My research focus is on the measurement, management and improvement of the performance of health care systems. Central research question in this work is ‘How can countries develop or maintain a high-performing health care system that fits within a specific socio-economic, political, cultural, demographic and epidemiological context?’ By answering this question, I aim to support evidence-based decision making that contributes to health system sustainability and improvement.

 In order to connect current policy and practice challenges to policy options and practice implementation strategies in my research, I work closely with international organisations (e.g., the World Bank, Organisation for Economic Cooperation and Development (OECD), World Health Organisation (WHO), European Commission) national governments, academics and other public and private organisations in the health care sector in high- and middle income countries, positioning my research at the macro and meso level of the health system.

 The health system performance areas I research are based on the health systems aims of delivering accessible, high quality care in an equitable manner, that is affordable and based on an efficient use of public resources to optimise health. To increase understanding of how a health system achieves a certain level of performance (at outcome level, e.g. accessibility), I investigate at process level how services are delivered (e.g. shared decision making, coordination of care, integration and continuity of care), and how this is facilitated or hampered by the health system design in terms of health system structures (e.g. workforce development, financing, medical technology, infrastructure, health information system, governance and accountability). 

I largely base my research on the underlying theories about learning health care systems (performance information as a driver for performance improvement); value creation instead of cost-effectiveness as the goal of healthcare systems; new ideas about health (the patient as a producer of his own health); and complex adaptive systems theory (a system is the dynamic result of mutual dependencies and reactions between and within sub-systems and professions). I employ mixed methods in my research, often combining quantitative and qualitative research methods.

Principal Investigator (PI); Health Systems Research; Principal Educator; Vice-Director APH