Primary Care And Home Care Scenarios 1990 2005

CARE AT HOME -HOME CARE Health care in the Netherlands looks to be a well structured system. Supplementing the vital level of self-care and informal care are four levels of professional care: the public health service (known in the Netherlands as basic health care) is mainly concerned with preventive work aimed at the population at large; individuals with problems can contact their general practitioner or other primary care provider, who can -depending on the problem -refer them to specialists in the cure-oriented and hospital-centred secondary sector; where necessary, patients can then be referred on to the institutions of the tertiary sector with their role in mainly long-term care. On paper this pyramidal structure appears to work well; in practice, and in particular where complex forms of care are involved, the boundaries become blurred. Medical advances and social and economic developments may delay death to ever greater ages, but disease is not defeated; and since the risk of developing chronic conditions rises with age, more and more people become incapacitated and those who do remain so for longer. This leads to a growing demand for care and compels us to reconsider patterns of provision. The need for such reconsideration is reinforced by users' changing needs and aspirations, as patients increasingly wish to be nursed and cared for in their own surroundings if at all possible. Technological advances mean that wish can often be accommodated.

CARE AT HOME -HOME CARE Health care in the Netherlands looks to be a well structured system. Supplementing the vital level of self-care and informal care are four levels of professional care: the public health service (known in the Netherlands as basic health care) is mainly concerned with preventive work aimed at the population at large; individuals with problems can contact their general practitioner or other primary care provider, who can -depending on the problem -refer them to specialists in the cure-oriented and hospital-centred secondary sector; where necessary, patients can then be referred on to the institutions of the tertiary sector with their role in mainly long-term care. On paper this pyramidal structure appears to work well; in practice, and in particular where complex forms of care are involved, the boundaries become blurred. Medical advances and social and economic developments may delay death to ever greater ages, but disease is not defeated; and since the risk of developing chronic conditions rises with age, more and more people become incapacitated and those who do remain so for longer. This leads to a growing demand for care and compels us to reconsider patterns of provision. The need for such reconsideration is reinforced by users' changing needs and aspirations, as patients increasingly wish to be nursed and cared for in their own surroundings if at all possible. Technological advances mean that wish can often be accommodated.

'Primary Care in the Driver's Seat?' studies the reforms of primary care in Europe as well as their impacts on the broader co-ordination mechanisms within European health care systems.

Care-Giving in Dementia, Volume 3 is updated to incorporate the rapid and palpable changes that have taken place in this area. It will prove invaluable to health and mental health professionals caring for people with dementia.

Harrison and Prentice aim to provide a source of reference and reflection for those who are concerned with the planning of hospitals themselves or who are concerned with the health care delivery system as a whole. The authors set out a detailed framework for analyzing hospital services in relation to other providers, based on clinical quality, costs of provision, and access. The book also contains a series of recommendations for action.

On the contrary, they are offered as a standard tool to which every user can add supplementary instruments.

The first STG report to embody scenarios on population aging, health and care appeared in 1985. This report describes developments since 1985, reviewing the current position and setting out updated scenarios. The 1985 report set out three scenarios, in which the central focus was on the developing future pattern of demand for care by the elderly. The present report too sets out three scenarios, centring on the demand for care, in which account is taken of a variety of factors; it also details four strategic scenarios whose central focus is on the developing supply of care and which set supply and demand one against the other. Three of the strategic scenarios -- emphasizing respectively intramural, extramural and informal care -- suppose the demand for care to be met in full; the fourth scenario, which rolls current policies on the care of the elderly forward into the future, pinpoints discrepancies between the need for care and the extent to which that need is likely to be met, making clear in so doing that a review of long-term policy for the elderly is urgently needed.