Netherlands Health System Overview
Health System Rankings
Outcomes
Health System Coverage
Costs for Consumers
Health System Expenditures
Netherlands COVID-19 Policy
Hospital Beds Per 1,000 Population (2020): 2.91
Doctors Consultations (In All Settings) (Number Per Capita) (2020): 8.4
Hospital Average Length of Stay (All Causes) (2020): 4.5 Days
Computed Tomography Scanners (Per Million Population) (2020): 14.68
Magnetic Imaging Resonance Units (Per Million Population) (2020): 13.36
Source: Organization for Economic Cooperation and Development. OECD.Stat. Last accessed Nov. 10, 2022.
“An account of the number of hospitals should distinguish between hospital locations and hospital organizations. After a merger, hospitals may continue as separate locations of one hospital organization. In 2014 throughout the country there were 131 hospital sites and 112 outpatient clinics, which were organized into 77 hospital organizations and 8 academic hospital organizations. Since 2009 the number of hospital sites has remained stable but the number of outpatient clinics has strongly increased, from 61 to 112. More and more hospitals are opening outpatient clinics on the edge of their catchment area in order to better compete with surrounding hospitals. Furthermore, the supply of hospital care is increasingly differentiated. Merged hospitals may offer specific functions in a location, thus leaving some locations with more enhanced services than others. Care is also increasingly provided through outpatient and day treatment.
“In 2012 there were 1296 cases of day care per 10,000 inhabitants, which is 3.5 times more than in 1993 (www.zorgatlas.nl). In addition to general hospitals, offering the full spectrum of hospital care, there are independent treatment centres (ZBCs) that provide selective non-acute treatments, covered by basic health insurance, for admissions shorter than 24 hours. Examples are cataract surgery or varicose veins surgery. In 2013 there were 214 of these independent treatment centres (Dutch Hospital Data, 2015). The growth of ZBCs since the beginning of the twenty-first century is related to the introduction of the DBC system by which these centres are paid, while hospitals were still mainly financed via the old functional budget system. ZBCs normally deal with less complicated care, whereas hospitals need to treat the whole spectrum of patients. The Health Care Institutions Admission Act (WTZi) does not legally distinguish between independent treatment centres and general hospitals. All these institutes are called ‘Medical Specialist Health Care Institutions’ (Deuning, 2009).”
Source: Kroneman M, Boerma W, van den Berg M, Groenewegen P, de Jong J, van Ginneken E (2016). The Netherlands: health system review. Health Systems in Transition, 2016; 18(2):1–239.
“The high density of the general infrastructure in the Netherlands also applies to the healthcare sector. A numerous population in a small country is favourable for the development of dense networks of facilities. The two maps in Fig. 4.1 show this for primary care and hospitals. Travelling by car, a large majority of Dutch people can reach their GP practice within 7 minutes. On the mainland, practically all Dutch people are within 25 minutes’ drive of a hospital (freestanding outpatient clinics are not taken into account). Outside office hours, a network of 122 GP out-of-hours centres (Huisartsenpost, HAP) are available. The average distance to a HAP is 6.2 kilometres. In case of emergency, 91 hospital locations offer 24/7 emergency services. More than 99% of the population can reach such an emergency department by ambulance within 45 minutes. For the population of the Frisian Islands in the north, a helicopter is available for emergencies (www.volksgezondheidenzorg.info).”
Source: Kroneman M, Boerma W, van den Berg M, Groenewegen P, de Jong J, van Ginneken E (2016). The Netherlands: health system review. Health Systems in Transition, 2016; 18(2):1–239.
