projects

A sustainable financing model for the telemonitoring of patients with cardiac implanted electronic devices.

Collaborators: Sarah Raes, Lieven Annemans, Jeroen Trybou

Site: https://research.ugent.be/web/result/project/4a823e92-2a81-11ec-a6b4-cd4eac00b947/details/3s000521-een-duurzaam-financieringsmodel-voor-de-telemonitoring-van-patienten-met-geimplanteerde-hartapparaten/nl

Period: 11/2021 –11/2025

Telemonitoring of patients with Cardiac Implanted Electronic Devices (CIEDs) refers to the process of using telecommunication and information technology to monitor the health status of a patient from a distance. It has emerged as a tool to evaluate several parameters of the cardiovascular physiology and risk of the patient. Moreover, it enables clinicians to promptly initiate the appropriate treatment and care, and prevent a full manifestation of a cardiac decompensation. However, the use of telemonitoring is discouraged by the current healthcare financing models. The traditional fee-for-service (FFS) models are challenged by the modalities of telemonitoring: telemonitoring has the possibility to reduce the number of follow-up visits, while FFS models would stimulate the number of follow-up visits. Therefore, this project aims to develop a sustainable financing model for the telemonitoring of CIEDs. To create this model, a health-economic analysis will be conducted to examine the clinical effects and cost savings of telemonitoring using long-term and routine practice data. The modalities of the financing model will be discussed with cardiologists, nurse specialists and patients. Different situations will be simulated to develop the optimal financing model. This research might stimulate future researchers to investigate sustainable healthcare financing models for other telemonitoring applications, including applications in other medical fields.

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Better4You (Horizon Europe)

Collaborators: Delfien Gryspeerdt, Nick Verhaeghe, Lieven Annemans, Ruben Willems

Site: https://cordis.europa.eu/project/id/101080117

Period: 11/2023 – 10/2027

BETTER4U aims at the identification and personalized management of all weight gain determinants to battle the increasingly rising numbers of overweight/obesity, via homogenous, globally adaptable and practically assessed public health initiatives and key interventions. Building on previous key projects and biobanks, the project will focus on the hitherto neglected impact of the polygenic background of weight gain on the effectiveness of lifestyle interventions for weight management in people with overweight/obesity.

BETTER4U aims to probe into the global obesity challenge, study the problem and offer solutions in a tangible realistic way with the assistance of modern AI technologies and the contribution of experts around the world. BETTER4U will be realized through the following objectives:

  1. To comprehensively understand and decipher genetics, metabolomics, microbiota, socio-economic, geographical, cultural and lifestyle features linked to weight gain throughout the life course, via meta-analyses (BETTER4U data from >50 studies, >1 million individuals) and extensive literature meta-review.
  2. To develop the BETTER4U intervention methodology for weight gain prevention, based on a causal AI model of obesity determinants and a pilot study in 7 European countries.
  3. To deploy technology-assisted, real-time monitoring tools to measure detailed behavioral indicators and their relation to the environmental context.
  4. To evaluate the efficacy of the novel BETTER4U intervention methodology in a controlled, randomized clinical trial, based on individually-tailored recommendations for lifestyle change.
  5. To maximize transferability and applicability of the BETTER4U intervention methodology by identifying implementation barriers and facilitators, as well as to evaluate implementation outcomes in both participants and stakeholders.
  6. To develop and disseminate the BETTER4U obesity prevention intervention methodology guidelines using a people-centred, sustainable care approach.

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Corporate Wellbeing in Practice

Collaborators: Andrea Prezzi, Lieven Annemans

Site: /

Period: 03/2024 – 03/2027

The University of Ghent and COWECO (Corporate Wellbeing and Coaching) are collaborating with the primary aim of supporting companies and organizations in developing a holistic understanding of their employees and optimizing their performance within the organization. COWECO's approach results in tailor-made guidance for each company, with a holistic perspective of every employee as the foundational principle. This includes offering advice on various aspects such as optimizing teamwork, improving interpersonal relationships, and fostering a healthy corporate culture.

The initial experiences with this approach show promising results. Subsequent research efforts will be essential for carefully assessing the extent to which the hypotheses are confirmed and identifying specific indicators crucial for promoting well-being and engagement in the workplace.

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Mental health promotion: definition, vision setting and policy priorities

Collaborators: Nick Verhaeghe, Ruben Willems

Site: /

Period: 01/2024 – 12/2024

Many policy and field actors are currently working on mental health promotion (GGB), which translates into a multitude of overlapping initiatives, actions, programmes and projects. This creates fragmentation and a lack of clarity, leaving many stakeholders and partners overwhelmed.

