Towards a more demand oriented health care: Analyzing demand for local primary health care - PowerPoint PPT Presentation

1 / 16
About This Presentation
Title:

Towards a more demand oriented health care: Analyzing demand for local primary health care

Description:

... record registries gp's (LINH) physiotherapy (LIPZ), social work (Madimonitor) ... Physiotherapy consultation. 0,57* GP-consultation. Spearmans rs ... – PowerPoint PPT presentation

Number of Views:69
Avg rating:3.0/5.0
Slides: 17
Provided by: Bode1
Category:

less

Transcript and Presenter's Notes

Title: Towards a more demand oriented health care: Analyzing demand for local primary health care


1
Towards a more demand oriented health care
Analyzing demand for local primary health care
  • De Bakker, D.H.
  • Zwaanswijk, M.
  • Zantinge, E.
  • Broek, R. van den
  • Verhaak, P.

2
Background
  • Health care reform in the Netherlands
  • Strengthening primary health care at community
    level
  • Increasing demand orientation in primary health
    care
  • Involve local decision makers (patients,
    financers, providers) in planning primary care
    services

3
But
  • Data on local demand for primary care services
    are missing
  • Data on demand are generally national, sample
    based
  • Locally only socio-demographic data available

4
Goal
  • Develop a local demand monitor
  • That provides local decision makers with a tool
  • To analyse local demand for primary health care
  • It should be an easy to use internet-tool

5
Methods
  • 1. Analyze effects of socio-demographic
    characteristics on demand in national sample
    based databases with multiple regression
    techniques
  • 2. Apply coefficients on neighboorhoods,
    districts and municipalities to compute local
    demand
  • 3. Build a dynamic internet-tool to present the
    results

6
Demand indicators
  • Consultation rates with gp and practice nurse
  • Consultation rates per disease cluster
  • Prevalence of specific chronic diseases
  • Prevalence of psychosocial problems in population
  • Visits of mental health care providers
  • Prescriptions in general practice
  • Visits of physiotherapists

7
Datasources
  • National sample based databases
  • Medical record registries gps (LINH)
    physiotherapy (LIPZ), social work (Madimonitor),
    PC-psychologist (LINEP)
  • Survey data general health survey (Statistics
    Netherlands), mental health survey (Nemesis)

Local area social demographic statistics
(Statistics Netherlands)
8
Regression consultation rate with general practice
R20,189, s.e.e.5.12476
9
Example 1 Overvecht
  • High rise-appartments
  • 1960s
  • deprived area
  • Immigrant
  • 31.000 inhabitants
  • www.nivel.nl/vaam

10
Example 2 Utrecht Inner City
  • Innercity
  • Medieval
  • Gentrified
  • Students
  • 15.000 inhabitants
  • www.nivel.nl/vaam

11
Example 3 Ondiep
  • Working class housing
  • 1930s
  • Deprived urban area
  • Dutch
  • 6.000 inhabitants
  • www.nivel.nl/vaam

12
Consultation rate per district 95 BI compared
to municipal average
13
ValidationComparison with HIS-data of
neighboorhoods in Utrecht
14
Limitations
  • Availability of data on small areas
  • Availability of data relating demand to
    socio-demographic characteristics (e.g. mental
    health survey)
  • Low percentage of explained variance
  • Demand is measured with utilization data

15
Nevertheless
  • Clear and significant variation between districts
  • Better estimate than population size
  • Used by regional primary care planners

16
  • Interested? www.nivel.nl/vaam
Write a Comment
User Comments (0)
About PowerShow.com