In the Netherlands several additional facilities and working methods are created to strengthen the effectiveness and capacity of the regular daily health care during large incidents and disasters. One system is called GGB (Large-scale medical assistance). The daily healthcare is organized in 25 safety-regions, which are far too small to handle big incidents. GGB provides in organizing assistance between regions, increasing the effectiveness of ambulance care, the deployment of other emergency services and volunteers, and coordination of this all. GGB is developed to deal with an incident with 250 injuries. This method was investigated to determine value.

Based on a standard questionnaire, key persons of ambulance care, trauma care, Red Cross and Offices of Public Health and Safety per safety region were asked about their experiences with GGB. (125 forms)

Subsequently, the regional outcomes for each discipline were evaluated in a national conferences (four conferences). To conclude, an interdisciplinary national meeting was held to bring the results together. The authors developed the questionnaires, supervised the research process, and presented the results to the authorities.

Results indicated that the working methods for scaled-up care is useful and should be continued. The extra financial costs outweigh the gained strength. The cooperation between professionals and volunteers also receives a lot of support. Proposals have been made for further improvements, in particular concerning cooperation between organizations. Bottlenecks have also been identified in the collaboration between health care, fire services and community care.

In the perception of the care providers there is added value and cost-effectiveness. This is important for the support of the system. As a next step, the authors want to focus on measuring the actual effectiveness. For that, we want to be able to compare systems in several countries. The presentation ends with a call to do so.