State of Health in the EU

The Netherlands
Country Health Profile 2023
 The Country Health Profile Series Contents
THE NETHERLANDS

The State of Health in the EU’s Country Health Profiles 1. HIGHLIGHTS 3

provide a concise and policy-relevant overview of
2. HEALTH IN THE NETHERLANDS 4
health and health systems in the EU/European Economic
Area. They emphasise the particular characteristics 3. RISK FACTORS 7
and challenges in each country against a backdrop of 4. THE HEALTH SYSTEM 9
cross-country comparisons. The aim is to support policy
5. PERFORMANCE OF THE HEALTH SYSTEM 12
makers and influencers with a means for mutual learning
and voluntary exchange. For the first time since the series 5.1 Effectiveness 12
began, the 2023 edition of the Country Health Profiles 5.2 Accessibility 15
introduces a special section dedicated to mental health.
5.3 Resilience 16
The profiles are the joint work of the OECD and the
6. SPOTLIGHT ON MENTAL HEALTH 19
||

European Observatory on Health Systems and Policies, in

co-operation with the European Commission. The team 7. KEY FINDINGS 22
is grateful for the valuable comments and suggestions
provided by the Health Systems and Policy Monitor
network, the OECD Health Committee and the EU Expert
Group on Health Systems Performance Assessment
(HSPA).

Data and information sources

The data and information in the Country Health Profiles
are based mainly on national official statistics provided
to Eurostat and the OECD, which were validated to
ensure the highest standards of data comparability. The
sources and methods underlying these data are available
in the Eurostat Database and the OECD health database.
Some additional data also come from the Institute for
Health Metrics and Evaluation (IHME), the European
Centre for Disease Prevention and Control (ECDC), the
Health Behaviour in School-Aged Children (HBSC) surveys
and the World Health Organization (WHO), as well as
other national sources.
The calculated EU averages are weighted averages of
the 27 Member States unless otherwise noted. These
EU averages do not include Iceland and Norway.
This profile was finalised in September 2023, based
on data that were accessible as of the first half of
September 2023.

Demographic and socioeconomic context in The Netherlands, 2022

Demographic factors The Netherlands EU

Population size 17 590 672 446 735 291
Share of population over age 65 (%) 20.0 21.1
Fertility rate¹ (2021) 1.6 1.5
Socioeconomic factors
GDP per capita (EUR PPP²) 46 093 35 219
Relative poverty rate³ (%) 14.5 16.5
Unemployment rate (%) 3.5 6.2
1. Number of children born per woman aged 15-49. 2. Purchasing power parity (PPP) is defined as the rate of currency conversion that equalises the
purchasing power of different currencies by eliminating the differences in price levels between countries. 3. Percentage of persons living with less than
60 % of median equivalised disposable income. Source: Eurostat Database.

Disclaimers: This work is published under the responsibility of the Secretary-General of the OECD. The opinions expressed and arguments employed herein do not
necessarily reflect the official views of the Member countries of the OECD. The views and opinions expressed in European Observatory on Health Systems and Policies
publications do not necessarily represent the official policy of the Participating Organizations.
This work was produced with the financial assistance of the European Union. The views expressed herein can in no way be taken to reflect the official opinion of the
European Union.
The names and representation of countries and territories used in this joint publication follow the practice of WHO.
Territorial disclaimers applicable to the OECD: This document, as well as any data and map included herein are without prejudice to the status of or sovereignty over any
territory, to the delimitation of international frontiers and boundaries and to the name of any territory, city or area. Additional specific disclaimers are available here.
Territorial disclaimers applicable to the WHO: The designations employed and the presentation of this material do not imply the expression of any opinion whatsoever on
the part of WHO concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. Dotted
and dashed lines on maps represent approximate border lines for which there may not yet be full agreement.
© OECD and World Health Organization (acting as the host organisation for, and secretariat of, the European Observatory on Health Systems and Policies) 2023.
02 | State of Health in the EU | The Netherlands: Country Health Profile 2023
 1 Highlights
Years Netherlands EU Health Status
2.8 2.5 Life expectancy Option
in the1:Netherlands increased in line with the EU average
by education level
1.2 1.5 A 0 two decades preceding the COVID-19 pandemic, and its reduction
in the
B 10 NL EU Low education High education
throughout the pandemic was slightly less severe than the EU average.
C
Life20expectancy Smoking
in 2022(daily)
stood at 81.7 years – 6 months below its 2019
-0.5 -0.6 0 10 20 30
level. Throughout the pandemic, excess mortality remained close to the
2000-2010 Obesity (BMI >30)
0 22010-2019 4 2019-2022
EU30 average, peaking at almost 14 %0 in 2020.10
D 20
Changes in life expectancy at birth Heavy drinking (at least
once per month) 0 10 20 30
% of population aged 15+
Netherlands EU Risk Factors
15 %
Smoking
19 % Mortality linked to behavioural risk factors in the Netherlands is
19 % slightly lower than the EU average. Prevalence of smoking and obesity
Heavy drinking
19 % is comparatively low, while heavy episodic drinking is on a par with the
14 %
Obesity
16 % EU average. Smoking and obesity are more prevalent among those with a
low level of education, while heavy drinking is more common among the
0% 10 % 20 % 30 %
% of adult population, 2019
most educated.

