The future of care in the Netherlands: application of foresight to explore challenges towards 2050

Abstract

Abstract Background Ageing populations have major impact on public health leading to more pressure on formal as well as informal health care. With rising health care expenditures, a sharp rise in geriatric diseases, multimorbidity, and a decrease in the available resources to manage complex health problems, it is of utmost importance to explore the impact of future public health challenges we are facing. Methods Foresight helps decision-makers anticipate future developments and inform current policies. It involves using the DESTEP methodology to analyze trends in formal and informal care and their impact on health. A participatory approach is used, including focus groups and interviews with stakeholders, to identify key drivers and challenges. Prioritized topics are then evaluated based on their potential impact on public health and healthcare, using both scientific and grey literature. Results Major future challenges such as the rising pressure on formal health care (shortage of personnel, limited financial resources) results in more people who will depended for the provision of informal care. At the same time many people have difficulties to be able to have sufficient control finding the right health care for of their own needs. Especially some vulnerable groups (lower educated, migrant background, elderly) will not be able to get proper care. At the same time digitalization is part of the solution (providing care more efficiently) and the problem (not all population groups are digitally literate, increased demand for care). Public health policy should target these challenges in order to achieve potential health gains in the future. Conclusions Long-term thinking could be stimulated by stronger involvement of policy-makers in the elaboration of options for action. Applying foresight aid understanding uncertainties and support policy makers focusing on challenges in the more distant future with the support of stakeholders. Key messages • The public health issues require an integrative approach with a focus on a more distant future and a comprehensive engagement of relevant stakeholders. • Long-term thinking could be stimulated by stronger involvement of policy-makers in the elaboration of options for action.