Chronic Diseases in the year 2005

Aims and approach In order to chart the way for long-tenn policies in the field of public health, the Dutch government needs to have the best possible insight into potential future trends and the problems to which these could give rise. It was with a view to compiling a number of long-range studies that the independent Steering Committee on Future Health Scenarios was set up in 1983. In 1988 this body appointed a board of experts to sUivey the future of Chronic Diseases. Three chronic diseases have been selected: diabetes mellitus, CNSLD (chronic non-specific lung disease) and rheumatoid arthritis (a chronic disorder of the joints). In close consultation with this board, the study has been conducted by the Department of Epidemiology of the National Institute of Public Health and Environmental Protection in Bilthoven. This report contains the results of the research into CNSLD. The report on diabetes mellitus was published in March 1990, while that on rheumatoid arthritis followed shortly (1991). The series has been concluded with a fmal report (spring 1992), in which, among other things, the results of the three reports have been brought together with a view to arriving at an overall picture of chronic diseases. The research had two main objectives: 1.

Zusammenfassung
Three chronic diseases have been selected: diabetes mellitus, CNSLD (chronic non-specific lung disease) and rheumatoid arthritis (a chronic disorder of the joints).

Inhalt
Summary.- 1. Introduction.- 1.1 For whom is this report intended?.- 1.2 Aims of the research.- 1.3 Delimiting the field: diabetes mellitus, CNSLD and rheumatoid arthritis.- 1.4 CNSLD.- 1.5 Approach adopted.- 2. Current situation and background.- 2.1 Introduction and explanation of concepts use.- 2.2 Current scale of the problem.- 2.3 Comparisons with other countries.- 2.4 Past trends and background to these trends.- 2.5 Future developments.- 3. Delphi-study of future expectations: results of an opinion survey among 30 experts.- 3.1 Brief summary of method used.- 3.2 Results of Delphi-study.- 4. Future health scenarios: possible situations in 2005.- 4.1 Introduction.- 4.2 Demographic scenario (I).- 4.3 Reference scenario (II).- 4.4 Alternative scenarios (III).- 4.5 Policy scenarios (IV).- 4.6 Conclusions.- 5. Conclusions: priority areas for government policy.- 5.1 Introduction.- 5.2 Determination of priorities.- 5.3 The formulation of a coherent policy.- 5.4 Improving the provision of information.- 5.5 The importance of scientific research.- 5.6 Conclusion.- 6. References.- Appendices.- 1. Diagnosis and treatment of CNSLD.- 2. Economic aspects of CNSLD.- Annexes:.- 1. Diagnostic criteria for classifying CNSLD by levels of clinical severity.- 2. I.C.D. codes Chronic Obstructive Pulmonary Disease and allied conditions (codes 490496).- 3. The number of patients with asthma, chronic bronchitis (including emphysema) and CNSLD in 2005 compared with 1990 according to the static model.- 4. Description of three typical Dutch CNSLD patients on whom questions were asked in the Delphi questionnaire.- 5. Acknowledgements and composition of Delphi panel.- List of abbreviations.