How can the public health system best be organised in the future and which factors are the main determinants thereof? These are key questions in the scenario report The Future of Public Health: a Scenario Study. The report is the result of a study commissioned by the Steering Committee on Future Health Scenarios and carried out by a research team of the TNO Institute of Preventive Health Care and the STG Scenario Committee on the Future of Public Health. The report focuses on activities in collective prevention of diseases, generally known as primary prevention. The future images developed make use of two examples, the control of infectious diseases and public health for the elderly. In designing those scenarios, two sets of possible trends were combined: centralisation versus decentralisation and nationalisation versus privatisation. These combinations resulted in three scenarios; a local government scenario, a central government scenario, and a private enterprise scenario. The consequences of these future alternatives were developed in terms of their effect on organisation, policy control, financing, information supply, expertise and effectiveness. Although the report primarily focuses on the public health system in the Netherlands, the analysis of the processes examined, and the alternative scenarios based on them are also thought-provoking for readers throughout the world.
How can the public health system best be organised in the future and which factors are the main determinants thereof? These are key questions in the scenario report The Future of Public Health: a Scenario Study. The report is the result of a study commissioned by the Steering Committee on Future Health Scenarios and carried out by a research team of the TNO Institute of Preventive Health Care and the STG Scenario Committee on the Future of Public Health. The report focuses on activities in collective prevention of diseases, generally known as primary prevention. The future images developed make use of two examples, the control of infectious diseases and public health for the elderly. In designing those scenarios, two sets of possible trends were combined: centralisation versus decentralisation and nationalisation versus privatisation. These combinations resulted in three scenarios; a local government scenario, a central government scenario, and a private enterprise scenario. The consequences of these future alternatives were developed in terms of their effect on organisation, policy control, financing, information supply, expertise and effectiveness. Although the report primarily focuses on the public health system in the Netherlands, the analysis of the processes examined, and the alternative scenarios based on them are also thought-provoking for readers throughout the world.
Aims and approach In order to chart the way for long-tenn policies in the field of public health, the Dutch government needs to have the best possible insight into potential future trends and the problems to which these could give rise. It was with a view to compiling a number of long-range studies that the independent Steering Committee on Future Health Scenarios was set up in 1983. In 1988 this body appointed a board of experts to sUivey the future of Chronic Diseases. Three chronic diseases have been selected: diabetes mellitus, CNSLD (chronic non-specific lung disease) and rheumatoid arthritis (a chronic disorder of the joints). In close consultation with this board, the study has been conducted by the Department of Epidemiology of the National Institute of Public Health and Environmental Protection in Bilthoven. This report contains the results of the research into CNSLD. The report on diabetes mellitus was published in March 1990, while that on rheumatoid arthritis followed shortly (1991). The series has been concluded with a fmal report (spring 1992), in which, among other things, the results of the three reports have been brought together with a view to arriving at an overall picture of chronic diseases. The research had two main objectives: 1.
9. 1 311 9. 2 The results in the four areas 313 9. 3 Likely causes of the growing demand for services 314 9. 4 The dominant perception of mental health problems 315 95 A shifting balance 317 9. 6 Mental health problems as a policy issue 319 311) 9. 7 Culture-dependence as an approach 9. 8 Culture-dependence and the four tbemes 322 9. 9 The value of a socia-cultural approach 323 9. 10 Two core notions: normality and identity 325 9. 11 Conclusions and policy options 328 Bibliography 333 Appendix Basic ~ssumptions in the exploratory and target-seuing sccnanos 368 v Preface This study of mental health issues breaks new ground. The task set by the Steering Committee on Future Health Scenarios was twofold, encompassing issues relating both to mental health and to mental health care. Discussions of mental health normally narrow down immediately to a focus on its care; this study, in contrast, seeks to deal with mental health as a theme in its own right alongside that of mental health care. This task led to the establishment of a broadly based committee whose members possessed a wide range of knowledge and experience in the field. The study was carried out by an equally expert team from the Netherlands Institute of Mental Health. In the course of the study over a hundred people with wide ranging expertise took part in consultative panels.
Will the present high work pace and the strong time pressure continue to exist in the coming 20 years? In the years 2010 will there be even more employees working under their level of education and suffering from health problems due to stress at work than is the case at the moment? Will the physical work-load of employees be reduced to a minimum over the next 20 years as a result of further application of ergonomic principles? Will the health risks due to working with chemicals increase or decrease? And will sickness, absenteeism and work disability have increased, as a result of these kinds of developments, around the year 2010 or will they have been mostly brought under control?; These and similar questions are dealt with in this book about the quality of the work, health and well-being of employees in the year 2010, carried out by the TNO Insitute of Preventive Health Care (NIPG/TNO) in Leiden, assisted by the Scenario Committee.; Using trend analysis the researchers demonstrate that many aspects of working life have improved in the Netherlands since 1980. Needless to say, not the past but the exploration of the future of the quality of working life takes a central place in this book. Finally the top 20 measures, suggested by a panel of 88 Dutch experts, are presented. These aim at halving the rate of sickness absenteeism and work disability in the Netherlands.
