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Primary Health Care in The Netherlands

Primary Health Care in The Netherlands. - relic of the 20 th or saviour of the 21 th century -. Niek Klazinga. Why The Netherlands might be of interest for the USA. private insurers private practice mandatory health insurance for all citizens strong primary health care system.

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Primary Health Care in The Netherlands

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  1. Primary Health Care in The Netherlands - relic of the 20th or saviour of the 21th century - Niek Klazinga

  2. Why The Netherlands might be of interest for the USA • private insurers • private practice • mandatory health insurance for all citizens • strong primary health care system

  3. Health insurance in The Netherlands • regulated private insurance market since 2006 • mandatory basic insurance • mandatory acceptance • voluntary supplementary insurance • nominal competitive premiums • contribution via employer • tax-based health care subsidy for persons with • a low income • risk-equalization fund

  4. Primary Care in The Netherlands • 8000 GP’s (13.000 specialists) • average practice 2400 persons • broad professional profile • registered patients • gate-keeper function • solo, duo, group-practices • pharmacists, midwives, allied-health professionals • complementary public health system at level • municipalities

  5. GP training, CME, visitation, re-registration National guideline programme NHG Peer-review activities Practice evaluation Emerging systems of indicators and P4P Quality assurance of GP care

  6. Relic? • eroding gate keeper function (occupational medicine, • youth medicine, nursing home physician) • outsourcing out-of-hours care • less psycho-social care • delayed organizational upscaling • labour market shortages • ownership shifting to other providers and insurers

  7. Saviour? • embedding prevention function • in primary health care • embedding long term care in • primary health care

  8. well developed information infrastructure • high level of professionalization GP’s • well developed quality policies • initiatives with task substitution and new professions • experimentation with organizational models • linkages with public health, long-term care and • hospital care • preferences patients and insurers • potential for benchmarking

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