Veerle Buffel unpaid staff

Research Veerle Buffel

Research team

Expertise

CURRENT RESEARCH -PROMISE Project (FWO-SBO), collaboration between UA and ITG Responsible for Work package 1: Web-Respondent Driven Sampling of MSM in Flanders Work package 2: Eligibility of PrEP use among SAM (analyzing the Together data) -SCUBY (H2020), international project, collaboration between UA and ITG, ‘SCale Up an Integrated Chronic Care Package for diaBetes and hYpertension for vulnerable people in Cambodia, Slovenia and Belgium’ Responsible for Work package 4: Exploring, collecting/searching for adequate (administrative) data and operationalizing indicators to monitor scale-up between and within countries, using a cascade of care approach. Studying the link between organization of care and quality of care (based on process and outcome indicators) as well as inequality in care use and adherence -Belgium: Developing cascades of care and quality indicators of chronic T2D and HTN care, using Administrative health insurance data (linked to labo data) for T2D care and using the Health interview survey data for the cascade of HTN care. -Cambodia:Developing household survey in Cambodia to collect data for HTN and T2D care -Slovenia: Using health insurance data •Primary care academy (Fonds Dr. Daniël De Coninck): Involved in WP 1 (developing a survey among primary care workers about self-management support, goal oriented care and interprofessional collaboration) and WP4 (action research on self management support, using realist evaluation methods) •Red noise project (co-supervisor, Ugent): A culturally-sensitive stigma survey among adolescents in Flanders: Understanding causes and consequences to tackle stigmatisation (a mixed method design) •Mind the Gate (co-supervisor, Ugent): Assessing General Practitioners’ referral of depressive clients of different ethnic origins through video-vignettes. •Expert in ECSR network: Labor market insecurity and health of family members, Bamberg, Germany Working on: An institutional approach to mental health and the mental health care use of unemployed people in Europe: Cross-national comparative research into the role of policies and social norms CURRENT EDUCATION •Guest lecture on ‘(Bio) medicalization’ in Health Sociology (University of Gent and UA) •Supervisor of master’s theses: Syndemics, Discrimination in health care, Unemployment stigma, Job insecurity and mental health among artists

Breaking the Chain: Addressing the Syndemic of type 2 diabetes, depression, and socio-economic vulnerability. 01/11/2023 - 31/10/2025

Abstract

Type 2 diabetes (T2D) and depression are highly prevalent conditions and have significant impact on health outcomes worldwide. Both conditions maintain a bidirectional relationship causing T2D and depression to occur together twice as frequently as would be predicted by chance alone. Current studies on this comorbidity however employ an individualistic perspective and ignore its social drivers– necessitating sociological research on the topic. A merger between Fundamental Cause Theory and Syndemic theory will be applied to(1) assess the clustering of T2D and depression and the role of socio-economic (SE) vulnerability within this clustering; (2) look how the adverse interactions between T2D, depression and SE vulnerability amplify disease burden and complications, and (3) study the contextual forces that cause and/or exacerbate this clustering. I will use HISlink data (Health Interview Survey + Health Insurance data) to assess (1) and (2) in Belgium. Next, I will address (3) by assessing the contextual variation in the syndemic across (a) Belgian communities (using Local Health Interview Survey data) and (b) European countries (using European Health Interview Survey data), and whether this variation can be explained by spatial and health system characteristics, respectively. The resulting fundamental knowledge has the potential to help policymakers in their endeavours to improve population health by offering insight into the drivers of the co-morbidity of T2D and depression.

Researcher(s)

Research team(s)

Project type(s)

  • Research Project

Households in mental health care: an experimental study on the role of the household in the care for people with a severe mental illness in South Africa. 01/01/2023 - 31/12/2026