Government/compulsory schemes Health System

Private sources
In 2021, health spending per capita stood at EUR 4 570 – the third highest
Netherlands 3 882 688 amount in the EU, although spending was only marginally above the
EU average when measured as a share of GDP. COVID-19-related public
EU 3 319 710 spending drove significant health expenditure increases in 2020 and
2021. Public sources accounted for nearly 85 % of health expenditure –
0 1 000 2 000 3 000 4 000 5 000 above the EU average of 81 %.
EUR PPP per capita, 2021

Effectiveness Accessibility Resilience

Mortality rates from causes
deemed preventable and treatable
in the Netherlands were 21 % and
36 % lower than the EU averages
in 2020. Over the last decade,
treatable mortality rates declined
much faster than the EU average,
driven by mortality reductions
from ischaemic heart disease and
breast cancer.
Netherlands
141
Preventable mortality
180
Only 0.2 % of the population in
the Netherlands reported unmet
medical care needs in 2022 – the
lowest share across EU countries
and equal to the rate reported
before the start of the pandemic.
However, the deferral of a
substantial volume of surgical
activity during the pandemic had
an adverse effect on waiting times.
EU
Low income All High income
Netherlands
In the years before the pandemic,
public health spending in the
Netherlands increased in line with
GDP. The pandemic temporarily
upended this trend, as the former
increased by over 9 % against a
near 4 % decline in GDP in 2020.
In 2021, public health spending
kept rising at a more moderate
rate, driven in large part by
COVID-19-related costs.
Low income All High income
Public spending on health GDP
10 %
Netherlands

EU 0% EU
59
Treatable mortality
92
% 2% 4% -10 % % 2% 4%
Age-standardised mortality rate per 100 000 2014/15 2016/17 2018/19 2020/21
population, 2020 % reporting unmet medical care needs, 2022 Annual change in real terms
% reporting unmet medical care needs, 2022

Special Norway
Mental Health
Mental health illnesses are more prevalent in the Netherlands than
Netherlands EU in most other EU countries,Netherlands
with nearly one
EU
in six Dutch people suffering from one 20
in 2019. In contrast to the EU trend, over
500 the past decade suicide rates
400
in the Netherlands increased by nearly 5 %, and were slightly above the EU average in 2020. The Dutch mental
300
10
healthcare system is struggling to meet increased demand in the aftermath 200 of the pandemic due to limited
capacity and a shortage of mental health professionals. 100
0 0
Spring 2021 Spring 2022 2017 2018 2019 2020 2021
Hip & knee replacements per 100 000 population
% unmet healthcare needs
 2 Health in the Netherlands
THE NETHERLANDS

Life expectancy in 2022 was 6 months lower sizeable reduction in COVID-19 mortality in 2022,
than before the COVID-19 pandemic life expectancy in the Netherlands rebounded by
0.3 years. Against this backdrop, in 2022 the life
In 2022, life expectancy at birth in the Netherlands
expectancy of the Dutch population was still 6
was 81.7 years, positioning it in the middle range
months below its pre-pandemic level.
among EU countries and surpassing the EU
average by one year (Figure 1). In the decade prior As in other European countries, men in the
to the COVID-19 pandemic, life expectancy in the Netherlands generally have shorter lifespans
Netherlands increased at a slightly slower rate than women. However, the gender gap in life
||

than in other EU countries with similar levels in expectancy in 2021 was 2.5 years narrower than
2010. By 2019, life expectancy in the Netherlands the EU average, owing to the comparatively low life
had surpassed the EU average by almost a year. expectancy of Dutch women, which was 0.2 years
The onset of the COVID-19 pandemic resulted in a below the respective EU average. The legacy of
0.8-year drop in life expectancy in 2020, aligning higher smoking rates in previous generations is
with the decline observed on average across the partly responsible for Dutch women’s relatively low
EU. In 2021, life expectancy in the Netherlands life expectancy. While smoking rates among Dutch
remained flat against the backdrop of a further men have declined since the 1950s, smoking rates
0.3-year average decline across the EU. Reflecting a among women climbed during the 1960s.

Figure 1. Life expectancy in the Netherlands is one year above the EU average, but over one year below
the best performing EU countries
Years
Years 2022 2010 2000
83 82.2
90 81.7
82 81.4 81.4

81
83.2

83.0

83.0

2019 2020 2021 2022

83.1

85
82.6
82.7

82.4

82.3

82.1

81.8

81.7

81.7

81.7

81.3

81.3

81.2

80.7

80.7

80.7
81.1

79.1

78.2

80
77.7

77.4

77.2

76.2

76.0

75.3

74.8

74.3
75

70

65

Notes: The EU average is weighted. Data for Ireland refer to 2021.

Source: Eurostat Database.

Cancer accounted for over one fourth of all Netherlands, accounting for 26.6 % all deaths.
deaths in the Netherlands in 2021 Diseases of the circulatory system ranked second,
being responsible for over a fifth of all fatalities.
Life expectancy gains witnessed in the
In 2021, COVID-19 was the third most prevalent
Netherlands throughout the decade before the
cause of death in the Netherlands, accounting for
pandemic are primarily attributed to reductions
over 19 600 deaths or 11.6 % of the total (Figure 2)
in mortality related to circulatory diseases –
– a comparable figure to the number of officially
particularly cerebrovascular diseases and, to a
reported COVID-19 deaths in 2020. Of all COVID-19
lesser extent, cancer. Against the backdrop of
deaths recorded in the Netherlands in 2020 and
an ageing population and the consequent rise
2021, over 90 % occurred among individuals aged
in the incidence of chronic conditions, in 2021
65 and older.
cancer was the leading cause of death in the

04 | State of Health in the EU | The Netherlands: Country Health Profile 2023

Figure 2. COVID-19 was responsible for over one in every 10 deaths in 2021

THE NETHERLANDS
4.8 %, Ischaemic heart diseases

5.3 %
Stroke

2.7 % 21.3 %
Colorectal 1.8 % Circulatory 2.9 %
Pancreas system Diseases of the digestive system
1.8 %
Breast
11.6 %
1.8 % 26.6 %
COVID-19
Prostate Cancers
All deaths 5.6 %
6.0 % 170 043
170 043 External causes 0.4 %
Lung
Transport accidents
1.7 %
Diabetes
6.0 %
Respiratory diseases 2.8 %
8.2 %
Falls
Alzheimer's and other
dementias 1.2 %
3.4 % Suicide
1.5 % COPD
Pneumonia

Note: COPD refers to chronic obstructive pulmonary disease.

Source: Eurostat Database.