In order to chart the way for long-term policies in the field of public health, the Dutch government needs to have the best possible insight into potential future trends and the problems to which these could give rise. It was with a view to compiling a number of long-range studies that the independent Steering Committee on Future Health Scenarios was set up in 1983. In 1985 the Steering Committee appointed a board of experts to conduct a long-range study of "Accidents and traumatology" (traumatology being that aspect of medicine concerned with the treatment of accident victims). In close consultation with this board, the Institute of Public Health and Social Medicine of the Erasmus University Rotterdam carried out a scenario study, the results of which are briefly summarized below. 0.1 Aims and approach The research had two objectives: To explore possible "autonomous" developments (in the sense of being independent of government intervention) in the field of accidents and the treatment of accident victims. To specify the effects of possible policy measures, in relation to both the prevention of accidents and improvements in the care for accident victims. The research was exploratory rather than predictive. It did not go beyond the year 2000, since it was felt that the pace of change in this field ruled out looking much further than ten to fifteen years ahead.
As noted in the Foreword, this report is one of several volumes resulting from this study of future health care technology. The purpose of the study, as formulated by the STG, was to analyze future health care technology. Part of the task was to develop an 'early warning system' for health care technology. The primary goal of the project was to develop a list or description of a number of possible and probable future health care technologies, as well as information on their importance. Within the limits of time and money, this has been done. However, given the vast number of possible future health care technologies, complete information on the importance of each area could not be developed in any depth for all technology. Therefore, four specific technologies were chosen and were prospectively assessed. These future technologies were examined in more depth, looking particularly at their future health and policy implications. Subsequently, the project was extended to September 1986, and two additional technologies were chosen for assessment.
The future place of medicines in health care is both exciting and uncertain. With an aging population, an increasing number of chronic sick, a growing range of treatment options and a developing European market, the one certainty is that medication patterns will change radically over the next 15 years or so. How the future might look, in terms of quality, volume and cost of pharmacotherapy, is the subject of this report. Four scenarios for the future are set out, all of which take account of already visible trends. Sobriety in sufficiency envisages rational and restrained consumption patterns. Risk of avoidance is dominated by fears of iatrogenic harm and hence minimal drug use. The central feature of Technology on demand, in contrast, is confidence in technological progress. Free market unfettered, finally, is marked by a Europe without frontiers and minimal state intervention. The reader is encouraged to reflect without preconceptions on the future of medicines in health care. No ready-made answers are offered; rather, a wealth of information and analysis is provided which serves to underpin decision making and policy development, not just by central government but also by every institution concerned with the role of medicines in health care.
Health Care Application of Lasers: The Future Treatment of Coronary Artery Disease. A report, commissioned by the Steering Committee on Future Health Scenarios
Health Care Application of Lasers: The Future Treatment of Coronary Artery Disease. A report, commissioned by the Steering Committee on Future Health Scenarios
As noted in the Foreword, this report is one of several volumes resulting from this study of future health care technology. The purpose of the study, as formulated by the STG, was to analyze future health care technology. Part of the task was to develop an 'early warning system' for health care technology. The primary goal of the project was to develop a list or description of a number of possible and probable future health care technologies, as well as information on their importance. Within the limits of time and money, this has been done. However, given the vast number of possible future health care technologies, complete information on the importance of each area could not be developed in any depth for all technology. Therefore, four specific technologies were chosen and were prospectively assessed. These future technologies were examined in more depth, looking particularly at their future health and policy implications. Subsequently, the project was extended to September 1986, and two additional technologies will be assessed.
Health Care Application of Lasers: The Future Treatment of Coronary Artery Disease. A report, commissioned by the Steering Committee on Future Health Scenarios
Health Care Application of Lasers: The Future Treatment of Coronary Artery Disease. A report, commissioned by the Steering Committee on Future Health Scenarios
As noted in the Foreword, this report is one of several volumes resulting from this study of future health care technology. The purpose of the study, as formulated by the STG, was to analyze future health care technology. Part of the task was to develop an 'early warning system' for health care technology. The primary goal of the project was to develop a list or description of a number of possible and probable future health care technologies, as well as information on their importance. Within the limits of time and money, this has been done. However, given the vast number of possible future health care technologies, complete information on the importance of each area could not be developed in any depth for all technology. Therefore, four specific technologies were chosen and were prospectively assessed. These future technologies were examined in more depth, looking particularly at their future health and policy implications. Subsequently, the project was extended to September 1986, and two additional technologies will be assessed.