Abstract

South Africa has a high burden of severe mental illness – such as schizophrenia, bipolar disorder and major depressive disorder. In step with global movements and budgetary limitations, the country promotes deinstitutionalisation – from hospitals to local communities – to care for these people living with severe mental illness (PSMI). This push towards deinstitutionalisation, however, has not been fit with an according health care model in these communities. PSMI are discharged into a household context without any support – often resulting in treatment non-adherence and a cyclical pattern of short readmissions to the hospitals that they have been discharged from, following relapses in treatment gains. In the context of limited resources for deinstitutionalized mental health care, research into the potential of the household in the care for discharged PSMI is a clear priority. We hypothesize that improving the mental health knowledge and communication skills of households will enable ownership of the problem and increase social support to the PSMI. This will eventually positively impact treatment adherence and lower re-admission rates of PSMI. Aim of this project is to develop and test an intervention stimulating this mental-health competence of households – in a cluster randomized-controlled trial using a longitudinal process evaluation. As such, this project responds to the urgent need in many low- and middle income settings to optimize the deinstitutionalisation of PSMI.

Researcher(s)

Research team(s)

Project type(s)

  • Research Project

Cost effectiveness of levels of implementation of integrated Chronic care for Diabetes and its Comorbidities across different primary care practices in Flanders (COSDCOM). 01/10/2022 - 30/09/2026

Abstract

The increasing prevalence of Type 2 Diabetes (T2D) and the frequent concurrence of comorbidity puts a heavy strain on societies (both the patients and health system), in terms of healthcare cost, patients' quality of life and loss of productivity. Interventions such as Integrated Chronic Care (ICC) and disease specific care trajectories are introduced to better address these complex needs but there is limited evaluation of these interventions. Most existing evaluations are limited in three ways: a) They show effects on diabetes-specific clinical outcomes, but do not take into account the comorbidity dimension; b) They do not take into account the variation in implementation of ICC; and c) have limited information on health-related quality of life (HRQoL) and cost-effectiveness. This proposal will triangulate different data sources (available health insurance data, laboratory and primary health care data combined with primary HR QoL data) in Belgium to addresses those gaps by examining the cost and cost-effectiveness of ICC for people with T2D and potential comorbidities for different levels of ICC implementation in Flanders. More specifically, we aim to (1) estimate the cost of care for T2D patients with and without comorbidities for different levels of ICC implementation in Flanders; (2) assess the impact of different levels of ICC implementation on HRQoL among T2D patients with and without comorbidities; and (3) evaluate the cost-effectiveness of different levels of ICC implementation in the provision of care among T2D patients with and without comorbidities. This project responds to a strongly felt need among 22 interviewed stakeholders that the increasing prevalence of chronic patients necessitates a move towards more ICC but that financing is a major barrier. This project pushed the boundaries of knowledge by quantifying costs and benefits. The knowledge generated in this study can contribute to a more effective and efficient implementation of ICC for the management of diabetes patients (with comorbidities) in Flanders. This is extremely relevant in a society with increasing health inequity and financial barriers to healthcare utilization and self-management.

Researcher(s)

Research team(s)

Project type(s)

  • Research Project

Determinants of diabetes care and outcomes: a multi-level analysis across the continuum of care. 01/01/2021 - 31/12/2024

Abstract

Type 2 Diabetes (T2D) is one of the leading causes of death in the world (3.7 million deaths/year). In Belgium, 6.1% of the population is diagnosed with diabetes. Effective treatment exits and is relatively straightforward from a technical point of view, but T2D care is socially and organizationally complex. It requires lifelong follow-up and self-management along a continuum of care: patients need to be diagnosed, treated, followed-up, and supported to achieve glycaemic control. Unfortunately, people (especially vulnerable groups) are lost at each of these steps, leading to complications and avoidable hospitalizations. Knowledge is urgently needed on the determinants of these leakages in the care continuum. In accordance with the socioecological model, we aim to disentangle the determinants of drop-out at 3 levels (patient, health system & community level) through an innovative multilevel Cascade-of-Care approach. The Cascade-of-Care visualizes the drops between the steps of the care continuum while our multilevel analyses will attempt to explain each drop using determinants at the 3 levels. We will build a unique dataset combining (1) individual health insurance and medical lab data, (2) organizational data of primary care practices and (3) administrative and self-gathered data of neighborhoods. Spatial multilevel analysis will allow us to assess (1) the relative impact of and (2) interaction between the determinants at these 3 levels on each step of the continuum of care.

Researcher(s)

Research team(s)

Project type(s)

  • Research Project