An assessment of occupational health care in the Netherlands (1996-2005).
BACKGROUND
The extensive Dutch occupational health care system of the past decade has not led to the desired outcomes, namely, a decrease of work absenteeism and the associated costs.


OBJECTIVE
To assess the differences between in-house and external occupational health care services in the process quality of occupational health care provided.


METHODS
In total, 26 interviews were conducted with chief executive officers of occupational health services (OHS). The responses and other relevant policy documents were analysed and described. A key component of this process was to compare differences between in-house and external services.


RESULTS
Notable differences in quality were found to exist between in-house and external occupational health care systems, with the in-house occupational health care services offering the highest process quality.


CONCLUSIONS
Our findings suggest that the effectiveness of OHS is mainly dependent on their structure (in-house versus external) and on economic factors (profit driven versus not for profit).
De Valk
M M A
MM
Adviesgroep Intermedic, Koninginnegracht 101, 2514 AL The Hague, Zuid Holland, The Netherlands. m.devalk@intermedic.nl
Oostrom
C
C
Schrijvers
A J P
AJ
D000041:Absenteeism; D001294:Attitude to Health; D003365:Costs and Cost Analysis / Q000191:economics; D006801:Humans; D009042:Motivation; D009426:Netherlands; D009786:Occupational Health Services / Q000191:economics / Q000458:organization & administration / Q000592:standards*; D011314:Preventive Health Services / Q000379:methods; D011787:Quality of Health Care / Q000592:standards*; D011795:Surveys and Questionnaires