This book is based on the findings of a nationwide study, the aim of which was to analyse general practitioners' performance as gatekeepers of the Dutch healthcare system. The study was undertaken along six themes: the health of the population; inequalities in health; utilisation of care; quality of care; communication; organisation and workload. Morbidity, Performance and Quality in Primary Care involves 400,000 patients, 1.5 million recorded GP-patient contacts and 2.1 million drug prescriptions. This survey appears at a timely moment. It coincides with the recent interest in primary care arising not only from the growing importance of cost containment in healthcare, but also from the now firmly established association between the life expectancy of a population and the existence of a strong primary care sector. The international interest in the Dutch situation is reflected in several chapters, where experts from all over the world put Dutch general practice into an international perspective.

part 1|32 pages


chapter 1|9 pages

General practice in the Netherlands: major findings from the second Dutch National Survey of General Practice

ByGert Westert, François Schellevis, Jouke van der Zee

chapter 2|9 pages

The design of the second Dutch National Survey of General Practice

ByFrançois Schellevis, Gert Westert

chapter 3|7 pages

The Dutch healthcare system: how are we organised?

ByLea Jabaaij

part 2|72 pages

Health and disparities

chapter 5|12 pages

Morbidity in the population and in general practice

ByMichiel van der Linden, François Schellevis, Gert Westert

chapter 6|12 pages

A comparison of disease prevalence in general practice in the Netherlands and in England and Wales

ByDouglas Fleming, François Schellevis, Michiel van der Linden, Gert Westert

chapter 7|10 pages

A matter of disparities: risk groups for unhealthy lifestyle and poor health

ByMariël Droomers, Hanneke van Lindert, Gert Westert

chapter 8|7 pages

Child health and general practitioners’ management, 1987-2001

ByHanneke Otters, François Schellevis

chapter 9|11 pages

Patients with a psychiatric diagnosis in general practice: (co)morbidity and contacts

ByPeter Verhaak, Anita Volkers, Jasper Nuyen

chapter 10|12 pages

Perceived health and consultation of GPs among ethnic minorities compared to the general population in the Netherlands

ByWalter Devillé, Ellen Uiters, Gert Westert, Peter Groenewegen

chapter 11|8 pages

Respiratory tract infections in general practice according to age, sex and high-risk comorbidity

ByEelko Hak, Maroeska Rovers, Marijke Kuyvenhoven, Theo Verheij

part 3|39 pages

Use of care

chapter 12|10 pages

The activities of general practitioners: are they still gatekeepers?

ByMieke Cardol, Dinny de Bakker, Gert Westert

chapter 13|10 pages

Prescription in Dutch general practice

ByLiset van Dijk

chapter 14|10 pages

Medical practice variation: does it cluster within general practitioners’ practices?

ByJudith de Jong, Peter Groenewegen, Gert Westert

chapter 15|8 pages

Social networks and receiving informal care

ByAlice de Boer, Mirjam de Klerk, Mieke Cardol, Gert Westert

part 4|42 pages

Organisation and communication

chapter 16|10 pages

The workload of general practitioners in the Netherlands: 1987 and 2001

ByMichael van den Berg, Esmée Kolthof, Dinny de Bakker, Jouke van der Zee

chapter 18|7 pages

Professionalisation of the practice assistant enables task delegation: 1987-2001

ByMichael van den Berg, Esmée Kolthof, Dinny de Bakker, Jouke van der Zee

chapter 19|7 pages

Communication in general practice

BySandra van Dulmen, Jozien Sensing

chapter 20|10 pages

Have gender preferences and communication patterns changed?

ByAtie van den Brink-Muinen, Sandra van Dulmen, Jozien Bensing

part 5|40 pages


chapter 21|6 pages

Quality of primary care

ByRoger Jones

chapter 22|10 pages

Assessment of primary care by clinical quality indicators

ByJozé Braspenning, François Schellevis, Richard Grol

chapter 25|8 pages

Adherence to pharmacotherapeutic advice in the guidelines of the Dutch College of General Practitioners

ByFeikje Groenhof, Carlijn Wefers Bettink, Liset van Dijk, Willem Jan van der Veen, Betty Meyboom-de Jong

part 6|57 pages

International perspective and the future

chapter 26|12 pages

Activities of the general practitioner: are they important?

ByPeter Davis

chapter 27|8 pages

Health status of the elderly in the future: demography, epidemiology and prevention

ByNancy Hoeymans, Anneke van den Berg Jeths

chapter 28|10 pages

The need for general practitioners in the Netherlands until 2020

An exploration of demographic and epidemiological changes in general practice
ByJohan Polder, Ronald Gijsen, Nancy Hoeymans, René Poos, Henriëtte Treumiet

chapter 29|8 pages

The supply of general practitioners in the Netherlands

ByLud van der Velden, Lammert Hingstman

chapter 30|8 pages

Collecting information in general practice:‘just by pressing a single button’?

ByRobert Verheij, Jouke van der Zee

chapter 31|12 pages

The future of data collection in general practice in Belgium

ByViviane van Casteren