Publicatie

Towards a more demand oriented health care: analyzing demand for local primary health care .

Bakker, D.H. de, Zwaanswijk, M., Zantinge, E.M., Verhaak, P.F.M. Towards a more demand oriented health care: analyzing demand for local primary health care . European Journal of Public Health: 2007, 17(suppl.2), p. 53. Abstract. 15th Annual EUPHA Meeting: "The future of public health in the Unified Europe", Helsinki, 11-13 oktober 2007.
One of the goals of the current health care reform in the Netherlands is to strengthen demand orientation. Community based primary health care provision should be tuned to local demand. Information on local demand is missing, however. Research goal is to provide local decision makers (patient organizations, insurers, providers) with a tool to analyse local demand, thus creating a basis for an informed discussion. Methods: Known sociodemographic characteristics of local areas on age, gender, household composition, income, ethnic composition and degree of urbanization are used as predictors for local demand. The relationship with demand for primary health care was computed with national, sample based data. Both population surveys (of the Central Statistics Office Nemesis) and electronic medical record registries were used (National Information Network in General Practice, National Information Service for Allied Health Care). Multiple regression techniques were used. Results: Demand for primary care for people with chronic disease proved to be higher in areas with more elderly, with a high percentage of people of non-western origin, a low percentage of one-person households and a high percentage of low income households. Demand for primary care for people with infectious disease proved to be higher in areas with young children (0–4 years) and elderly over 75 years. Also, the presence of people with non-western ethnic origin and low income households increased demand for care for infectious disease. These and more results will be presented. Conclusions: National, sample based data can be used to predict local demand for primary health care. This can be a starting point for discussion on primary care service provision in local communities. Adding information on supply would enhance the analysis further, making detection of underserved areas possible. (aut. ref.)