Work performance is undermined by high stress levels, yet what are risks of stress to performance of novice experts receiving different forms of supervisor support in high-risk situations? This question is addressed in this innovative project, focusing on high-risk situations in emergency medicine where novices, i.e., junior doctors, diagnose critically ill patients. In this diagnostic process, risks of stress to junior doctors’ diagnostic performance will be uncovered, as well as how these risks can be mitigated by supervisor support. These novel insights are generated by experimental studies using realistic clinical simulations, advancing theoretical understanding of stress in high-risk work situations.

Through its colonial past, the Netherlands remains connected to the Caribbean islands of Aruba, Curaçao, Bonaire, Sint Maarten, Sint Eustatius, and Saba. In healthcare, these entities work closely together, for instance because there are few available doctors locally. However, these relations are challenged by mutual distrust and misunderstandings, which harms the quality of care. This research looks into why these problems occur and offers practical solutions to improve collaboration.

This project investigates how maternal stress during pregnancy, caused by the unexpected death of a close family member, affects offspring health in both the short and long term. It introduces the concept of "health spillovers squared," integrating two research areas: health spillovers and the developmental origins of health and disease. Using Dutch and Norwegian administrative data, the project analyzes perinatal outcomes like preterm births, as well as midlife conditions such as diabetes and cardiovascular disease. Through its innovative approach, the project will demonstrate how dramatic events in family members lives can have lasting health effects that ripple through the family.

As healthcare systems are overwhelmed with the consequences of the Corona virus pandemic, they struggle with substantive, institutional and strategic uncertainties. We know little about how decision-making under such circumstances evolves and to what consequences for organisations, professionals, and citizens/patients. To contribute to current and future pandemic decision-making, we collect ethnographic data in a large university hospital and a municipality, focussing on local and regional decision-making structures and practices by observing meetings and interviewing key actors.

The pressure on healthcare budgets is growing, fuelled by an ever-increasing availability of new healthcare technologies. The relative scarcity of resources inspires heated debates about priorities in healthcare. The recent Dutch discussions on reimbursement of expensive drugs for rare diseases, costing up to €700,000 a year per patient, illustrate this. A central issue is the willingness of society to pay for health gains, especially in light of the countless other legitimate demands of other patients on the healthcare system. Where to draw the line? This important and difficult issue is at the heart of the current research proposal, which aims to investigate the monetary value of health gains. This proposal takes a novel approach to estimate the monetary value of health gains in the Netherlands, using randomized experiments with actual payments and a context-free sensory experience as a description of the valued health gains. The proposal aims to obtain both hypothetical and actual social and private monetary value of a health gain in the Dutch population. It will also produce the first indication of the monetary value of QALYs achieved in distinct subgroups, defined according to central health-related equity characteristics (age and disease severity). Attention will be given to different methodological issues, notably, the aggregation of WTP values across the population, the decomposition of social values, extensive validity testing and reliability testing using a novel stochastic frontier approach. By estimating valid and reliable monetary value of health gains, this research can directly inform the debate on the appropriate size of the cost-effectiveness threshold. Thus, our findings can help interpret the results of economic evaluations and therefore draw appropriate conclusions based on such information.