title: Netherlands: Health System Review.
abstract: This analysis of the Dutch health system reviews recent developments in organization and governance, health financing, healthcare provision, health reforms and health system performance. Without doubt, two major reforms implemented since the mid-2000s are among the main issues today. The newly implemented long-term care reform will have to realize a transition from publicly provided care to more self-reliance on the part of the citizens and a larger role for municipalities in its organization. A particular point of attention is how the new governance arrangements and responsibilities in long-term care will work together. The 2006 reform replaced the division between public and private insurance by one universal social health insurance and introduced managed competition as a driving mechanism in the healthcare system. Although the reform was initiated almost a decade ago, its stepwise implementation continues to bring changes in the healthcare system in general and in the role of actors in particular. In terms of performance, essential healthcare services are within easy reach and waiting times have been decreasing. The basic health insurance package and compensations for lower incomes protect citizens against catastrophic spending. Out-of-pocket payments are low from an international perspective. Moreover, the Dutch rate the quality of the health system and their health as good. International comparisons show that the Netherlands has low antibiotic use, a low number of avoidable hospitalizations and a relatively low avoidable mortality. National studies show that healthcare has made major contributions to the health of the Dutch population as reflected in increasing life expectancy. Furthermore, some indicators such as the prescription of generics and length of stay reveal improvements in efficiency over the past years. Nevertheless, the Netherlands still has one of the highest per capita health expenditures in Europe, although growth has slowed considerably after reverting to more traditional sector agreements on spending.
authors.affiliation: NIVEL, Netherlands Institute for Health Services Research.
authors.forename: Madelon
authors.initials: M
authors.lastname: Kroneman
authors.affiliation: NIVEL, Netherlands Institute for Health Services Research.
authors.forename: Wienke
authors.initials: W
authors.lastname: Boerma
authors.affiliation: RIVM, the National Institute for Public Health and the Environment.
authors.forename: Michael
authors.initials: M
authors.lastname: van den Berg
authors.affiliation: NIVEL, Netherlands Institute for Health Services Research.
authors.forename: Peter
authors.initials: P
authors.lastname: Groenewegen
authors.affiliation: NIVEL, Netherlands Institute for Health Services Research.
authors.forename: Judith
authors.initials: J
authors.lastname: de Jong
authors.affiliation: European Observatory on Health Systems and Policies, Berlin University of Technology.
authors.forename: Ewout
authors.initials: E
authors.lastname: van Ginneken
mesh_terms: D003695:Delivery of Health Care / Q000379:methods* / Q000458:organization & administration*; D018166:Health Care Reform / Q000379:methods / Q000458:organization & administration; D005102:Health Expenditures; D006291:Health Policy; D061889:Healthcare Financing; D006801:Humans; D007348:Insurance, Health / Q000458:organization & administration; D008134:Long-Term Care / Q000379:methods / Q000458:organization & administration; D009426:Netherlands; D011787:Quality of Health Care