Skip to ContentSkip to Navigation

Centre for Public Health in Economics and Business

Faculty of Economics and Business
Centre for Public Health in Economics and Business Events Conferences

2015 - The Dream Team!?

Informal carer, patient, and professional


Healthwise Groningen organised its third annual Healthwise conference on Friday 30 October 2015. Keynote speakers Edward Norton (University of Michigan), Marius Buiting (NVTZ) and Sophia de Rooij (UMCG) held lectures on the theme: ‘The Dream Team!? Informal care provider, patient, and professional’. Managers, professionals and researchers who work in the healthcare sector, science and policy world were cordially invited for this meeting. The conference offered a diverse programme with plenary presentations and parallel sessions of both scientists and professionals from practice.

Looking back

Keynote Edward Norton

The subject of the keynote lecture of prof. dr. Edward Norton was ‘Economics of Informal Care’. Norton gave an economic analysis of informal care, which is long ignored by economists. Informal care is unpaid care and is known as the most common long-term care (LTC), usually provided by for example adult children to their elderly parents. Informal care will become much more important in our society due to the increasing ageing – of course, economists have to be aware of this in their analyses.

It is difficult to quantify informal care in amounts or monetary value. Norton divided the models of informal care in (i) the supply of informal care, (ii) the relation between (paid) care and informal care and (iii) the family bargaining over living arrangements of the carereceiver. The supply of informal care usually consists of the children of the elderly with needs. These children try to find the right marginal rate of substitution between caregiving, leisure and work. Joint-decision making within a family about the living arrangements of the care receiver often leads to inefficient decisions due to the different preferences.

Informal care reduces home healthcare and nursing home use, so informal care can be seen as a substitute for (paid) care. The remaining question is, why do so many adult children give freely of their time to informal care? Is informal care really unpaid if children receive transfers of money like inter-vivos transfers and bequests from their parents? It appears that children who provide informal care have a higher probability to receive transfers. A stylised fact is that bequests are equally divided among children and inter-vivos transfers are not. The motives of the parents are often based on altruism to help their children and to avoid taxes, but aren’t the bequests exchange for informal care?

The primary focus of the theory is on exchange, the idea that elderly parents with needs will exchange money for informal care, so that informal care is in many cases not really unpaid care. Although, this theory is hard to quantify. Besides that, informal care adversely affects the physical and mental health of the caregiver. Concluding, informal care is an interesting and determinative phenomenon for economists and it is a fruitful area for future research.

Slides Edward Norton

Keynote Marius Buiting

Mr. Marius Buiting held a presentation on ‘Vision on the management of patient-centred healthcare’. In his lecture Buiting focused on the development of modern healthcare, which is patient-centred. He explained that changes in the current healthcare system are required in order to develop a patient-centred healthcare system. These changes include a different way of thinking that is based on the healthcare system of years ago. “Moving forward to the past” according to Buiting. Hereby, he emphasised that the time of professionals is wasted nowadays, due to the policies in which they should register all their actions, which doesn’t contribute to the quality of the healthcare in general.

Buiting mentioned three factors which are essential for providing patient-centred healthcare in stead of system-centred healthcare. First, the core of the quality of care depends on figurative love, one should return to the intended purpose of care wherein the system serves the patients. Second, the scarcity should be perceived as positive, this produces creativity in the delivery of healthcare. Third, the original meaning of the word ‘profession’ has to be taken into account; the dedication to something or someone is essential.

In the end, Buiting explained seven elements, which are important key elements to people who receive healthcare. (1) Professionals should know who the patient is, (2) simplicity; one patient, one plan and one caregiver, (3) loyalty and remaining attention for the patient, (4) care that fits the needs of the patient, (5) patient is in charge of his own care, (6) reciprocity and (7) professionals should realise that patients desire a sufferable and pleasurable day.

Keynote Sophia de Rooij

Prof. dr. Sophia de Rooij gave a keynote lecture on ‘Cooperation between professionals and cares in the transitional care for vulnerable patients’. Nowadays we are facing a greying society in which not only the number of people aged 60 years and older but also the number of people aged 80 years and older is growing. Because of this grey ‘tsunami’, there are less people who can give care and more people who need care. When older, vulnerable people need care and have to go the hospital, the most important question they often have is ‘Can I go home after my stay in the hospital or do I have to go to a nursing home?’ As a vulnerable patient then, it can be difficult to find your way in our highly (over) organised society due to health literacy amongst others.

To address this problem, the Dutch National Care for the Elderly Program was set up. In this nationwide program, research was used as a tool to improve the daily base practices and the networks for frail elderly. The participation of elderly in the set-up of this program was therefore really important. A transitional care model was applied in which an increase of the health span (adding healthy years) was an important goal.

There are a lot of factors during hospitalisation and the discharge of patients that will influence the abilities of the patient after their discharge. The ultimate goal of the program was to develop interventions with value. An example of an intervention is the transitional care bridge, in which the intervention started at the end of hospitalisation and continued in the home situation of the patient with the aid of a community care nurse. The transitional care bridge is implemented in 25 hospitals at this moment. Sophia de Rooij is working on new initiatives, ‘hospital@home’ is one of them.


11.30-12.30 Parallel sessions in the morning

1. Governance dilemmas regarding integrating formal and informal healthcare (Dutch)

dr. Manda Broekhuis (RUG), dr. Marjolein van Offenbeek (RUG) and Esther Kuiper (Espria Academy)

Governance dilemmas regarding integrating formal and informal healthcare

2. The role of the caregiver and the patient (Dutch)

Wilma Klaassen ( caregiver , healthcare freelancer)

Who takes care of whom?

drs. Jannie Oskam (author, expert by experience)

Shared decision making via an App?

3. Incentives in healthcare

Bart Noort , MSc (RUG)

The COPD care pathway: the right care at the right place?

Laura Viluma , MSc (RUG)

Economic downturns and babies’ health

4. Economic analysis of informal care

Prof.dr. Erik Buskens (UMCG), Prof.dr. Maarten Postma (UMCG), and R. Slegtenhorst, MSc

Economic analysis of informal care

slides Buskens

13.30-14.30 Parallel sessions in the afternoon

1. Early life conditions and late(r)-life outcomes

Dr. Viola Angelini (RUG)

Late-life health effects of teenage motherhood

Dr. Govert Bijwaard ( NIDI )

Understanding the Effects of Early Malnutrition: The Dutch Hunger Winter

2. Family participation in healthcare (Dutch)

Ellen van Weert, Antje van der Goot (Noorderbreedte) and Yvonne de Jong (advisor informal healthcare, Vilans)

Family participation in healthcare ( slides Noorderbreedte ) ( slides Vilans )

3. Citizen participation in healthcare (Dutch)

Organised by Zorg Innovatie Forum

Karin Kalverboer, MHD (Zorg Innovatie Forum), dr. Ellen Bos (Value2Share)

Citizen participation in healthcare

4. Incentives in healthcare

Lydia de Jong, MSc (RUG)

How can reward systems influence cross-disciplinary collaboration among medical specialists?

Maxim Laurijssen , MSc (RUG)

Beyond Money: Autonomy and Motivation

Last modified:09 April 2020 4.14 p.m.
Follow us ontwitter linkedin