A healthy judgement? Health and Health care in theNetherlands in international perspective

摘要

International comparisons of health and health care are increasingly usedto 'benchmark' national health system performances. This reportsummarises earlier Dutch RIVM reports. It analyses: 1) the policyrelevance of several other international reports, among which the WHO2000report, which compared health and health care in Europe 2) the stagnatingincrease in life expectance, especially for Dutch woman 3) the relativelybad trends in Dutch perinatal mortality. Major conclusions are: 1) TheWHO2000 report presents a new vision and puts health systems at thepolitical agenda. Its policy implications are unclear, however, and itsmethodology is wedely critezised. Other reports have presented importanttopics 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 futureimprovements in Dutch health status. 3) Giving birth at relatively oldages, high rates of twin births and smoking during pregnancy have grownto become even more important as riskfactors for perinatal mortality inthe Netherlands. The increased number of children born to ethnicminority mothers is also associated with higher perinatal mortalityrisks. Improvements in care and prevention around birth are possible inthe Netherlands with special attention for ethnic minority groups. Theimportance of internationally comparable datasets as tools for nationalbenchmarking of health and healthcare is evident, but needs muchimprovement. Recommendations have been made to the Dutch Minister ofHealth and she has immediately taken on board several of them. Thisclearly shows the added value of internationalcomparisons.