A healthy judgement? Health and Health care in the Netherlands in international perspective

Abstract

International comparisons of health and health care are increasingly used to 'benchmark' national health system performances. This report summarises earlier Dutch RIVM reports. It analyses: 1) the policy relevance of several other international reports, among which the WHO2000 report, which compared health and health care in Europe 2) the stagnating increase in life expectance, especially for Dutch woman 3) the relatively bad trends in Dutch perinatal mortality. Major conclusions are: 1) The WHO2000 report presents a new vision and puts health systems at the political agenda. Its policy implications are unclear, however, and its methodology is wedely critezised. Other reports have presented important topics for further analysis. 2) Lifestyle factors, especially smoking, are responsible for stagnating increase in Dutch life expectancy, especially for women. Prevention remains a key factor for future improvements in Dutch health status. 3) Giving birth at relatively old ages, high rates of twin births and smoking during pregnancy have grown to become even more important as riskfactors for perinatal mortality in the Netherlands. The increased number of children born to ethnic minority mothers is also associated with higher perinatal mortality risks. Improvements in care and prevention around birth are possible in the Netherlands with special attention for ethnic minority groups. The importance of internationally comparable datasets as tools for national benchmarking of health and healthcare is evident, but needs much improvement. Recommendations have been made to the Dutch Minister of Health and she has immediately taken on board several of them. This clearly shows the added value of international comparisons.<br>