The broader indicator of excess mortality, defined Figure 3. Excess mortality in the Netherlands
as deaths occurring (regardless of their cause) peaked in 2020 and declined marginally in 2021
above a baseline derived from pre-pandemic levels, and 2022 3-year
provides a more comprehensive picture of the ● 2020 ● 2021 ● 2022 average
pandemic’s mortality impact. The more than 58 900 Poland 20.3 %
excess deaths that occurred in the Netherlands Bulgaria 20.2 %
between 2020 and 2022 account for a level 13.1 % Cyprus 20.1 %
Slovakia 19.7 %
above their historic baseline, which is slightly
Malta 17.1 %
higher than the average excess mortality observed Czechia 17.0 %
on average in the EU during the same period. Romania 15.3 %
Throughout the first three years of the pandemic, Slovenia 15.2 %
Netherlands 13.1 %
excess mortality in the Netherlands showed EU 12.6 %
comparatively minimal fluctuations, peaking at Portugal 12.4 %
13.8 % in 2020 and slightly declining in both 2021 Spain 12.2 %
and 2022 (Figure 3). Italy 12.2 %
Croatia 12.1 %
Confirmed COVID-19 fatalities slightly exceeded Greece 11.9 %
Austria 11.6 %
the tally of excess deaths in 2020, indicating a
Estonia 11.4 %
lower occurrence of deaths from other, non-COVID- Lithuania 11.2 %
19-related causes. While excess deaths nearly Hungary 11.1 %
equalled the number of confirmed COVID-19 France 11.0 %
Germany 10.1 %
deaths in 2021, in 2022 the gap between confirmed Latvia 10.1 %
COVID-19 deaths and excess mortality widened Iceland 9.1 %
significantly, with the latter declining only slightly Luxembourg 8.8 %
Ireland 8.6 %
as the number of confirmed COVID-19 deaths
Belgium 8.5 %
decreased by more than 50 % (Figure 4). The Finland 7.9 %
persistently high excess mortality in 2022 can be Denmark 6.8 %
attributed at least partly to the return, after two Norway 5.2 %
Sweden 4.4 %
years of near-absence, of a severe flu epidemic
extending from March to June, followed by another 0% 10 % 20 % 30 % 40 %
flu wave beginning in mid-December 2022 (CBS, % change, all-causes of mortality
2023a). Note: Excess mortality is defined as the number of deaths from all
causes exceeding the average annual number of deaths in the five years
preceding the pandemic (2015-19).
Source: OECD Health Statistics 2023, based on Eurostat data.

State of Health in the EU | The Netherlands: Country Health Profile 2023 | 05

 Figure 4. Despite a substantial decline in level and the ageing baby-boom generation, the
THE NETHERLANDS

COVID-19 deaths in 2022, excess mortality share of people aged 65 and over in the Netherlands
Option 2 only slightly
decreased has grown from 13.6 % in 2000 to 19.8 % in 2020.
This share is projected to increase to more than
Number of deaths
one in four by 2050.
25 000
In 2020, women in the Netherlands at age 65 were
20 000
projected to live for another 20.7 years – slightly
15 000
below the EU average, while men at the same age
10 000 had a life expectancy of 18.2 years – slightly above
5 000 the EU average (Figure 5). Women were expected
0 to live less than half of their remaining years of
life free from disabilities and activity limitations
Excess mortality

COVID-19 mortality

Excess mortality

COVID-19 mortality

Excess mortality

COVID-19 mortality
||

–for men this was 55 % . As a result of women

being expected to live longer and spend a smaller
portion of their remaining lives without disabilities
compared to men, the gender gap in healthy life
2020 2021 2022
years at 65 was nearly non-existent.

In 2020, an equal proportion of Dutch men and

Note: Excess mortality is defined as the number of deaths from all causes
above the average annual number of deaths over the previous five years women aged 65 and over reported having more
before the pandemic (2015-19). than one chronic condition (26 %). This figure
Sources: CBS (for COVID-19 mortality) and OECD Health Statistics 2023, was considerably lower than the EU average (32 %
based on Eurostat data (for excess mortality).
among men and 40 % among women). However,
a higher proportion of women in the Netherlands
Women live a greater portion of their lives after
reported experiencing limitations in daily activities
age 65 with disabilities (27 % compared to 20 % of men), as is also the case
Due to the combination of increasing life in other EU countries.
expectancy, a fertility rate below the replacement

Figure 5. Fewer older people in the Netherlands report having chronic conditions than the EU average
Life expectancy
Life expectancy and
and healthy
healthy life
life years
years at
at 65
65
Life
Lifeexpectancy
expectancyand
andhealthy
healthylife
lifeyears
yearsatat65
65
Healthy life years Life expectancy with activity limitation
Healthy
Healthy lifelife years
years Life
Life expectancy
expectancy with
with activity
activity limitation
limitation
Healthy life years Life expectancy with activity limitation
Years Men Women
Years Men Women
Women
Years
Years Men
Men Women
25
2525
25 20.7
20.7
21.0
21.0
18.2 20.7 21.0
21.0
20 18.2 17.4 20.7
2020
20
18.2
18.2 17.4
17.4
17.4
15
15 15
15
10
1010
10
5 55 % 55 % 47 % 48 %
5 55 5555
%%
55 % 5555
%% 4747
%%
47 % 4848
%%
48 %
55 %
0
00 0 Netherlands EU Netherlands EU
Netherlands
Netherlands EUEU Netherlands
Netherlands EUEU
Netherlands EU Netherlands EU

