By Prof. E. Schadé, Dr. H. J. Wennink, S. E. Kooiker, W. G. W. Boerma, Dr. D. H. de Bakker, Dr. P. P. Groenewegen (auth.)
CARE AT domestic -HOME CARE future health care within the Netherlands appears to be a good established approach. Supplementing the important point of self-care and casual care are 4 degrees care: the general public wellbeing and fitness carrier (known within the Netherlands as uncomplicated health and wellbeing care) is principally excited by preventive paintings geared toward the inhabitants at huge; people with difficulties can touch their health care professional or different fundamental care supplier, who can -depending at the challenge -refer them to experts within the cure-oriented and hospital-centred secondary zone; the place useful, sufferers can then be referred directly to the associations of the tertiary area with their position in commonly long term care. On paper this pyramidal constitution seems to paintings good; in perform, and particularly the place complicated sorts of care are concerned, the bounds turn into blurred. clinical advances and social and monetary advancements may perhaps hold up dying to ever higher a while, yet sickness isn't really defeated; and because the danger of constructing persistent stipulations rises with age, progressively more humans develop into incapacitated and people who do stay so for longer. This ends up in a growing to be call for for care and compels us to think again styles of provision. the necessity for such reconsideration is bolstered by way of clients' altering wishes and aspirations, as sufferers more and more desire to be nursed and cared for of their personal atmosphere if in any respect attainable. Technological advances suggest that want can frequently be accommodated.
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Additional info for Primary Care and Home Care Scenarios 1990–2005: Scenario report commissioned by the Steering Committee on Future Health Scenarios
5. 2. Background The Netherlands has a population of 15,131,000 (CBS 1992); it is both densely populated (with 446 people per square kilometre) and highly urbanized (with 51 per cent living in urban and 38 per cent in suburban municipalities). 6 per thousand, high by western European standards. Immigration adds to the natural increase of the population (and indeed to its health problems). In order of arrival three groups of immigrants can be distinguished. The first comprises foreign workers from southern Europe, Turkey and northern Mrica.
The payment system for GPs differs as between privately and publicly insured patients. For each publicly insured patient on their list a GP receives a capitation fee at the full rate (116 guilders in 1992) for the first 1,600 and a lower rate (69 guilders) for the remainder. Privately insured patients pay their GP directly on a fee-for-service basis (33 guilders per consultation in 1992), which they can recover from their insurance company if their policy covers GP costs. Specialists In 1991 there were 12,477 medical specialists in the Netherlands (CBS), equivalent to one specialist per 1,200 population; the ratio of specialists to GPs is two to one.
Health care providers Relevant features of the various providers are described below. 2. Chapter 4 outlines trends in the use of care. General practitioners The GP is the first point of contact with the system for people with health or health-related problems. At the start of 1992 there were 6,535 GPs working in the Netherlands, giving an average of 2,315 people per GP. Each GP has a fixed list of patients. 1 per cent in multidisciplinary health centres in which one or more GPs work in a team with community nurses and social workers in shared premises.