What method is followed by health and social care organizations in Utrecht and Amsterdam to reduce the high utilization of care? Results found through action research
Residents of deprived neighbourhoods are more likely to suffer from chronic diseases, overweight, unhealthy lifestyles, and experience more problems with work, housing, income and child rearing. Even when corrected for this higher burden of problems, the utilisation of care is higher than in non-deprived neighbourhoods. Increasingly promoted solutions focus on the integrating of fragmented care services, on prevention and self-management as strategy to drive back elevated utilisation of care. In two projects in Utrecht and Amsterdam, The Netherlands, experiments are undertaken to integrate preventive care- and social care in order to decrease high utilisation of care. In this article we report on the first phase in this research, in which the strategies of these projects are described and explored by clarifying the definition of the problem and the program theory. The project in Amsterdam North focuses on adults with multiple problems and is primarily top down in nature. The project in Utrecht Overvecht focuses on adults with vague health complaints and develops primarily bottom up. In both projects the aim is for professionals to develop new competencies that will enable them to work in a generalist, population health oriented, and coaching manner, which makes more adequate care and support to clients from deprived neighbourhoods possible. We hope this description of the program theories will stimulate others in the development of initiatives to drive back high utilisation of care in deprived neighbourhoods.