Moreover, because each partner is committed to its defined area, there is little room for a coherent GGB strategy and to adjust where necessary. Developing a shared guiding policy vision and a clearly defined conceptual framework on GGB makes it possible to structure the existing supply, makes supply gaps visible and set priorities for the future.

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DigiCare4You (Horizon Europe)

Collaborators: Delfien Gryspeerdt, Lieven Annemans, Ruben Willems

Site: https://digicare4you.eu/ and https://cordis.europa.eu/project/id/945246

Period: 04/2021 – 09/2025

The DigiCare4You project aims to develop, implement and evaluate an organizational, technological and public health innovation aiming to empower families and integrate community care services in Europe for the prevention and management of type 2 diabetes (T2D) and/or hypertension (HTN). A multidisciplinary, cross-sectorial, international team will jointly work with local stakeholders to adaptively develop the DigiCare4You innovative solution, tailor-made to local contextual circumstances. Specifically, local community health centres in collaboration with schools will implement a non-invasive digital screening procedure (1st screening) targeting all families associated with the local schools.

The adults identified at high risk for T2D and/or HTN will be invited for a brief medical examination at the community health centres (2nd screening) and those confirmed to be at risk (or patients) will be provided with access to an m-health lifestyle and counselling intervention, coordinated by the available community healthcare workforce. For both screening and lifestyle intervention, real-time monitoring will be applied to allow corrective actions when needed to refine protocols and ensure equitable and inclusive access to better health services for all segments of the population.

Implementation, service and client outcomes, as well as cost-effectiveness of the project will be used to develop a prediction model to help decision makers decide on its future implementation and evaluate its potential impact on health system performance. These outcomes will further contribute to formulate guidance on the successful scaling-up or transfer of the innovative solution. Via co-participatory procedures, researchers, stakeholders and policymakers will promote capacity building for local communities and health systems and provide the evidence needed to support digital transformation of health and care in Europe.

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FEBRIS: Flemish joint Effort for Biomarker pRofiling in Inflammatory Systemic diseases (FWO-TBM)

Collaborators: Nick Verhaeghe, Pieter Vynckier

Site: https://biblio.ugent.be/project/3T004721

Period: 10/2021 – 09/2025

With the multi-centre Flemish Joint Effort for Biomarker pRofiling in Inflammatory Systemic diseases FEBRIS), we will integrate cytokine profiles by multiplex immunoassay (MIA) into the diagnostic workup and management of pediatric and adult patients with inflammatory syndromes of unknown origins and/or with insufficient response to first line therapy. In parallel with recent literature, we characterized specific cytokine profiles differentiating different diseases, allowing to implement it as a generic test that copes with the wide variety of diseases in the target group. The validation of our assay in larger cohorts with proven or suspected inflammatory disorders will guide time-, resource- and cost-efficient workup and personalized management.

This project is a collaboration between Ghent University, Antwerp University, Hospital Ghent University,  Hospital Jessa Ziekenhuis, ZiekenhuisNetwerk Antwerpen and the Health Economics and Management Unit of Ghent University.

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Experience of empowerment and client-centered care in cash-for-care schemes

Collaborators: Eva Pattyn, Jeroen Trybou, Ruben Willems

Site: /

Period: 2018-2024

Several countries have experimented, nationally or regionally, with cash-for-care schemes to enhance the experience of empowerment and client-centered care. In a cash-for-care scheme, governments offer a cash budget or voucher to the care user instead of directly funding the care organization or care provider. This way, care users get purchasing and decisional power over their care arrangement.

However, debate exists whether cash-for-care schemes enhance empowerment and client-centered care, since, according to opponents, these scheme often comes together with an hidden agenda of financial austerity and the delegation of responsibilities from the government to the care user and/or their proxy. By giving the responsibility of managing care and support to the care user, opponents argue that care users become more vulnerable to accountability issues, service gaps and poor service quality. Since discussion exists on whether cash-for-care schemes are associated with the experience of empowerment and client-centered care, this doctoral dissertation focuses on exploring the experience of empowerment in cash-for-care schemes and the factors associated with this experience. These factors can be inherent to the cash-for-care scheme or inherent to the care user/budget holder. Furthermore, the association between empowerment and client-centered care is explored.

