Rijckmans Madeleine, Garretsen Henk, van de Goor Ien, Bongers Inge
Faculty of Social and Behavioural Sciences, Tilburg University, Tilburg, The Netherlands.
Scand J Caring Sci. 2007 Sep;21(3):406-16. doi: 10.1111/j.1471-6712.2007.00476.x.
In most European countries, there is an increasing demand for demand-oriented and demand-driven approaches in the development of health care policy and the organization of health care services. Both approaches, in which the main focus is on 'the demand', are seen as counterparts of the supply-oriented approach, that has 'the supply' as point of departure. However, there is much confusion about the definition of the concepts. To identify the different views, and to examine to what extent there is consensus in the Netherlands about the concepts of demand-orientation and demand-driven care, a Delphi study was done among 26 experts; scientists, health care insurance companies, health care suppliers, the government, independent advisory bodies and client interest groups. The study resulted in a typology. The similarities and differences between the two concepts were demonstrated in five dimensions; responsibility, control, need-determination, formal embedment of vision in organization and choice. Furthermore, the typology was used to identify existing types of services as being either demand-oriented or demand-driven services. The typology provides an understanding of the similarities and differences between the two concepts, and appears to be a useful tool in identifying services to the extent that they are demand oriented or demand driven.
在大多数欧洲国家，医疗保健政策制定和医疗保健服务组织中，对以需求为导向和由需求驱动的方法的需求日益增加。这两种主要关注“需求”的方法，被视为以“供给”为出发点的供给导向方法的对应方法。然而，对于这些概念的定义存在很多混淆。为了识别不同的观点，并考察荷兰在需求导向和需求驱动型护理概念上的共识程度，对26位专家进行了一项德尔菲研究；这些专家包括科学家、医疗保险公司、医疗服务供应商、政府、独立咨询机构和客户利益集团。该研究得出了一种类型学。这两个概念之间的异同体现在五个维度上：责任、控制、需求确定、愿景在组织中的正式嵌入以及选择。此外，该类型学被用于确定现有服务类型是需求导向型服务还是需求驱动型服务。该类型学有助于理解这两个概念之间的异同，并且似乎是一种识别服务在多大程度上是需求导向或需求驱动的有用工具。
