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This article analyzes Dutch experiences of health care reform--in particular in primary care--with emphasis on lessons for current United States health care reforms. Recent major innovations were the introduction of private insurance based on the principles of primary care-led health care and including all citizens irrespective of their financial, employment, or health status; introduction of primary care collaboratives for out-of-hour services and chronic disease management; and primary care team building, including practice nurses. These innovations were introduced on top of a strong primary care tradition of family practices with defined populations based on patient panels, practice-based research, evidence-based medicine, large-scale computerization, and strong primary care health informatics. Dutch health reform redirected payment to support introduction of innovative health plans and strengthening of primary care to respond to public health objectives. Five recommendations for US primary care follow from this Dutch experience: (1) a private insurance model is compatible with thriving primary care, but it must include all people, especially the most vulnerable in society, and espouse a primary care-led health care system; (2) patient panels or practice lists strengthen continuity of care and community orientation to focus on and respond to local needs; (3) reward collaboration within primary care and between primary care, hospital care, and public health; (4) stimulate primary care professionals to exert their passion and expertise through participation in primary care research and development; and (5) health informatics should be primary care based, preferably adopting the International Classification of Primary Care. With these recommendations, it will be possible for the United States to obtain better population health for its population.
evidence based medicine, health status, Integrated health care systems, Universal Health Insurance, Outcome Assessment, Health Care, medical informatics, Humans, human, health service, Primary health care, Netherlands, general practice, Social Responsibility, Insurance, Health, health care system, Primary Health Care, health care need, Keywords: automation, NCEBP 7: Effective primary care and public health, Quality Improvement, health care planning, United States, health care policy, Health Care Reform, health insurance, medical r Health care reform, employment status, Patient Safety, Family Practice, hospital care, Medical Informatics
evidence based medicine, health status, Integrated health care systems, Universal Health Insurance, Outcome Assessment, Health Care, medical informatics, Humans, human, health service, Primary health care, Netherlands, general practice, Social Responsibility, Insurance, Health, health care system, Primary Health Care, health care need, Keywords: automation, NCEBP 7: Effective primary care and public health, Quality Improvement, health care planning, United States, health care policy, Health Care Reform, health insurance, medical r Health care reform, employment status, Patient Safety, Family Practice, hospital care, Medical Informatics
citations This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically). | 74 | |
popularity This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network. | Top 10% | |
influence This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically). | Top 10% | |
impulse This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network. | Top 10% |