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IDECA

Collaborators: Ruben Willems, Liesbeth Borgermans, Lieven Annemans

Site: /

Period: 10/2021 – 12/2024

Depression creates a substantial personal burden for affected individuals and their families, and produces significant economic and social hardships that affect society as a whole. In Belgium, depression is a leading cause of disability, measured as disability-adjusted life years. The COVID-19 pandemic has greatly exacerbated the already substantial health and socioeconomic consequences of depression and has led to major changes in the need for and delivery of mental health services. Integrating mental health services into primary care is the most viable way to closing existing treatment gaps. The majority of people with mental disorders treated in primary care have good outcomes, particularly when linked to a network of services at secondary level and in the community.

A balanced model of depression care calls for a system with community-based mental health care, delivered by primary care physicians and supported by other professionals in an eco-system of care. This projects aims to implement an integrated depression care (IDECA) intervention in two regions in Flanders, Belgium with evaluation of the intervention’s working components, its acceptance by patients and care providers, and the contextual conditions which needs to be fulfilled to safeguard success of the model of care.

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iMens hybrid care path

Collaborators: Lisa Van Wilder, Jeroen Trybou, Ruben Willems

Site: https://www.i-mens.be/pers/nieuwe-hybride-dienstverlening-voor-diabetes

Period: 10/2021 – 03/2024

i-mens and Z-Plus in collaboration with Roche and Syndo Health are developing a possibly cost-efficient, modular and digitally-supported type 2 diabetes care path. Via self-monitoring and personalised medical and lifestyle interventions, they aim to improve quality of life and general health of patients.  This pilot project evaluates the effectiveness and cost-effectiveness of the hybrid care path.

Leerstoel NN-UGent: nationaal geluksonderzoek / National Happiness Study

Collaborators: Sara Claes, Lieven Annemans

Site: geluk.ugent.be (niet up to date)

Period: 2017 – dec 2024

Interest in the subjective well-being of individuals and nations has grown rapidly over the past 50 years, both in the scientific and popular literature. Moreover, subjective well-being (the scientific term for "happiness") is increasingly used alongside objective economic data to investigate social progress and prosperity, evaluate public policies and predict outcomes in individuals and societies. Well-being indeed deserves to be recognized in policy making. After all, happy people have higher-quality social relationships, perform better at work, are healthier and tend to live longer.

Given the numerous benefits in various life domains, maintaining and promoting the well-being of the general population is of key importance. Therefore, a first objective of this research project is to identify factors contributing to the subjective well-being of the Belgian population. Secondly, this project will evaluate the effectiveness of an online well-being intervention which promotes physical activity and mindfulness practices.

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CHW Compass (FWO-SBO)

Collaborators: Nick Verhaeghe, Tijs Van Iseghem

Site: https://www.uantwerpen.be/en/projects/compass/about-us/

Period: 01/23 - 12/26

The main research objective of this project is to design, implement and test an outreach integrated primary healthcare (PHC) model, with the CHW intervention as the key innovative characteristic, inspired by the reverse innovations from Brazil and South Africa. This outreach integrated PHC system aims to improve access to PHC for vulnerable groups in Flanders, who are not or not adequately being reached today. In particular, we will focus on health economic aspects including an evaluation of the cost-effectiveness of the intervention.

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Measuring the health and economic impact of skin cancer to optimalize skin cancer care

Collaborators: Nick Verhaeghe, Annick Meertens

Site: /

Period: 09/2022 – 08/2026

Skin cancer is the most common cancer in Belgium, 1 out of 5 persons will develop skin cancer before the age of 75 years. Due to the high incidence rates, skin cancer constitutes a significant economic burden on society. It is important to examine this economic burden. Within this PhD project we want to identify the main cost drivers in skin cancer. The three most common types of skin cancer are; basal cell carcinoma squamous cell carcinoma and melanoma skin cancer. Basal and squamous cell carcinoma are together called keratinocyte carcinomas (KC) and are less aggressive than melanoma. Although KC may be less aggressive, it is known to influence the health-related quality of life in a specific way.

One of the aims of this project is to measure the impact of KC on health-related quality of life. By identifying the most important costs within skin cancer and measuring the impact on health-related quality of life, strategies to optimize skin cancer care can be identified by an international expert panel according to the Delphi methodology. Subsequently, the most relevant strategy to optimize skin cancer care will be evaluated on its cost-effectiveness.

This PhD project is a collaboration between the Department of Dermatology of the University Hospital Ghent and the Health Economics and Management Unit of Ghent University.