Will the present high work pace and the strong time pressure continue to exist in the coming 20 years? In the years 2010 will there be even more employees working under their level of education and suffering from health problems due to stress at work than is the case at the moment? Will the physical work-load of employees be reduced to a minimum over the next 20 years as a result of further application of ergonomic principles? Will the health risks due to working with chemicals increase or decrease? And will sickness, absenteeism and work disability have increased, as a result of these kinds of developments, around the year 2010 or will they have been mostly brought under control?; These and similar questions are dealt with in this book about the quality of the work, health and well-being of employees in the year 2010, carried out by the TNO Insitute of Preventive Health Care (NIPG/TNO) in Leiden, assisted by the Scenario Committee.; Using trend analysis the researchers demonstrate that many aspects of working life have improved in the Netherlands since 1980. Needless to say, not the past but the exploration of the future of the quality of working life takes a central place in this book. Finally the top 20 measures, suggested by a panel of 88 Dutch experts, are presented. These aim at halving the rate of sickness absenteeism and work disability in the Netherlands.
9. 1 311 9. 2 The results in the four areas 313 9. 3 Likely causes of the growing demand for services 314 9. 4 The dominant perception of mental health problems 315 95 A shifting balance 317 9. 6 Mental health problems as a policy issue 319 311) 9. 7 Culture-dependence as an approach 9. 8 Culture-dependence and the four tbemes 322 9. 9 The value of a socia-cultural approach 323 9. 10 Two core notions: normality and identity 325 9. 11 Conclusions and policy options 328 Bibliography 333 Appendix Basic ~ssumptions in the exploratory and target-seuing sccnanos 368 v Preface This study of mental health issues breaks new ground. The task set by the Steering Committee on Future Health Scenarios was twofold, encompassing issues relating both to mental health and to mental health care. Discussions of mental health normally narrow down immediately to a focus on its care; this study, in contrast, seeks to deal with mental health as a theme in its own right alongside that of mental health care. This task led to the establishment of a broadly based committee whose members possessed a wide range of knowledge and experience in the field. The study was carried out by an equally expert team from the Netherlands Institute of Mental Health. In the course of the study over a hundred people with wide ranging expertise took part in consultative panels.
In order to chart the way for long-term policies in the field of public health, the Dutch government needs to have the best possible insight into potential future trends and the problems to which these could give rise. It was with a view to compiling a number of long-range studies that the independent Steering Committee on Future Health Scenarios was set up in 1983. In 1985 the Steering Committee appointed a board of experts to conduct a long-range study of "Accidents and traumatology" (traumatology being that aspect of medicine concerned with the treatment of accident victims). In close consultation with this board, the Institute of Public Health and Social Medicine of the Erasmus University Rotterdam carried out a scenario study, the results of which are briefly summarized below. 0.1 Aims and approach The research had two objectives: To explore possible "autonomous" developments (in the sense of being independent of government intervention) in the field of accidents and the treatment of accident victims. To specify the effects of possible policy measures, in relation to both the prevention of accidents and improvements in the care for accident victims. The research was exploratory rather than predictive. It did not go beyond the year 2000, since it was felt that the pace of change in this field ruled out looking much further than ten to fifteen years ahead.
In order to chart the way for long-term policies in the field of public health, the Dutch government needs to have the best possible insight into potential future trends and the problems to which these could give rise. It was with a view to compiling a number of long-range studies that the independent Steering Committee on Future Health Scenarios was set up in 1983. In 1985 the Steering Committee appointed a board of experts to conduct a long-range study of "Accidents and traumatology" (traumatology being that aspect of medicine concerned with the treatment of accident victims). In close consultation with this board, the Institute of Public Health and Social Medicine of the Erasmus University Rotterdam carried out a scenario study, the results of which are briefly summarized below. 0.1 Aims and approach The research had two objectives: To explore possible "autonomous" developments (in the sense of being independent of government intervention) in the field of accidents and the treatment of accident victims. To specify the effects of possible policy measures, in relation to both the prevention of accidents and improvements in the care for accident victims. The research was exploratory rather than predictive. It did not go beyond the year 2000, since it was felt that the pace of change in this field ruled out looking much further than ten to fifteen years ahead.
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