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Research program 1987 of the Netherlands Institute of Primary Health Care.
NIVEL. Research program 1987 of the Netherlands Institute of Primary Health Care. Utrecht: NIVEL, 1987. 34 p.
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In the Netherlands primary health care and the position of the general practitioner were for a long time synonymous. The position of the Dutch general practitioner in the health care system was quite strong, because entrance to secondary medica! care is and was channelled through the genera! practitioner's surgery. The provision of pshysiotherapy and Rx prescriptions is initiated by a visit to the general practitioner (or to a specialist in these types of health care).
The domain of referral nowadays has even been extended to the provi-sion of ambulatory mental health care. The general practitioner and the social worker are the entries at the gate of this (flourishing) sector of the Dutch health care system.
A rather generous capitation fee for the publicly insured patients (on average about 65% of the population) makes the Dutch general practitioner financially quite well off in comparison with most of his European colleagues. A further improvement in the Dutch general practitioner's position has been reached through reduction of the relatively large listsize without reducing the genera! practitioner' s income in a substantial way.
Primary health care is not confined to general practitioners. The core of primary care is formed by genera! practitioners and district nurses, representing the health professions' part in primary care, and social workers and family assistants, representing the social sector. Apart from these professions, physiotherapists (in private, ambulatory practice), dispensing chemists and midwives are counted as primary health care providers.
As has been the case in most industrialized countries containment of the cost of health care has been a major politica! objective for successive Dutch governments over the last decade. The objective of cost containment was translated in four major topics of policy concern:
1. the reduction of the number of hospita! beds;
2. the containment of coats by a policy of budgetting (initially in second-line medica! institutions, but later on among all providers of health care);
3. the strengthening of primary health care;
4. the (reluctant) imposition of price thresholds on the client' s side.
The domain of referral nowadays has even been extended to the provi-sion of ambulatory mental health care. The general practitioner and the social worker are the entries at the gate of this (flourishing) sector of the Dutch health care system.
A rather generous capitation fee for the publicly insured patients (on average about 65% of the population) makes the Dutch general practitioner financially quite well off in comparison with most of his European colleagues. A further improvement in the Dutch general practitioner's position has been reached through reduction of the relatively large listsize without reducing the genera! practitioner' s income in a substantial way.
Primary health care is not confined to general practitioners. The core of primary care is formed by genera! practitioners and district nurses, representing the health professions' part in primary care, and social workers and family assistants, representing the social sector. Apart from these professions, physiotherapists (in private, ambulatory practice), dispensing chemists and midwives are counted as primary health care providers.
As has been the case in most industrialized countries containment of the cost of health care has been a major politica! objective for successive Dutch governments over the last decade. The objective of cost containment was translated in four major topics of policy concern:
1. the reduction of the number of hospita! beds;
2. the containment of coats by a policy of budgetting (initially in second-line medica! institutions, but later on among all providers of health care);
3. the strengthening of primary health care;
4. the (reluctant) imposition of price thresholds on the client' s side.
In the Netherlands primary health care and the position of the general practitioner were for a long time synonymous. The position of the Dutch general practitioner in the health care system was quite strong, because entrance to secondary medica! care is and was channelled through the genera! practitioner's surgery. The provision of pshysiotherapy and Rx prescriptions is initiated by a visit to the general practitioner (or to a specialist in these types of health care).
The domain of referral nowadays has even been extended to the provi-sion of ambulatory mental health care. The general practitioner and the social worker are the entries at the gate of this (flourishing) sector of the Dutch health care system.
A rather generous capitation fee for the publicly insured patients (on average about 65% of the population) makes the Dutch general practitioner financially quite well off in comparison with most of his European colleagues. A further improvement in the Dutch general practitioner's position has been reached through reduction of the relatively large listsize without reducing the genera! practitioner' s income in a substantial way.
Primary health care is not confined to general practitioners. The core of primary care is formed by genera! practitioners and district nurses, representing the health professions' part in primary care, and social workers and family assistants, representing the social sector. Apart from these professions, physiotherapists (in private, ambulatory practice), dispensing chemists and midwives are counted as primary health care providers.
As has been the case in most industrialized countries containment of the cost of health care has been a major politica! objective for successive Dutch governments over the last decade. The objective of cost containment was translated in four major topics of policy concern:
1. the reduction of the number of hospita! beds;
2. the containment of coats by a policy of budgetting (initially in second-line medica! institutions, but later on among all providers of health care);
3. the strengthening of primary health care;
4. the (reluctant) imposition of price thresholds on the client' s side.
The domain of referral nowadays has even been extended to the provi-sion of ambulatory mental health care. The general practitioner and the social worker are the entries at the gate of this (flourishing) sector of the Dutch health care system.
A rather generous capitation fee for the publicly insured patients (on average about 65% of the population) makes the Dutch general practitioner financially quite well off in comparison with most of his European colleagues. A further improvement in the Dutch general practitioner's position has been reached through reduction of the relatively large listsize without reducing the genera! practitioner' s income in a substantial way.
Primary health care is not confined to general practitioners. The core of primary care is formed by genera! practitioners and district nurses, representing the health professions' part in primary care, and social workers and family assistants, representing the social sector. Apart from these professions, physiotherapists (in private, ambulatory practice), dispensing chemists and midwives are counted as primary health care providers.
As has been the case in most industrialized countries containment of the cost of health care has been a major politica! objective for successive Dutch governments over the last decade. The objective of cost containment was translated in four major topics of policy concern:
1. the reduction of the number of hospita! beds;
2. the containment of coats by a policy of budgetting (initially in second-line medica! institutions, but later on among all providers of health care);
3. the strengthening of primary health care;
4. the (reluctant) imposition of price thresholds on the client' s side.