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Ontwikkeling van een vragenlijst voor het bevragen van de ervaringen van gebruikers betrokken in de pilootfase RTH

Collaborators: Eva Pattyn, Jeroen Trybou, Ruben Willems

Site: /

Period: 07/2023 – 12/2024

In Flanders, a person-based funding system (PVF) was introduced in the disability sector in 2017. This system consists of two stages: directly accessible assistance (RTH) and the person-following budget (PVB). The aim of PVF is to give caregivers more control over their care, support and life, and to give them the opportunity to tailor their care and support to their wishes, needs and lifestyle. In other words, this would ensure that care and support is offered in a more demand-driven way and the person with a disability is placed at the centre of both funding and organisation of care. However, this also requires the care organisations involved to adapt their services. To stimulate demand-driven work, the Flemish Government therefore offered resources and space to let organisations experiment with new forms of service provision in a regulatory framework. 111 initiatives were selected which form the RTH pilot projects.

The aim of the study is to measure the client-orientation of care and support among the users of the RTH pilot projects and subsequently among all clients using RTH. The experience of client-orientation is thereby considered from four predefined themes: 1. rapidly deployable and flexibly adaptable, 2. approachable and nearby, 3. demand-oriented and tailored, and 4. integrated and aligned with other (non-VAPH) support.

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PrevenD 2.0: Implementation of gamified cognitive control training to prevent recurrence of depression (FWO-TBM)

Collaborators: Nick Verhaeghe, Constance Nève de Mévergnies

Site: https://cogtrain2.ugent.be/nl/about-us

Period: 01/2021 – 12/2024

PrevenD 2.0 focuses on the implementation of a well-validated eHealth intervention for remitted depressed (RMD) patients. Despite the availability of a wide range of pharmacological and psychological interventions for depression, there is a specific problem in the prevention of recurrence of depression. In this context, sustained impairments at the level of working memory- and executive functioning have shown to form an important risk factor, interfering with daily life activities following remission from depression.

For this purpose, we developed and evaluated a gamified cognitive control training (CCT) platform in close contact with stakeholders (PrevenD 1.0). The CCT procedure was well received among the target population, where the intervention has shown to impact cognitive functioning in the long-term and reduce risk for recurrence of depression. However, before CCT can readily be implemented in clinical practice, several questions need to be addressed. PrevenD 2.0 aims to resolve these questions. In particular, we focus on health economic aspects including an evaluation of the cost-effectiveness of the intervention.

This project is a collaboration between The UGhent departments ‘Head and Skin’, ‘Experimental Clinical and Health Psychology’ and the Health Economics and Management Unit of Ghent University.

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PRIORITY: Personalized remotely guided preventive exercise therapy for a healthy heart (FWO-TBM)

Collaborators: Nick Verhaeghe

Site: https://www.inspanningstherapie.be/

Period: 01/2021 – 12/2024

The current research proposal aims to deliver the needed scientific evidence to support  the use of remotely guided exercise therapy as an imperative preventive cost-effective treatment in  the heart failure preserved ejection fraction (HFpEF) continuum; with prevention of progression of asymptomatic diastolic dysfunction towards symptomatic HFpEF at one hand (=primary prevention) and delaying progression of symptomatic HFpEF at the other hand (= secondary prevention). Therefore, we will conduct a large randomized controlled multicenter exercise trial which will compare the proportion of patients with a clinically relevant improvement in pVO2 following person-tailored exercise therapy or usual care in patients with HF stage A/B/C.

We further also hypothesize that personalized exercise therapy, delivered according to our hybrid exercise intervention, will engage a larger proportion of patients to take up and maintain an active lifestyle in the longer-term. Finally, using a machine learning approach, PRIORITY will develop models that can identify patients that are more likely to 1) engage with exercise therapy, and 2) respond favorably to the PRIORITY exercise intervention in order to facilitate a more personalized intervention strategy and exercise program to maximize its therapeutic effectiveness.

This project is a collaboration between partners from the KU Leuven, UZ Leuven, University of Antwerp, UZA and the Department of Public Health (Prof. Delphine De Smedt and Prof. Nick Verhaeghe) at Ghent University.

