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Netherlands Expert Center for Integrated Primary Care Insight in the demand for care of a defined population: A key element of Population Health Management Auke Vlonk A,, Paul Reijn A A Jan van Es Institute, Netherlands Expert Center for Integrated Primary Care Expected demand for care: Diabetes Mellitus (Wijkscan.com) TRIPLE AIM Better Care Better Health Lower Costs MONITORING & BENCHMARKING Forecasts vs actual development Benchmarking INTERVENTIONS/SUPPLY Choose target groups Goalsetting Adjust supply to demand POPULATION DENOMINATOR: NEIGHBOURHOOD AND PRACTICE Expected and actual Demographic data Data about prevalance of diseases At all geographical levels RESULTS Geographical distribution Actual vs expected demand for care Multimorbidity FORECASTS Different scenarios Expected number of chronic diseases Expected care for the complex elderly Vulnerable elderly (65+) in Almere-Haven COSTS Data regarding costs POPULATION STRATIFICATION Self-, disease- and casemanagement Debate Statement: To perform Population Health Management, we need 1. To have insight in the demand for care and needs of a defined population, 2. To choose and implement the right interventions for target groups and 3. To monitor the effects of those interventions Correspondence to : A. Vlonk [email protected] www.jvei.nl Jan van Es Institute Netherlands Expert Center for Integrated Primary Care T +3136 7670360 Randstad 2145a 1314 BG Almere, The Netherlands