PhD defence Laura Joanna Damen

Keywords: Relocating care, Healthcare system, Healthcare professional perspectives, Direct access
 

"Organising the right care in the right place: Exploring healthcare relocation in the Netherlands from multiple perspectives"

The demand for healthcare is growing worldwide. As demand increases, so will the costs, and there is a shortage of healthcare workers. Because of this, changes to healthcare systems are needed to help control rising costs and address the lack of staff. It is believed that relocating care can play a big part in keeping healthcare affordable and sustainable. This thesis focused on the organisation of relocating care. 
This thesis highlights that citizens are generally positive about relocating care when certain conditions are met, particularly when care can be provided close to, or within, the home environment. General practitioners (GPs) identified several types of care that could be relocated. These included certain diagnostic care and follow-up services from hospitals to GPs, provided they have sufficient time to manage these additional responsibilities. Additionally, care that does not require the medical expertise of a GP, or care that citizens seek from GPs due to difficulty navigating the healthcare system to find the appropriate provider, could be relocated to alternative settings. This thesis also looked into factors linked to direct access. Younger patients and those with higher incomes were more likely to use direct access. There was also a lot of variation between practices in the use of direct access. Some allied health professionals encountered difficulties with direct access, leading some to stop using it altogether. These challenges were linked to issues with policy, motivation, and public profile.

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