Proportion of
of people
people aged
aged 65
65 and
and over
over Limitations in
Limitations in daily
daily activities
activities among
among
Proportion
Proportion ofofpeople aged 65 and over Limitations
Limitationsinindaily
dailyactivities
activitiesamong
among
Proportion people
with multiple aged
multiple chronic 65 and
chronic conditions
conditionsover people aged 65 and over
with peopleaged
people aged 65and
and over
with
withmultiple
multiplechronic
chronicconditions
conditions people aged65 65 andover
over
Men Wo m e n Men Women
Men
Men Women
Women Men
Men Women
Women
50 % Men Women 50 % Men Women
70
7070
%%% 5050
%%
50 %
60
40
6060
%%% 40 %
4040
% %
40 %
50
5050
% %
30 % 30 %
40 % 30
3030
%%%
4040
%%
20
30 % 40 % 20 %
3030
%% 20
%%
2020
32 % % 27 % 30 %
20 % 26 % 26 % 40 % 3030
%%
2020
%%
10 % 32 % 4040
%% 10 % 20 % 22 %
22 2727
%% 30 %
10 % 26
2626
%%% 3232
%% 26
2626
%%% 1010
% %
10 % 2020
%%
20 %%
% 2222 %
27 %
1010
%%
0% 0%
0%0% 0%0%
0% Netherlands EU Netherlands EU 0%
NetherlandsEUEU
Netherlands NetherlandsEUEU
Netherlands NetherlandsEUEU
Netherlands NetherlandsEUEU
Netherlands
Netherlands EU Netherlands EU Netherlands EU Netherlands EU
Sources: Eurostat Database (for life expectancy and healthy life years) and SHARE survey wave 8 (for multiple chronic conditions and limitations in daily
activities). All the data refer to 2020.
Life expectancy
Life expectancy and
and healthy
healthy life
life years
years at
at 65
65
Life
Lifeexpectancy
expectancyand
andhealthy
healthylife
lifeyears
yearsatat65
65
Healthy life years Life expectancy with activity limitation
Healthy
Healthy lifelife years Life
years Life expectancy
expectancy with
with activity
activity limitation
limitation
Healthy life years Life expectancy with activity limitation
Years Men Women
Years
Years Men
Men Women
Women
06 | State of Health in the EU Years
| The Netherlands:
25 Men Country Health Profile Women
2023 21.0
2525
25 20.7
20.7 21.0
18.2 20.7 21.0
21.0
20 18.2 17.4 20.7
2020 18.2
18.2 17.4
17.4
 The burden of cancer in the Netherlands is exceeded the EU average by over 20 %, while the

THE NETHERLANDS
considerable cancer incidence rate among Dutch men stood at
less than 4 % above its EU average. Prostate cancer
According to incidence estimates from the Joint
was projected to be the single most common cancer
Research Centre based on historical trends,
site among men, comprising nearly one fifth of all
about 116 200 new cancer cases were expected to
new cancers in 2022. For women, breast cancer
have arisen in the Netherlands in 2022.1 Cancer
was expected to account for nearly 30 % of all new
incidence among Dutch men was expected to
cancer cases. Both among Dutch men and women,
be about 20 % higher than among women, a gap
colorectal and lung cancers were anticipated to be
that was nearly half the EU average. This smaller
the second and third most frequent cancer sites
difference reflects a comparatively higher projected
(Figure 6).
cancer incidence among Dutch women, which

Figure 6. Over 116 000 new cancer cases in the Netherlands were estimated in 2022

Prostate
Prostate
Others
Others Others
Others
19%
19% Breast
Breast
24%
24% 23%
23%
29%
29%

Men
Men 3%
3%
Women
Women
3%
3% Pancreas
Pancreas
Leukaemia
Leukaemia 60
60845
845new
new 17%
17% 55
55379
379new
new
3%
3% Colorectal
Colorectal Non-Hodgkin 3%
3%
cases
cases Non-Hodgkinlymphoma
lymphoma cases
cases
Oesophagus
Oesophagus 4%
4%
4%
4%
Bladder
Bladder 4%
4%
Non-Hodgkin
Non-Hodgkinlymphoma
lymphoma 13%
13%
7%
7%
13%
13% Uterus
Uterus 8%
8% Colorectal
Colorectal
10%
10% 13%
13%
Melanoma
Melanomaskin
skin
Lung
Lung Melanoma
Melanomaskin
skin
Bladder
Bladder Lung
Lung

Age-standardised
Age-standardisedrate
rate(all
(allcancer):
cancer):710
710per
per100
100000
000population
population Age-standardised
Age-standardisedrate
rate(all
(allcancer):
cancer):589
589per
per100
100000
000population
population
EU average: 684
EUaverage: 684per
per100
100000
000population
population EU average: 488
EUaverage: 488per
per100
100000
000population
population

Note: Non-melanoma skin cancer is excluded; uterus cancer does not include cancer of the cervix.
Source: ECIS – European Cancer Information System.

3 Risk factors
Behavioural risk factors account for more than
one third of all deaths
More than one third (35 %) of all deaths in the
Netherlands in 2019 could be attributed to
behavioural risk factors – a proportion slightly
lower than the EU average of 39 %. These
behaviours include smoking, dietary risks, alcohol
consumption and low physical activity (Figure 7).
Tobacco consumption was the main behavioural
risk factor contributing to mortality in the
Netherlands, responsible for over one in five deaths
and surpassing the EU average of 17 %. Dietary
risks, encompassing factors like inadequate fruit
and vegetable intake along with high sugar and
salt consumption, accounted for 11 % of deaths in
2019 – notably below the EU average of 17 %. About
5 % of deaths were linked to alcohol consumption,
closely aligning with the EU average of 6 %.
Environmental factors such as air pollution – in the
form of exposure to fine particulate matter (PM 2.5)
and ozone – accounted for nearly 5 000 deaths
in the Netherlands in 2019 (or 3 % of all deaths,
compared to 4 % in the EU).
Smoking in both adults and teenagers have
decreased, but heavy drinking remains an issue
In the five years preceding the COVID-19 pandemic,
the adult smoking rate in the Netherlands declined
significantly from over 19 % in 2014 to 15.5 % in
2019, falling below the EU average of 18.7 %. This
accomplishment can be attributed, at least in
part, to the implementation of stricter tobacco
control measures that commenced in 2015, which
aim to achieve a smoke-free generation by 2040
(RIVM, 2023). The downtrend continued during
the pandemic, with smoking rates reaching 14.7 %
in 2021 following the introduction of increased
tobacco taxation, plain packaging and other

1 According to preliminary data from the Netherlands Cancer Registry (2023), 124 109 new cancer cases arose in the Netherlands in 2022. This figure is 6.8 %
higher than the estimated count by the Joint Research Centre.

