Publicatie
Publication date
07-03-1996
Research program 1996 of the Netherlands Institute of Primary Health Care.
Visser, J., Notenboom, L., Meulen, M. van der, Cornelius, M. Research program 1996 of the Netherlands Institute of Primary Health Care. Utrecht: NIVEL, 1996. 41 p. 3rd ed.
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Since its inception in 1985 the lnstitute's research programma has been featuring four salient topics.
The first topic is research with respect to the professions in primary care. With NIVEL having evolved trom the Netherlands lnstitute of General Practitioners, historically much research has been done on general practica. Considerable information concerning this field was provided by the large scale Dutch National Survey of General Practica, the data for which were gathered in 1987 and 1988. Over the last few years the lnstitute has been extending its range of attention to ether professions in primary care, such as the nursing profession, midwifery and paramedical professions (physiotherapy, speech therapy and occupational therapy). In addition to doing research with respect to these fields, NIVEL also keeps records of the number of established (and prospective) GPs, physiotherapists and midwives in the Netherlands. The records are used as the database bath for analysis and supply of manpower and for random selection in scientific research.
Quality of care is a second topic of NIVEL research. In recent years professionals and their organizations have been werking hard setting up standards and monitoring the quality of the care provided. NIVEL research into quality systems in health care has shed some light on the actual results. Besides, NIVEL has a long tradition of research, by way of analysing videotaped consultations, into the communication between general practitioners and their patients. More recently this field of research was extended to include ether professionals as well. Besides, a series of research projects is being carried out on the patients' judgement of the care provided - and ways to measure this judgement.
Epidemiological research is a third major topic on the lnstitute's research programma. The Dutch National Survey of General Practica mentioned before has provided abundant data on health and health behaviour, both in the population and in GPs' surgeries. In addition to this, for over twenty five years a nationally representative group of GPs (Sentinel Stations) have been making weekly reports on a set number of diseases encountered in their practica. The National Information Network on General Practica monitors a growing number of daily activities (referrals, diagnoses, prescriptions, etc.) in some 150 practices.
Finally, as NIVEL is a WHO collaborating centre, international comparative studies form an important aspect of its work. Comparing the Dutch health system with systems in other European countries is more than just an interesting exercise. Others may learn from the Dutch experience, where curative and preventive health care are separated, health insurance is divided into public and private sectors, and the GP has a 'gate-keeping function' in the medica! sector. Particularly Eastern European countries, that are building up new health care systems, may well learn from the experience in the West. Studying heaith care in other countries may also encourage the domestic debate on changes in the system and may help us avoid possible pitfalls.
New topics
Owing to the intended changes in Dutch health care, some new elements have appeared in the NIVEL research programma. As the strict separation between primary and secondary care is bound to disappear, renewal of the relations between these sectors is emphasized. Topics to be studied include the co-operation between professionais in different sectors of health care, with a view to improving the quality of care and encouraging appropriate use of health care facilities; the relations between general practitioners, medical specialists and hospitals; and the relation between primary care and mentai health care. A series of research efforts deals with the effects of changes in the medical specialists' reimbursement system. Information on the (chronic) consumers' views on health care facilities will be gathered through a newly set up Chronic Consumer Panel.
The first topic is research with respect to the professions in primary care. With NIVEL having evolved trom the Netherlands lnstitute of General Practitioners, historically much research has been done on general practica. Considerable information concerning this field was provided by the large scale Dutch National Survey of General Practica, the data for which were gathered in 1987 and 1988. Over the last few years the lnstitute has been extending its range of attention to ether professions in primary care, such as the nursing profession, midwifery and paramedical professions (physiotherapy, speech therapy and occupational therapy). In addition to doing research with respect to these fields, NIVEL also keeps records of the number of established (and prospective) GPs, physiotherapists and midwives in the Netherlands. The records are used as the database bath for analysis and supply of manpower and for random selection in scientific research.
Quality of care is a second topic of NIVEL research. In recent years professionals and their organizations have been werking hard setting up standards and monitoring the quality of the care provided. NIVEL research into quality systems in health care has shed some light on the actual results. Besides, NIVEL has a long tradition of research, by way of analysing videotaped consultations, into the communication between general practitioners and their patients. More recently this field of research was extended to include ether professionals as well. Besides, a series of research projects is being carried out on the patients' judgement of the care provided - and ways to measure this judgement.
Epidemiological research is a third major topic on the lnstitute's research programma. The Dutch National Survey of General Practica mentioned before has provided abundant data on health and health behaviour, both in the population and in GPs' surgeries. In addition to this, for over twenty five years a nationally representative group of GPs (Sentinel Stations) have been making weekly reports on a set number of diseases encountered in their practica. The National Information Network on General Practica monitors a growing number of daily activities (referrals, diagnoses, prescriptions, etc.) in some 150 practices.
Finally, as NIVEL is a WHO collaborating centre, international comparative studies form an important aspect of its work. Comparing the Dutch health system with systems in other European countries is more than just an interesting exercise. Others may learn from the Dutch experience, where curative and preventive health care are separated, health insurance is divided into public and private sectors, and the GP has a 'gate-keeping function' in the medica! sector. Particularly Eastern European countries, that are building up new health care systems, may well learn from the experience in the West. Studying heaith care in other countries may also encourage the domestic debate on changes in the system and may help us avoid possible pitfalls.
New topics
Owing to the intended changes in Dutch health care, some new elements have appeared in the NIVEL research programma. As the strict separation between primary and secondary care is bound to disappear, renewal of the relations between these sectors is emphasized. Topics to be studied include the co-operation between professionais in different sectors of health care, with a view to improving the quality of care and encouraging appropriate use of health care facilities; the relations between general practitioners, medical specialists and hospitals; and the relation between primary care and mentai health care. A series of research efforts deals with the effects of changes in the medical specialists' reimbursement system. Information on the (chronic) consumers' views on health care facilities will be gathered through a newly set up Chronic Consumer Panel.