Health care policy and regional epidemiology: International comparisons and a case-study from the Netherlands

1987 ◽  
Vol 24 (3) ◽  
pp. 247-253 ◽  
Author(s):  
J.P. Mackenbach
Keyword(s):  
Health Care ◽  
The Netherlands ◽  
Health Care Policy ◽  
International Comparisons ◽  
Care Policy

Primary Health Care Under Pressure: A Case Study of Amalgamation in Victoria

1996 ◽  
Vol 2 (3) ◽  
pp. 38 ◽  
Author(s):  
Brigid McCoppin ◽  
Christine Birrell
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Health Care Policy ◽  
Care Policy ◽  
Community Health Centres ◽  
Primary Health ◽  
Health Centres ◽  
Common Response ◽  
Future Demands

Amalgamation of community health centres has become a fairly common response to Victorian government changes in primary health care policy (both Labor and Coalition). This is a study of one such amalgamation and of its effects. The amalgamation brought staff and management many difficulties of adjustment, but it has produced a larger organisation which, while it has some residual problems, appears well fitted to withstand the pressure of today's policy directions and to meet future demands.

Costs of deinstitutionalization in a rural catchment area in the Netherlands

2002 ◽  
Vol 32 (8) ◽  
pp. 1435-1443 ◽  
Author(s):  
Y. J. PIJL ◽  
S. SYTEMA ◽  
R. BARELS ◽  
D. WIERSMA
Keyword(s):  
Mental Health ◽  
Health Care ◽  
The Netherlands ◽  
Mental Health Care ◽  
Health Care Policy ◽  
Price Level ◽  
Day Treatment ◽  
Care Policy ◽  
Case Register ◽  
Unit Costs

Background. In contrast to many other countries, the Netherlands left the initiative in deinstitutionalizing mental health care to the traditional providers of mental health services. The goal of this study is to determine the effect of this policy on the allocation of mental health care resources to services.Method. All 20- to 64-year old users and their use of community- and hospital-based services between 1990 and 1999 were retrieved from the Groningen case register. Service utilization was combined with the direct unit costs of these services for the 1999 price level. Changes in the population as to size and age were taken into account.Results. In 1999 the direct costs of mental health care were €268 per adult inhabitant of the register area, which is 9% higher than in 1990. Costs increased most in the early 1990s before deinstitutionalization policy took effect. From 1993 and onwards the reduced length of stay in the hospital was the main cause for the decreased costs of in-patient care. These savings equalled the increased expenditures for day-treatment, sheltered residences and home-treatment, even though the unit costs of these types of community care are much lower than the unit costs of admissions. This was not caused by an increasing number of new clients, but was a result of longer periods of care during a larger number of years.Conclusions. These findings are in accordance with Dutch mental health care policy, which aims at prolonged care and aftercare outside the hospital whenever possible.

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