RESUMEN
Policy-oriented foresight reports aim to inform and advise decision-makers. In value-laden areas such as public health and healthcare, deliberative scenario methods are clearly needed. For the sixth Dutch Public Health Status and Forecasts-report (PHSF-2014), a new approach of co-creation was developed aiming to incorporate different societal norms and values in the description of possible future developments. The major future trends in the Netherlands were used as a starting point for a deliberative dialogue with stakeholders to identify the most important societal challenges for public health and healthcare. Four societal challenges were identified: 1) To keep people healthy as long as possible and cure illness promptly, 2) To support vulnerable people and enable social participation, 3) To promote individual autonomy and freedom of choice, and 4) To keep health care affordable. Working with stakeholders, we expanded these societal challenges into four corresponding normative scenarios. In a survey the normative scenarios were found to be recognizable and sufficiently distinctive. We organized meetings with experts to explore how engagement and policy strategies in each scenario would affect the other three societal challenges. Possible synergies and trade-offs between the four scenarios were identified. Public health foresight based on a business-as-usual scenario and normative scenarios is clearly practicable. The process and the outcomes support and elucidate a wide range of strategic discussions in public health.
Asunto(s)
Atención a la Salud/tendencias , Política de Salud/tendencias , Salud Pública/tendencias , Atención a la Salud/economía , Humanos , Países Bajos , Autonomía Personal , Salud Poblacional , Poblaciones VulnerablesRESUMEN
The Dutch Public Health Status and Foresight report 2014 explores the future of public health in the Netherlands, using a trend scenario and four future scenarios. The trend scenario provides projections until 2030, based on the trends over the last decades and assuming the policy stays the same. After many years the unfavourable trends in lifestyle seem to have ended: the percentage of smokers is decreasing and the percentage of people who are overweight is no longer increasing. Life expectancy will continue to increase, but the differences between socioeconomic groups will not become smaller. Demographic changes (rise in the ageing population) and improvements in health care will contribute to an increase in the number of chronically ill which will increase from 5.3 million in 2011 to 7 million in 2030. However, most people with a chronic disease feel healthy, have no disabilities and participate fully in society. Health care expenditures rose from 9.5% of the GDP in 2000 to 14% in 2012. How this growth will continue in the next years is uncertain.