Recently, FEB researchers Taco van der Vaart and Huib Cense received funding from Stichting Kwaliteitsgelden Medisch Specialisten (SKMS, Foundation for Quality Funds for Medical Specialists) for a large four-year research project titled ‘Datadriven Insights into Healthcare Quality and Affordability’. The research team will examine whether and how healthcare claims data can be used to generate meaningful insights into the outcomes and quality of specialist medical care.

Research objective

The project aims to build a scientific foundation for whether – and especially how – healthcare claims data can be used to generate meaningful insights into the outcomes and quality of specialist medical care. The ultimate goal is to support improvements in healthcare delivery, based on the principle that such improvements are only possible when differences in outcomes and quality can be properly understood and explained.

The project examines the extent to which claims data can generate additional insights into healthcare outcomes and the quality of specialist medical care. In particular, it explores how these data can help explain differences in quality between hospitals and how they can support learning and improvement, inform patient choice, and enhance managerial decision-making. A further key objective is to design an approach – and corresponding tools – that enables the added value of claims data to be used more easily and systematically in the future, thereby strengthening quality registries.

The research consortium

The project is powered by Zorgverzekeraars Nederland (ZN, Health Insurers Netherlands) and the Federation of Medical Specialists (FMS). The research consortium includes several crucial partners, including Vektis (organizes data of insurance companies) and DICA (Dutch Institute for Clinical Auditing) and other medical quality registries. FEB’s team is headed by Huib Cense and Taco van der Vaart.

Research set up

Van der Vaart and Cense have used the funding to appoint two post-doctoral researchers (Michael Fröhlke and Maurits Visser) and there are two PhD candidate positions still to be filled. Fröhlke and Visser will primarily address the technical challenges associated with the data sources – claims data and clinical quality registries – and focus on how these sources can be meaningfully integrated to enable the evaluation and comparison of outcomes and the quality of specialist medical care. Building on this groundwork, the two PhD candidates will conduct in-depth studies on the quality of specialist medical care through multiple case studies focusing on selected medical conditions. They will use the linked claims and registry data to assess quality and outcomes across hospitals. Furthermore, they will explore inter-hospital differences in detail, based on the premise that meaningful improvements in care can only be achieved when variations in outcomes and quality are properly understood and explained.

Societal relevance

Quality registries play a central role in monitoring and improving healthcare quality by systematically comparing outcomes between hospitals and visualizing trends over time. However, they face several methodological and practical limitations. Most registries are organized at the hospital level and focus on a single condition or treatment pathway within one specialty. As result, quality registrations can track patients across care providers only to a limited extent, leaving important aspects of integrated care, parallel treatments, and follow-up primary care largely invisible. This constrains the ability to adjust for additional case-mix differences and to fully interpret observed variations in quality between hospitals.

Claims data offer important opportunities to partly overcome these limitations. Because they capture the full spectrum of healthcare use – before, during, and after treatment, and across hospital care and non-hospital care – they enable a more longitudinal and cross-sectoral view of patient pathways. Combining these insights can open new possibilities for explaining regional differences in quality, patterns of care use, and costs, while supporting the management of sustainable, value-driven care tailored to patients’ needs and circumstances.

The Federation of Medical Specialists and the Quality Funds for Medical Specialists

The Federation of Medical Specialists (FMS) unites 23,000 medical specialists and 32 scientific associations, collaborates on the practice and development of the profession, and represents the medical profession in politics and society. The Quality Funds for Medical Specialists (SKMS) are used to finance projects that contribute to improving the quality and transparency of care provided by medical specialists. This includes the development of guidelines, the development and refinement of quality assessments and quality registrations, as well as the creation of choice cards, decision aids, knowledge agendas, and long-term quality policies.

About the research leads

Taco van der Vaart is Professor of Supply Chain Management and Department Chair of FEB’s Department of Operations. His expertise lies in the field of Supply Chain Management, and Healthcare Operations & Supply Chains. “In this research project, I will focus especially on examining the underlying factors and mechanisms that help to explain the inter-hospital differences in care quality.”

Huib Cense is Endowed Professor of Health System Innovation at FEB and the UG’s Faculty of Medical Sciences. Apart from his role at the UG, he is a surgeon at the Rode Kruis Ziekenhuis Beverwijk and NoordWest Ziekenhuisgroep in Alkmaar and Den Helder. In addition, he is a member of the supervisory board of DICA and president of the Dutch Association for Surgery. “My role in this project is to bring together knowledge of quality registrations and quality policy from medical specialists and hospitals with the possibilities offered by claims data.”