['Public health status and perspectives' 1997. VII. Health care needs and health care consumption]. / 'Volksgezonheid toekomst verkenning' 1997. VII. Zorgbehoefte en zorggebruik.

In the 'Public health status and forecasts' 1997 attention is given to the relationship between health status and health care. The theme report 'Health care need and health care consumption' integrates information about both phenomena and about waiting lists in the different sectors of health care. It is difficult to quantify the need for health care, because statements about need always imply a judgment by parties involved. In the literature need for health care is often operationalized by historical data on health care consumption or by health status indicators. At the national level only limited quantitative information is available to support policy on waiting lists and waiting times. The data are seldom disease-specific. Changes in size and distribution (by age and sex) of the population will increase health care cost over the period 1994-2015 in the Netherlands by 0.9-1.0% per year. More detailed demographic projections, however, indicate that there are large disease-specific differences.

[Role of the family physician in mental and social problems in homes for the aged]. / De rol van de huisarts bij psychische en sociale problemen in het verzorgingstehuis.

Based on Dutch nationally representative data, this article reports on the number of psychological and social problems that residents of homes for the elderly (n = 2893) present to their general practitioner (GP). Furthermore, the number of encounters residents with psychological or social problems have with the general practice and the interventions which the GP applies are described. A comparison is made with elderly patients living independently (n = 28056). In a three-month period the GP found psychological problems in 33 per cent of the patients from homes for the elderly. For elderly patients living independently this was 17%. Controlling for background variables the patients from homes for the elderly still show considerably more psychological problems. Social problems are reported less frequently to GP's; 8% of patients from homes for the elderly and 5% of patients living independently report these problems. After controlling for background variables no statistically significant differences were found. The most frequently used intervention is the prescription of drugs. In both groups almost 80% of the respondents received drugs. Referral to mental health care is the least frequently used intervention. Many patients living in homes for the elderly have psychological or social problems. This implies a high workload for the GP. However, no evidence is found that GP's treat their patients in homes for the elderly differently from those living independently.

Dutch general practice care for patients with epilepsy: results from the Dutch National Survey of Morbidity and Interventions.

This study aimed to assess the share which Dutch general practice has in the care of patients with epilepsy. During a 3-month period 400,000 patient contacts in 103 general practices with a total list of 335,000 patients were registered, 1536 of these, concerning 1059 patients, concerned epilepsy. Contacts with patients with known epilepsy in Dutch General Practice were handled mainly by the practice nurse and most involved repeat prescriptions. Patients suspected of having epilepsy had more attention from the General Practitioner. The involvement of General Practitioners in the care of epilepsy was found to be small, but not unimportant. GPs are in a crucial position as regards the detection of epilepsy. They can enlarge their role in respect of patients with known epilepsy and improve continuity of care.

[Family practitioner's and specialist's role in the care of the patient with epilepsy]. / Aandeel van huisarts en specialist in de zorg voor de patiënt met epilepsie.

Differences of opinion between GPs and medical specialists about their roles in the care of patients with epilepsy make it difficult to improve this care. To assess the roles of GP and specialist care a random sample of 500 GPs and all clinical neurologists in The Netherlands were sent a questionnaire about their attitude and actual behaviour towards tasks concerning epilepsy. The response was 54%. Non-response analysis did not bring forward statistically significant differences. Both GPs and specialists considered further diagnosis and starting antiepileptic drug regimens tasks for the specialist. The treatment of attacks in the patient's home situation was considered by both groups as a task for the GP. About other tasks opinions were that they ought to be shared or opinions appeared to be divided. According to the authors tasks about which consensus exists as well as tasks about which opinions differ should be considered carefully: on management level by the Epilepsy consultation group of the Dutch Society of General Practitioners and the Dutch Epilepsy Federation, on care level by introducing a patient information card.

Task and driving performance of patients with a severe concussion of the brain.

Patients who had sustained a severe concussion of the brain more than 2 years earlier were tested in choice reaction time tasks in the laboratory in order to investigate their impaired reactive capacity. The focus of investigation was whether specific stages in the chain of the information process are affected by the injury. In addition, driving skills were measured in an instrumented car to determine if reaction time performance is predictive of car driving. In general, patients were much slower than control subjects, both in the reaction time and in the driving tasks. The results obtained in the reaction time tasks provide no conclusive evidence, however, that severe concussion of the brain affects particular stages in information processing. Reaction time tasks appear to have predictive value for the ability to drive a car.