State of Health in the EU | The Netherlands: Country Health Profile 2023 | 07

 Figure 7. Tobacco use is the leading behavioural risk factor for mortality in the Netherlands
THE NETHERLANDS

Dietary risks Alcohol

Netherlands: 11 % Netherlands: 5 %
EU: 17 % EU: 6 %
||

Tobacco Air pollution Nether-

Netherlands: 21 % Netherlands: 3 % lands: 1 %
EU: 17 % EU: 4 % EU: 2 %

Low physical activity

Note: The overall number of deaths related to these risk factors is lower than the sum of each one taken individually, because the same death can be
Netherlands EU
attributed to more than one risk factor. Dietary risks include 14 components such as low fruit and vegetable intake, and high sugar-sweetened beverage
consumption. Air pollution refers to exposure to PM2.5 and ozone.
Source: IHME (2020), Global Health Data Exchange (estimates refer to 2019).

tobacco control measures in 2020 and 2021.
Smoking among adolescents followed a similar
pattern, with 15 % of Dutch 15-year-olds reporting
regular smoking in 2022, marking a decline from
the 20 % reported in 2014.
While overall alcohol consumption among adults
has declined over the past two decades and is
now lower than in most other EU countries,
heavy drinking remains relatively high. Nearly
one in five adults (19 %) reported heavy episodic
drinking in 2019, a higher proportion than
in most EU countries.2 Similarly, the rate of
repeated drunkenness among Dutch teenagers is
comparable to the EU average, with nearly 20 %
of 15-year-olds reporting having been drunk more
than once in their life in 2022.
Overweight and obesity rates in the Dutch
population are low, especially among
adolescents
Although the prevalence of overweight and obesity
in the Netherlands is low compared to most other
EU countries, there has been a slight increase in
obesity rates among adults over the past decade.
In 2021, nearly 14 % of Dutch adults were classified
as obese – a higher rate than the 11.4 % recorded
in 2011, but still below the EU average of 16.3 %.
Likewise, among Dutch 15-year-olds in 2022, 14 %
were identified as either overweight or obese.
Notably, this percentage was the lowest in the EU,
standing over 7 percentage points below the EU
average (Figure 8).

Figure 8. The Netherlands performs relatively well on most behavioural risk factors for health
Smoking (adolescents)

Fruit and vegetable consumption (adults) Smoking (adults)

Vegetable consumption (adolescents) Drunkenness (adolescents)

Fruit consumption (adolescents) Heavy drinking (adults)

Physical activity (adults) Overweight and obesity (adolescents)

Physical activity (adolescents) Obesity (adults)

Notes: The closer the dot is to the centre, the better the country performs compared to other EU countries. No country is in the white “target area” as there
is room for progress in all countries in all areas.
Sources: OECD calculations based on HBSC survey 2022 for adolescents indicators; and EHIS 2019 for adults indicators.

2 Heavy drinking is defined as consuming six or more alcohol drinks on a single occasion for adults.

08 | State of Health in the EU | The Netherlands: Country Health Profile 2023

People with lower education are more likely to lower education levels smoked daily, compared

smoke while higher educated people are more
often heavy drinkers
Similar to trends in other EU countries, the
prevalence of behavioural risk factors in the
Dutch population varies significantly across
socioeconomic groups. In 2019, 19 % of adults with
THE NETHERLANDS
to only 7 % of those with higher education levels.
People with lower educational attainment were
also less likely to eat five portions of fruit and
vegetables per day. Conversely, people with a
higher level of education were more likely to report
heavy drinking (Figure 9).

Figure 9. Dutch people with lower levels of education are more inclined to smoke and less likely to
engage in regular heavy drinking
Low education EU High education Total

Smoking (daily)
% of population aged 15+ 0 5 10 15 20 25

Low fruit and vegetable consumption

(<5 portions per day)
% of population aged 15+ 0 20 40 60 80 100

Heavy drinking (at least once per month)

% of population aged 15+ 0 5 10 15 20 25

Note: Low education is defined as people who have not completed their secondary education (ISCED 0-2), whereas high education is defined as people who
have completed a tertiary education (ISCED 5-8).
Source: Eurostat Database (based on EHIS 2019).
0 5 10 15 20 25

Low income EU High income Total

Smoking (daily)

4 The health system

% of population aged 15+ 0 5 10 15 20 25 30
Low fruit and vegetable consumption
(<5 portions per day)
% of population aged 15+ 0 20 40 60 80 100

Four
Heavyseparate
drinking (atcoverage schemes
least once per month) form the basis The second scheme (Long-term Care Act) entails
of the
% of Dutchaged
population health
15+ system a single-payer social insurance system for
0 5 10 15 20 25
long-term care, which is administered regionally
The Dutch government oversees four coverage
by the dominant health insurer in each area.
schemes (or Acts) that collectively ensure
This scheme covers long-term, often residential,
healthcare coverage. As part of the first scheme
care that should be available 24 hours a day. The
(Health Insurance Act), competing health insurers
third scheme (Social Support Act) is a tax-funded
administer an insurance system for curative care.
social care scheme implemented by municipalities
The system, introduced in 2006, mandates all
and covers social care at people’s home or in
residents to purchase insurance encompassing
small-scale settings. Lastly, the fourth scheme
a government-defined benefits package. Insurers
(Youth Act) covers support, assistance and social
are obliged to accept all applicants, engaging in
care for children and adolescents, overseen by
negotiations and contracting with providers based
local authorities and encompassing a spectrum
on quality and cost considerations. In addition,
from general prevention to specialised voluntary
health insurers provide voluntary, supplemental
or compulsory care. Health services are mostly
insurance care not covered in the basic package.
provided by private non-profit providers, and most
The scope of this scheme is broad, as it covers most
physicians are self-employed.
specialist care, primary care, pharmaceuticals
and medical devices, as well as some adult mental On top of these four schemes, the Public Health
healthcare services, allied care services and Act covers public health, prevention and control
community nursing. Individuals over the age of of infectious diseases. Examples include the
18 are subject to a mandatory deductible of at large-scale vaccination campaign during the
least EUR 385 per year. This deductible does not COVID-19 pandemic and general activities of
apply to maternity care, district nursing, care for municipal health services.
minors and general practice care, but pertains to
prescribed medications and diagnostic tests in
primary care.

