Steering Committee on Future Health Scenarios – författare

This report focuses on the organization of primary and home care in the future. Realistic possibilities are outlined in scenario form, with positive and negative aspects being brought out in each case. Together with expected trends in health and sickness the report charts the developing pattern of care needs and consumption. The prospects for home care are examined notably in relation to complex medical conditions and patients with multiple pathology. The essential conditions for home care are presented, linked to various categories of patients. These extramural network, extramural centre, transmural network and deconstruction scenarios represent different approaches to the organization of care delivery. Possible ways of putting the various approaches into practice are indicated in this report. Preceding the scenario report proper is an outline of the structure of the Dutch health care system.

The first STG report to embody scenarios on population ageing, health and care appeared in 1985. This report describes developments since 1985, reviewing the current position and setting out updated scenarios. The 1985 report set out three scenarios, in which the central focus was on the developing future patterns of demand for care by the elderly. The present report also sets out three scenarios, centring on the demand for care, in which account is taken of a variety of factors; it also details four strategic scenarios whose central focus is the developing supply of care, and which set supply and demand one against the other. Three of the strategic scenarios - emphasizing, respectively, intramural, extramural and informal care - suppose the demand for care to be met in full; the fourth scenario, which rolls current policies on the care of the elderly forward into the future, pinpoints discrepancies between the need for care and the extent to which that need is likely to be met, making clear in so doing that a review of long-term policy for the elderly is urgently needed.

This report is the third specialized report of the Chronic Diseases Scenario Project. An exploration has been made of the likely trends in the number of patients, the number and severity of consequences and complications, the quality of life and the demands likely to be made on the health system as a result of rheumatoid arthritis up to the year 2005. Rheumatoid arthritis is a growing problem. Key issues therefore include the need for expansion of health care facilities and health care innovations and the prospects to prevent the disease itself and to cope with its consequences and complications. The report is therefore of relevance to all groups involved in the care of rheumatoid arthritis patients and for society as a whole.

With an ageing 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 in the future. 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. Free market unfettered, finally, is marked by a Europe without frontiers and minimal state intervention. The reader is encouraged to reflect on the future of medicines in health care.

This publication represents the report of the Scenario Committee on Ageing. In addition to the scenario report, a background report containing the basic analysis employed in the scenarios on ageing has been prepared.