title: A clients' perspective on demand-oriented and demand-driven health care.
abstract: BACKGROUND
  In many Western European countries, there is an increasing request for demand-oriented and demand-driven approaches in health care. In these approaches, the emphasis is on the clients' perspective on healthcare policy and healthcare services. A study was conducted to gain insight into the clients' view of health care.
  
  
  METHODS
  In 2004 a survey was conducted in the Netherlands among 4250 ambulatory mental health clients, by means of a postal questionnaire. To include clients with different experiences of mental health care, the sample was stratified according to the length of the treatment history. A total of 865 clients responded to the survey.
  
  
  RESULTS
  Elements that are found to be important to most clients are that 'needs are determined in consultation with the client', that 'the client is treated in a pleasant manner' and that 'the professional informs the client about the possibilities in his/her situation'. Significant differences were found between groups with different background factors: income, education, age, sex and treatment history all had significant correlations.
  
  
  CONCLUSIONS
  Most clients in ambulatory mental health care appreciate the demand-oriented and demand-driven approaches. However, not all the elements are appreciated in the same manner. In general, clients do not seem to care much about who makes the decisions, but they care much more about the way the decision-making process is carried out. Clients especially value being heard and being involved in the process as a serious party.
authors.affiliation: Tilburg University, Research Program TRANZO, The Netherlands. M.J.N.Rijckmans@UvT.nl
authors.forename: Madeleine J N
authors.initials: MJ
authors.lastname: Rijckmans
authors.forename: Inge M B
authors.initials: IM
authors.lastname: Bongers
authors.forename: Henk F L
authors.initials: HF
authors.lastname: Garretsen
authors.forename: Ien A M
authors.initials: IA
authors.lastname: Van De Goor
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001008:Anxiety Disorders / Q000523:psychology / Q000628:therapy; D003156:Community Mental Health Services / Q000379:methods / Q000600:supply & distribution*; D003657:Decision Making; D003695:Delivery of Health Care / Q000379:methods*; D003866:Depressive Disorder / Q000523:psychology / Q000628:therapy; D005260:Female; D006301:Health Services Needs and Demand; D006302:Health Services Research; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000523:psychology / Q000628:therapy*; D008875:Middle Aged; D009426:Netherlands; D010358:Patient Participation / Q000523:psychology*; D017060:Patient Satisfaction; D026684:Personal Autonomy; D010554:Personality Disorders / Q000523:psychology / Q000628:therapy; D011369:Professional-Patient Relations; D011618:Psychotic Disorders / Q000523:psychology / Q000628:therapy; D011795:Surveys and Questionnaires