State of Health in the EU | The Netherlands: Country Health Profile 2023 | 09

 Spending on health as a share of GDP is slightly a partial rebound in private health expenditure,
THE NETHERLANDS

above the EU average as volumes of non-COVID-19-related care began

resuming towards pre-pandemic levels. Despite
In 2021, health expenditure in the Netherlands
this increase, the share of health spending
reached an unprecedented 11.3 % of GDP, a
financed out of pocket remained low, at 9.3 %
level slightly above the EU average of 11 %. On
relative to the EU average of 14.5 %. The remainder
a per capita basis (adjusted for differences in
of health expenditure in the Netherlands was
purchasing power), health expenditure in the
funded through voluntary health insurance (VHI),
country amounted to EUR 4 570, surpassing the
which covers services outside of the standard
EU average by over 13 % (Figure 10). Government
benefits package, such as adult dental care and
and compulsory insurance schemes funded
physiotherapy and accounts for a relatively large
85 % of health expenditure – a higher share than
share of total health expenditure (5.8 % in 2021
the EU average of 81 %. Between 2010 and 2019,
||

compared to 4.4 % in the EU) (see Section 5.2).

health expenditure in the Netherlands rose by a
modest average of 1.3 % annually. In 2020, health
expenditure surged by 6.5 % in real terms, driven
by a 9.3 % increase in public funding implemented
to address the COVID-19 emergency (see
Section 5.3). Concurrently, private expenditure fell
by 6.8 %, reflecting disruptions in non-COVID-19
care from private providers and changes in
patients’ healthcare-seeking behaviour.
Preliminary data for 2022 indicates a slight
1.2 % rise in total health expenditure compared
to 2021. This slowdown in the growth of
healthcare spending can be primarily attributed
to the cessation of a substantial portion of
COVID-19-related expenditures incurred in 2020
and 2021 (CBS, 2023b).

In 2021, health expenditure in the Netherlands

experienced a second significant increase of 4.6 %,
reflecting continued growth in public spending and

Figure 10. Health spending per capita in the Netherlands is among the highest in the EU
EUR PPP per capita Government and compulsory schemes Voluntary schemes and household out-of-pocket
6 000 Share of GDP (2021)
11.0% 11.3%
5 000

4 000

3 000 EU Netherlands

2 000

1 000

Note: The EU average is weighted.

Source: OECD Health Statistics 2023 (data refer to 2021, except Malta (2020)).

The Netherlands allocates nearly 28 % of its the largest health spending category, accounting
health budget to long-term care
EUR PPP per capita Government and compulsory schemesfor 27.5 %Voluntary
of totalschemes
healthandexpenditure – the largest
household out-of-pocket
6 000 share in the EU (Figure 11). High LTC
In 2021, the Netherlands’ expenditure on long-term Share of GDPexpenditure
(2021)
reflects the wide scope of coverage
11.0%of the Dutch
11.3%
care
5 000 (LTC) surpassed the EU average in both per
LTC scheme, which covers elderly care, care for
capita terms and as a proportion of its total health
4 000 disabled people and long-term mental healthcare.
budget. In contrast, spending on inpatient care and
retail
3 000 pharmaceuticals was comparatively lower, During the COVID-19 pandemic, EU the share of the
Netherlands
with the latter constituting only slightly more than Netherlands’ health budget dedicated to prevention
2 000
10 % of overall health expenditure in contrast to increased from 3.3 % in 2019 to 4.7 % in 2020.
the
1 000almost 18 % on average across the EU. LTC was In 2021, expenditure on prevention more than
0

10 | State of Health in the EU | The Netherlands: Country Health Profile 2023

doubled, reaching 8.7 % of total health spending – a testing, tracing and vaccines, which collectively

THE NETHERLANDS
share above the EU average of 6 %. This increase accounted for more than two thirds of spending on
was attributable to expenditure on COVID-19 preventive care in 2021.

Figure 11. Long-term care absorbs the largest share of health spending in the Netherlands

EUR PPP per capita Netherlands EU 5%

9%
Long-term care
5 000
4 570
Outpatient
4 500 10%
4 028 27%
Inpatient
4 000

3 500 Pharmaceuticals
22%
27% Prevention
3 000

2 500 Admin. & others

2 000

1 500 1 258 1 239 1 133 1 092

986
1 000 697 699
474 395
500 250 217 157
0
Total spending Long-term care¹ Outpatient care² Inpatient care ³ Pharmaceuticals & Prevention ⁵ Administration &
medical devices⁴ others⁶

Notes: 1. Includes only the health component; 2. Includes home care and ancillary services (e.g. patient transportation); 3. Includes curative-rehabilitative
care in hospital and other settings; 4. Includes only the outpatient market; 5. Includes only spending for organised prevention programmes; 6. Includes
health system governance and administration and other spending. The EU average is weighted.
Source: OECD Health Statistics 2023 (data refer to 2021).

