Primary care is a valuable component of Dutch health care: accessible to all, cheap, local and an effective filter for costlier secondary care. Primary care plays a crucial role in coping with the continually rising demand for health care, particularly from the growing group of chronically ill. However, some changes are needed. Primary care is not being used to its full potential yet. Two challenges facing primary care:
- Improving and standardizing the variable, and frequently inadequate, quality of the care offered to chronic patient groups;
- A significant proportion of the demand for health care is currently being handled by secondary care (which is significantly more expensive), without good reason. Primary care providers need to take responsibility for this, but in many cases the care requirements currently occupying primary care should be made the patient’s own responsibility. Patients are still not sufficiently involved in prevention and treatment of their own health problems. Self management is still at a very early stage of development in the Netherlands.
So the organization of health care will need to change. However, there is one significant obstacle to change. Primary care is still funded by a mixture of consultation fees and subscription financing not linked to any identifiable performance. As a result, primary care is deeply fragmented: each provider has a separate income stream and organizing integrated care is a complex matter.
The introduction of ‘integrated funding’ for four chronic conditions (to be rolled out to other conditions later) is intended to act as a catalyst for this improvement. In the initial phase, it will apply to care for diabetes, COPD, heart failure and people with increased cardiovascular risk; all conditions for which proactive integrated care focused on disease management has been shown to produce significant returns in efficiency and quality.
What does all this mean for you as a primary care provider? First, you need to consider your current position within primary care provision and how the developments described will affect this. Second, many different parties (care groups, or even home care institutions or hospitals) can put themselves forward as integrated multidisciplinary care providers. What role will you take? Will you get involved in new initiatives or just wait and see what happens? What added value can you offer?
Want to know more?
Contact Walter Balestra or Stef Groenewoud:
T +31 (0)20 3010800
E balestra@plexus.nl
E groenewoud@plexus.nl