“As in most EU15 countries, the number of acute care beds in the Netherlands has gradually dropped, by around 18% between 1990 and 2009, from 373 to 306 per 100,000 population (WHO Regional Office for Europe, 2015). The decrease was driven by several factors. The need for cost-containment resulted in a more efficient use of hospital bed capacity, which was enabled by new technologies, such as laparoscopic surgery, which promoted day surgery. Furthermore, more treatments for chronically ill patients could be delivered in the patients’ home situation. The decline in acute care beds up to 2009 was in line with the aim of the government to reduce bed supply to approximately 2 per 1000 inhabitants in 2015 (Board for Health Care Institutions, 2003). However, with the abolition of central planning for hospitals in 2008, central steering was no longer effective, and it was deemed no longer necessary as well. In the years after 2008 the number of beds increased again by 9%, up to 332 beds per 100,000 population in 2012. As Fig. 4.3a shows, the acute hospital bed supply in the Netherlands is still below the average in the EU15 countries, but it is the only country where the number of acute beds is on the rise again. Between 1990 and 2012 the average number of acute beds in the EU countries before 2004 decreased from 532 per 100,000 population to 338.”
Source: Kroneman M, Boerma W, van den Berg M, Groenewegen P, de Jong J, van Ginneken E (2016). The Netherlands: health system review. Health Systems in Transition, 2016; 18(2):1–239.
“Between 2005 and 2013 the number of PET scanners more than doubled from 24 to 54. The number of MRI units also strongly increased, by 80%, from 107 to 193. The increase of CT scanners amounted to 45%, from 134 to 194. If the population growth is taken into account, the availability increase percentages are slightly lower, but still considerable.
“In an international comparison, the availability of MRI and CT units in the Netherlands is rather low. Compared to the EU15, the Netherlands had the lowest number of CT scanners per million population in 2013: 11.5 compared with 24.1 (OECD, 2015). The Netherlands also has relatively few MRI units (11.5 per million population compared with 14.9 on average in the EU15). Only France (9.4) and the United Kingdom (6.1) have fewer MRI units (OECD, 2015). In contrast, there are more PET scanners in the Netherlands (54, or 3.2 per million population) than in most other countries. Only in Denmark is the number larger (6.1 per million).
“In the Netherlands in 2013 the available CT scanners produced 6735 scans per device per year. The usage of CT scans in neighbouring countries is most intensive in Belgium, with 13 281, and the least extensive in Germany, with 2849 scans per device per year. The usage of MRI scans in the Netherlands is 4145 scans per device per year, which is at the lower end of the scale compared with neighbouring countries. The UK, at the high end, produces 6893 scans per MRI device and Germany, at the low end, 1821 scans. There are no norms regarding the required number of these devices per population, but if there are too few, this may lead to access problems in terms of geographic proximity or waiting times. If there are too many, this may result in an overuse (OECD, 2012; OECD 2015b).”
Source: Kroneman M, Boerma W, van den Berg M, Groenewegen P, de Jong J, van Ginneken E (2016). The Netherlands: health system review. Health Systems in Transition, 2016; 18(2):1–239.
“The Netherlands has a dense network of health care providers, ensuring high geographical availability of services. In 2020, fewer than 0.15 % of the population had to travel more than 10 minutes by car to the nearest GP practice, and GP out-of-hours centres cover care outside office hours. However, GP practices struggle to replace GPs after retirement, and shortages are becoming a concern.
“Although there have been a substantial number of mergers between hospitals over the last decade, this has not yet affected the number of locations for accessing health care. In the Netherlands, 99 % of the population lived within 30 minutes from a hospital by car in 2020 (Volksgezondheidenzorg, 2021). However, the Dutch system has been experiencing excessive waiting times in some outpatient departments.
“Mental health care for children is of particular concern, as waiting times can exceed one year. It remains unclear how the pandemic will affect waiting times in the longer term.
“Typically, insurance companies have the option of reimbursing only 75 % of costs of services provided by non-contracted providers. This could result in financial barriers to accessing some hospitals for patients who purchase cheaper (“budget”) insurance policies that contract a limited number of providers. During the COVID-19 pandemic, insurers agreed to cover care delivered by all hospitals in 2020 and 2021, even if they are outside their networks (see Section 5.3).”
Source: OECD (2021), Health at a Glance 2021: OECD Indicators, OECD Publishing, Paris, https://doi.org/10.1787/ae3016b9-en.
Health Systems Facts is a project of the Real Reporting Foundation. We provide reliable statistics and other data from authoritative sources regarding health systems in the US and sixteen other nations.
Page last updated Nov. 10, 2022 by Doug McVay, Editor.