EUR PPP per capita Netherlands EU 5%

9%
Long-term care
Workforce
5 000
shortages worsened during the expansion in the availability and scope of practice
4 570
COVID-19 pandemic of nurses, the nursing workforce within hospitals
Outpatient
4 500 10%
4 028 remains overstretched. 27%
Shortages of nursing and
In 2021, the Netherlands had 3.9 practising doctors
4 000 Inpatient
home care staff have also persisted and were
per
3 5001 000 population – a marginally lower density
further amplified during the COVID-19 pandemic.
Pharmaceuticals
than
3 000 the EU average (Figure 12). However, this 22%
27%
represented
2 500
an increase from 3.4 doctors per 1 000 In recent years, there has been a sharp Prevention
increase
population
2 000
in 2010. Nearly a quarter of doctors are in the number of healthcare workers,Admin. constituting
& others
general practitioners (GPs) 1 258– a share that surpasses
1 239 15 % of the total workforce, and hospitals have
1 500 1 133 1 092
the EU average of 20 %. Against this backdrop, the 986
1 000 697 increasingly turned 699 to enlisting freelance nurses to
Dutch healthcare system faces a scarcity of GPs, a 474 shortages. In
offset staffing response
395
250 to this trend,
500 217 157
situation projected to intensify in the coming years health insurers in the Netherlands called on the
0
(RVS,2023). Shortages of doctors extend to varying government to improve
Total spending Long-term care¹ Outpatient care² Inpatient care ³ Pharmaceuticals & conditions
Prevention ⁵ for employees
Administration &
degrees across other specialties as well, including and to curb the devices⁴
medical growth of this practice dueothers⁶ to its
psychiatry, paediatrics, addiction medicine and adverse impact on costs and care quality (ZN,
geriatrics, among others. 2022).
The relative number of nurses also increased
in the Netherlands over the last decade, rising
from 10.3 per 1 000 population in 2014 to 11.4
per 1 000 in 2021 – nearly a third higher than the
EU average. A growing number of nurses in the
Netherlands practice at a more advanced level and
take over tasks from doctors, resulting in greater
opportunities for career progression. In 2012,
nurse specialists were granted the right to practice
independently, a legal status that was ratified
in 2018 which allows them to prescribe certain
medications and perform selected non-surgical
procedures (e.g. endoscopies). Despite this

State of Health in the EU | The Netherlands: Country Health Profile 2023 | 11

 Figure 12. The Netherlands has a higher number of nurses than the EU average
THE NETHERLANDS

Practising nurses per 1 000 population

20
Doctors Low FI Doctors High
18 NO
Nurses High Nurses High

16
IS
14

IE
12 DE
LU
NL
BE SE
SI AT
10 CZ DK
EU EU average: 8.5
FR
||

8 RO
HR MT LT PT
EE
6 IT ES
SK
HU CY
PL
4 LV BG
EL

2 Doctors Low Doctors High

Nurses Low Nurses Low
EU average: 4.1
0
2.0 2.5 3.0 3.5 4.0 4.5 5.0 5.5 6.0 6.5
Practising doctors per 1 000 population

Notes: The data on nurses include all categories of nurses (not only those meeting the EU Directive on the Recognition of Professional Qualifications). In
Portugal and Greece, data refer to all doctors licensed to practise, resulting in a large overestimation of the number of practising doctors (e.g. of around
30 % in Portugal). In Greece, the number of nurses is underestimated as it only includes those working in hospitals.
Source: OECD Health Statistics 2023 (data refer to 2021 or the nearest available year).

Practising nurses per 1 000 population

5 Performance of the health system

20

Doctors Low FI Doctors High

18 Nurses High NO Nurses High

16
5.1 Effectiveness these conditions were the leading causes of death
that IS
could be mitigated through timely healthcare
14
Preventable and treatable mortality rates remain interventions, accounting for approximately half
consistently below the EU average IE of all deaths from treatable conditions in the
12 DE
LU
In 2020, the mortality rates from causes deemed
NL
Netherlands.
BE SE
to be preventable and treatable in the Netherlands
SI AT
10 CZ DK
were 21 % and 36 % lower than their respectiveEU The flu vaccination rate among DutchEU people
average: 8.5
FR
EU averages (Figure 13). Against the backdrop of a aged 65 and over increased significantly during
8 RO
nearly 17 % surge in the EU’s preventable mortality HR MTthe pandemic
LT PT
EE
rate
6 in 2020, the Netherlands saw its rate increase
As in other
ES EU countries, Dutch health authorities
IT
SK
by 14.5 %, reflecting slightly lower COVID-19 have long advised
CY older people to get the influenza
HU
mortality
4 among its populationLV under 75PLyears vaccine,
BG which is available free of charge from
EL
of age compared to most other EU countries. The GPs for several at-risk groups, including people
primary
2 single causes of preventable mortality in aged 60 and older. Throughout the last decade,
Doctors Low Doctors High
the Netherlands
Nurses Low were lung cancer and COVID-19, the Netherlands consistently maintainedNurses a flu Low
EU average: 4.1
accounting
0 for 40 % of all preventable deaths in vaccination coverage rate among this target
2020.
2.0 2.5 3.0 3.5 group
4.5 that exceeded
4.0 5.0 the EU5.5average. However,
6.0 its 6.5
coverage rate declined significantly from a high of
In 2020, the Netherlands had the lowest mortality Practising doctors per 1 000 population
over 80 % in 2010 to a low of 60 % in 2018 among
rate from treatable causes in the EU. This
people of 65 years and older. The emergence of
accomplishment can be attributed to a significantly
the COVID-19 pandemic contributed to reigniting
more rapid decline over the past decade compared
interest in receiving the flu vaccine among people
to the EU average, largely driven by mortality
at higher risk of complications and hospitalisation:
reductions from ischaemic heart disease and
in 2021, the flu vaccination coverage rate for people
breast cancer. Together with colorectal cancer,

12 | State of Health in the EU | The Netherlands: Country Health Profile 2023

Figure 13. Avoidable mortality in the Netherlands was lower than in most other EU countries in 2020

THE NETHERLANDS
Rate per 100 000 population Preventable causes of mortality Treatable causes of mortality

700

600

500

400

300

200

100

Preventable causes of mortality Treatable causes of mortality

Colorectal
Lung cancer cancer
24% 21%
Others
Others 35%
39%
Deaths Deaths
23 815 9 878 Breast cancer
COVID-19 17%
16%
Diabetes
Accidents Stroke Ischaemic
COPD 4%
6% 10% heart diseases
Suicide 8%
13%
7% Netherlands

