The
Willemijn Schäfer, NIVEL, Netherlands Institute for Health Services Research
Madelon Kroneman, NIVEL, Netherlands Institute for Health Services Research
Wienke Boerma, NIVEL, Netherlands Institute for Health Services Research
Michael van den Berg, RIVM, National Institute for Public Health and the Environment
Gert Westert, RIVM, National Institute for Public Health and the Environment
Walter Devillé, NIVEL, Netherlands Institute for Health Services Research
World Health Organization April 2010, on behalf of the European Observatory on Health Systems and Policies
Available online PDF [267p.] at: http://www.euro.who.int/Document/OBS/NEThit2010.pdf
"……..The Health Systems in Transition (HiT) profiles are country-based reports that provide a detailed description of health systems and of policy initiatives in progress or under development. HiTs examine different approaches to the organization, financing and delivery of health services and the role of the main actors in health systems. They also describe the institutional framework, process, content, and implementation of health and health care policies, highlighting challenges and areas that require more in-depth analysis.
Undoubtedly the dominant issue in the Dutch health care system at present is the fundamental reform that came into effect in 2006. With the introduction of a single compulsory health insurance scheme, the dual system of public and private insurance for curative care became history. Managed competition for providers and insurers became a major driver in the health care system. This has meant fundamental changes in the roles of patients, insurers, providers and the government. Insurers now negotiate with providers on price and quality and patients choose the provider they prefer and join a health insurance policy which best fits their situation.
To allow patients to make these choices, much effort has been made to make information on price and quality available to the public. The role of the national government has changed from directly steering the system to safeguarding the proper functioning of the health markets.
With the introduction of market mechanisms in the health care sector and the privatization of former sickness funds, the Dutch system presents an innovative and unique variant of a social health insurance system…."
Content
Preface
Executive summary
1. Introduction
1.1 Geography and sociodemography
1.2 Economic context
1.3 Political context
1.4 Health status
2. Organizational structure
2.1 Overview of the health
2.2 Historical background
2.3 Organizational overview
2.4 Concentration and (de)centralization
2.5 Patient empowerment
3. Financing
3.1 Health expenditure
3.2 Population coverage and basis for entitlement
3.3 Revenue collection/sources of funds
3.4 Pooling of funds
3.5 Purchasing and purchaser–provider relations
3.6 Payment mechanisms
4. Regulation and planning
4.1 Regulation
4.2 Planning and health information management
5. Physical and human resources
6. Provision of services
6.1 Public health services
6.2 Patient pathways
6.3 Primary health care
6.4 Secondary care, specialized ambulatory care/inpatient care
6.5 Emergency care
6.6 Pharmaceutical care
6.7 Long-term care
6.8 Services for informal carers
6.9 Palliative care
6.10 Mental health care
6.11 Dental care
6.12 Complementary and alternative treatments
7. Principal health care reforms
7.1 Analysis of recent reforms
7.2 Future developments
8. Assessment of the health care system
8.1 The stated objectives of the health system
8.2 The distribution of the health system's costs and benefits across the population
8.3 Efficiency of resource allocation in health care (across services, across inputs)
8.4 Technical efficiency in the production of health care
8.5 Quality of care
8.6 The contribution of the health system to health improvement
9. Conclusions
10. Appendices
10.1 References
10.2 Further reading
10.3 Useful web sites
10.4 HiT methodology and production process
10.5 The review process
* * *
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