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SMILE: cost-utility and impact of high-intensity speech therapy on Speech, MotIvation, and quality of LifE in children with cleft palate (FWO-TBM)

Collaborators: Nick Verhaeghe

Site: /

Period: 01/2024 – 12/2027

A cleft palate ± a cleft lip is the most prevalent congenital craniofacial defect. The societal burden of this condition is substantial as it impacts speech, hearing, feeding, oral behavior, dentition, and satisfaction with appearance. These consequences have a prolonged and adverse influence on social integration and well-being. The WHO reported considerable financial costs incurred from this defect in terms of morbidity, health care, emotional issues and social exclusion for patients, their environments and society. Achieving speech that is understandable and acceptable to others is the key outcome in cleft treatment. Unfortunately, speech disorders often persist even after successful surgical closure of the palate. Therefore, speech therapy provided by a speech-language pathologist (SLP) is necessary. This intervention is traditionally provided twice per week for 30 minutes for months or even years by first-line SLPs. Unfortunately, this low intensity intervention is based on a historical context rather than scientific evidence. This means that current speech therapy knows several shortcomings including poor outcomes, treatment fatigue and high costs related to year-long therapy. Because of these issues, the use of high intensity speech intervention is proposed.

Even though solid proof-of-concepts exist for this model, it has not yet found its way into clinical practice. Before this intensity can be implemented and utilized in clinical practice, we must determine the effect of this novel program on a larger societal scale. We will tackle this issue by conducting a largescale RCT. This project will compare the effect high intensity and low intensity speech intervention in children with a cleft palate in terms of speech, quality of life, cost-utility, and acceptability as provided by first-line SLPs. The final goal is to utilize this program in clinical practice and to create awareness of the benefits for children with a cleft palate among stakeholders.

This project is a collaboration between the UGhent department of Rehabilitation Sciences, Ghent University Hospital, Leuven University Hospital, KU Leuven, and Health Economics and Management Unit of Ghent University.

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SUBOD

Collaborators: Pieter Vynckier, Lieven Annemans, Nick Verhaeghe

Site: https://www.sciensano.be/en/projects/improved-monitoring-disease-burden-attributable-substance-use

Period: 03/2023 – 03/2025

Tobacco and alcohol use are among the largest contributing risk factors for illness and premature death in the world. The SUBOD (Improved monitoring of the disease burden attributable to substance use) project aims to integrate the burden attributable to tobacco and alcohol use in the Belgian national burden of disease study. SUBOD provides a direct support to both the Tobacco plan 2022/2028 and the Alcohol plan 2022/2028, which explicitly call for an improved monitoring of tobacco and alcohol use and their respective impacts. The ultimate goal is to initiate an improved and routine monitoring of these impacts and estimate the economic cost of tobacco and alcohol use using the comparative risk assessment framework, defining the burden of risk factors as the sum of attributable burdens of the different causally related diseases.

For each risk-outcome pair, the attributable burden is obtained by multiplying the overall burden of the health outcome (e.g. in terms of Disability-Adjusted Life Years or economic cost) with the population attributable fraction (PAF), which is obtained by integrating data on exposure with the relative risks associating consumption with disease incidence or mortality. The SUBOD project directly contributes to the federal tobacco and alcohol plans, which explicitly call for an improved monitoring of tobacco and alcohol use and their respective impacts.

This project is a collaboration between Sciensano and the Health Economics and Management Unit of Ghent University.

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Staff turnover in the healthcare and welfare sector

Collaborators: Herlinde Wynendaele, Yannai Dejonghe, Jeroen Trybou

Site: https://www.steunpuntwvg.be/projecten/onderzoek-naar-uitstroom-van-personeel-in-de-zorg-en-welzijnssectoren

Period: 01/2023 – 06/2025

The healthcare and welfare sector in Flanders has faced a major staff shortage for decades, initially affecting mainly nurses and nursing assistants but eventually spreading to nearly all roles within the sector. Consequently, organisations have had to close wards, leave residential care beds vacant, and cut childcare spots. The reasons for and extent of staff turnover remain unclear, as do the factors that retain employees. Therefore, the aim of this study is to (1) gain insight into the staff turnover and (2) understand the reasons behind staff turnover in the health and welfare sector.

Through this knowledge, we seek to better understand staff dynamics in these sectors and contribute to an evidence-based approach to influence these staff dynamics in a positive way. The specific aim of this research is to develop a methodology that can be used in the long term to monitor the situation. The focus here is on setting up a scientifically based monitoring system that maps the (reasons for) turnover in all Flemish WVG (In Dutch: Welzijn Volksgezondheid & Gezin) sectors for all Dutch-speaking professional groups. This monitoring system will be a valuable tool for studying and understanding personnel dynamics in the healthcare and welfare sector.

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