Health Care in The Netherlands

Abstract

This article analyzes Dutch experiences of health care reform-in particular in primary care-with emphasis on lessons for current United States health care reforms. Recent major innovations were the introduction of private insurance based on the principles of primary care-led health care and including all citizens irrespective of their financial, employment, or health status; introduction of primary care collaboratives for out-of-hour services and chronic disease management; and primary care team building, including practice nurses. These innovations were introduced on top of a strong primary care tradition of family practices with defined populations based on patient panels, practice-based research, evidence-based medicine, large-scale computerization, and strong primary care health informatics. Dutch health reform redirected payment to support introduction of innovative health plans and strengthening of primary care to respond to public health objectives.Five recommendations for US primary care follow from this Dutch experience: (1) a private insurance model is compatible with thriving primary care, but it must include all people, especially the most vulnerable in society, and espouse a primary care-led health care system; (2) patient panels or practice lists strengthen continuity of care and community orientation to focus on and respond to local needs; (3) reward collaboration within primary care and between primary care, hospital care, and public health; (4) stimulate primary care professionals to exert their passion and expertise through participation in primary care research and development; and (5) health informatics should be primary care based, preferably adopting the International Classification of Primary Care. With these recommendations, it will be possible for the United States to obtain better population health for its population. (J Am Board Fam Med 2012;25:S12-17.)

Key strategies to improve systems for managing patient complaints within health facilities – what can we learn from the existing literature?

“…Provide dedicated complaints officer, confidential counsellors, patient groups and citizen monitors [36,45–49,54–56]…”

Multicomponent Program to Reduce Functional Decline in Frail Elderly People: A Cluster Controlled Trial

“…A last explanation relates to the Dutch health care system, in which the GP already has a strong position and a central role in delivering geriatric care, often in collaboration with practice nurses, and facilitated by high-quality EMRs. 7 This suggests that limited room for improvement exists in comparison to health care settings in which primary care is less well organized. On the other hand, our results may hold external validity to health care settings in which collaboration can be set up between health care and welfare and between primary and geriatric care.…”

“…Care delivery is facilitated by the use of high-standard electronic medical records (EMRs) and patient panels, defining the population under care. 6,7 In the Netherlands, GPs often collaborate with practice nurses in the delivery of care (programs) according to the needs of the practice population. 7 Moreover, physicians providing geriatric care increasingly operate (as consultants) in caring for frail older people in the community.…”

“…6,7 In the Netherlands, GPs often collaborate with practice nurses in the delivery of care (programs) according to the needs of the practice population. 7 Moreover, physicians providing geriatric care increasingly operate (as consultants) in caring for frail older people in the community. 8 However, the coordination between GPs, other primary and specialist care providers, and home care and community services is often perceived to be insufficient, leading to fragmented delivery of care.…”

International Learning on Increasing the Value and Effectiveness of Primary Care (I LIVE PC)

“…In the Netherlands, practice registries are based largely on geography, and relationships with patients often last a lifetime. 2 Australia is poised to follow England's geographic accountability model, creating Primary Health Care Organizations, known more parochially as "Medicare locals." 3 These geographically based entities will be accountable funding agencies and practice facilitators.…”