To broaden the horizon
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- Molly Fletcher
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1 To broaden the horizon Comparing Australian and Dutch healthcare for people with ID Willemijn Hensbroek Resident Intellectual Disability Medicine
2 Content The Dutch ID Physician Demographics Housing and care facilities Funding NVAVG Research (Dis)similarities
3 The Dutch ID Physician Ideals In general, the prevailing ideals are equal in Australia and The Netherlands: Normalisation Integration De-institutionalisation In NL de-institutionalisation is less extensive than in AUS. At the same time the quality of live for people living in residential facilities had been increased. The medical/mental health focus has been replaced by a residential focus. Governmental and professional push to abandon restrictive practices. Individualised assistance/ care.
4 The Dutch ID Physician General information Professional association (1981) Recognized speciality (2000) 2 professorial chairs: Prof. Evenhuis (Rotterdam), Prof. Schrojenstein-Lantman (Nijmegen) 207 registered ID physicians (jan 2013) ± 60 residents 3 year postgraduate training program
5 The Dutch ID Physician Work setting Primary care provided by GP or ID physician, depending on where person lives ID medicine clinics in hospitals Clinics in residential services Specialised clinics Long term, integral care Partial, specialist care after referral by GP
6 The Dutch ID Physician The ID physician provides Health care for ID related health problems Health care for other health problems Coordination of individual health care Preventive care (health watch programs) Support for patient and care system
7 The Dutch ID Physician Skills Communication skills Multidisciplinary settings Knowledge of (regional) professional network Methodical approach Growing number of professional guidelines Health legislation (Participation in) research See also: short movie The working day of and ID physician
8
9 The Netherlands vs. Holland Holland --> The Netherlands
10 Demographics Distribution of people with ID Almost people in The Netherlands people with ID group homes in community with family or individually in community in group homes in residential services in campus like area
11 Funding Regulated and funded by Ministry of Health 5% of national income used to pay for care for people with chronic disease (both housing, assistance and chronic health care) Possible to use funding to pay family/ neighbour etc. Changes will be made to system over the next few years because of rising costs.
12 NVAVG General Dutch association of ID physicians Goals: Accessibility to ID physician and other specialised professional services Promote co-operation between ID physician, GP and clinical specialist International co-operation Development of professional guidelines
13 Professional guidelines Epilepsy Sexuality and family planning And also: Health watches (10) Pharmacological presedation Gastro-oesophageal reflux Visual and hearing impairment Infection prevention Ethical directives for scientific research In the making: Coeliac disease Swallowing disorders Down syndrome End of life decision making CPR Cervix- and mammascreening
14 Health Watches Information on 10 different syndromes For doctors and dentists Providing: Background on syndrome (incidence, genetics, signs and symptoms, etc) Common health problems in children and adults Recommended follow up on health issues Useful references
15 Research Healthy aging Visual disorders Effects of reduction of usage of antipsychotic medication Molecular and clinical definition of rare genetic disorders Sleep and sleep-wake rhythm in older adults with ID Palliative care Adequate GP-care No national database available. Data on people with ID accessible via GP, ID physician, paediatricians, tertiary centres, special interest psychiatrists, etc.)
16 (Dis)similarities Similarities: Continuous reform in health care systems Misconceptions capabilities and needs Quality/ quantity of staff
17 (Dis)similarities Dissimilarities: More advanced de-institutionalisation in Australia Better accessibility to specialist medical care in The Netherlands Same ideals, different implementation Further comparison will follow in report after traineeship.
18 Questions? Contact information:
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