Notes: Preventable mortality is defined as death that can be mainly avoided through public health and primary prevention interventions. Treatable (or
amenable) mortality is defined as death that can be mainly avoided through healthcare interventions, including screening and treatment. Both indicators
refer to premature mortality (under age 75). The lists attribute half of all deaths from some diseases (e.g. ischaemic heart disease, stroke, diabetes and
hypertension) to the preventable mortality list and the other half to treatable causes, so there is no double-counting of the same death. COPD refers to
chronic obstructive pulmonary disease.
Source: Eurostat Database (data refer to 2020).

aged 65 and above surged to nearly 73 %, marking Figure 14. The uptake of influenza and HPV
an increase of over 12 percentage points from 2019 vaccines has increased significantly in recent
(Figure 14). years
In recent years, the Netherlands has also Netherlands EU

undertaken various initiatives to boost human Influenza vaccination HPV

papillomavirus (HPV) vaccine uptake among % of people aged 65 and over % of girls aged 15
adolescent girls, resulting in an increase from 100
90
52 % in 2019 to 66 % in 2022. This figure, however, 80
falls short of meeting the WHO target for cervical 70
cancer eradication, which foresees achieving 90 % 60
50
HPV vaccination coverage among 15-year-old girls. 40
In 2023, the Netherlands launched a large-scale 30
catch-up HPV vaccination campaign for people up 20
10
to 18 years old. Additionally, starting in 2022 the
0
eligibility for free HPV vaccination was extended to 2017 2018 2019 2020 2021 2017 2018 2019 2020 2021
include adolescent boys.
Sources: OECD Health Statistics 2023 and Eurostat Database (influenza)
and WHO (HPV).

State of Health in the EU | The Netherlands: Country Health Profile 2023 | 13

 Low potentially avoidable hospitalisations attest hospitalisation rates for asthma and COPD in the
THE NETHERLANDS

to the quality and accessibility of outpatient care
Hospital admissions volumes for conditions that
are generally manageable outside of hospital
settings provide insights into the availability and
effectiveness of outpatient care services. In this
regard, the Netherlands performs better than
most other EU countries. In 2019, its combined
hospitalisation rate for diabetes, congestive heart
failure (CHF), asthma and chronic obstructive
pulmonary disease (COPD) was nearly 29 % below
the EU average. While admission rates for diabetes
||
Netherlands reflect the notable prevalence of these
conditions, which affected over 6 % of the Dutch
population in 2021 (VZinfo, 2021).
The large decline in hospital admissions for asthma
and COPD observed between 2019 and 2021 should
be interpreted in the context of the disruption
caused by COVID-19, which severely impacted the
capacity of hospitals to provide acute care and
altered patients’ healthcare-seeking behaviour (see
Section 5.3). These declines cannot therefore be
understood as indicative of improved accessibility

and CHF were significantly lower than their or quality of care for these chronic conditions in
respective EU averages, rates for asthma and COPD outpatient settings.
had been on a par with the EU average in recent
years (Figure 15). To some extent, relatively high

Figure 15. Except for asthma and COPD, avoidable hospital admissions rates are notably lower than
the EU average
Asthma and COPD Diabetes Congestive heart failure
Age-standardised rate per 100 000 population aged 15+ Netherlands EU
500

400

300

200

100

0
20

20

20
18

18

18
14

14

14
16

19

16

19

16

19
21

21

21
15

15

15
17

17

17
20

20

20

20

20

20

20

20

20

20

20

20

20

20

20

20

20

20

20

20

20

20

20

20
Note: Admission rates are not adjusted for differences in disease prevalence across countries.
Source: OECD Health Statistics 2023.

The impact of the COVID-19 pandemic on cancer
screening services was limited
As in most other EU countries, the
pandemic-induced reconfiguration of health
services had a negative impact on cancer screening
programmes in the Netherlands (OECD, 2023).
Screening was temporarily halted in March 2020
and gradually resumed in late June. As a result,
breast cancer screening rates declined by four
percentage points to 72 % in 2020. As screening
volumes picked up in 2021, the rate partially
recovered to 73 % in 2021 – below pre-pandemic
levels, but notably above the EU average (Figure 16).
Cervical cancer screening rates experienced a more
significant drop of over six percentage points in
2020, but rebounded in 2021 close to pre-pandemic
levels. In contrast, the colorectal cancer screening
rate was minimally affected, owing to an earlier
resumption of screening activities and the use of
the faecal immunochemical test, which does not
require in-person visits to healthcare facilities.
The combined effect of disruptions to cancer
screening, reduced GP availability and patients’
hesitancy to consult GPs at the height of the
pandemic was reflected in the number of new
cancers diagnosed in the Netherlands in 2020,
which declined for the first time in a decade by
5.6 % compared to 2019 (IKNL, 2023). Following the
significant rebound in cancer screening activities
in 2021, the number of new diagnoses climbed
by nearly 8 % year-on-year. Preliminary data
on the observed incidence of cancer from 2022
indicates a continued increase at a rate in line with
the decade-long trend, suggesting a substantial
resolution of the diagnostic backlog from 2020.

14 | State of Health in the EU | The Netherlands: Country Health Profile 2023

Figure 16. COVID-19 had a limited impact on routine cancer screening programmes in the Netherlands

THE NETHERLANDS
Breast Cervical Colorectal
Netherlands
% of women aged 50-69 % of women aged 20-69 % of people aged 50-74
EU
100
90
80
70
60
50
40
30
20
10
0
2018 2019 2020 2021 2018 2019 2020 2021 2018 2019 2020 2021

Note: Rates refer to the share of individuals within the target groups who have undergone screening in the last two years (or within the specific screening
interval recommended in each country)
Source: OECD Health Statistics 2023 (based on national programme data).

Breast Cervical
5.2 Accessibility
% of women aged 50-69
above-average proportion of spending funded
% of women aged 20-69 Netherlands EU
through VHI and a low share of OOP expenditure.
100
Unmet
90
needs for medical care in the A large part of OOP spending relates to the cost for
Netherlands
80 are the lowest in the EU care subject to the mandatory yearly deductible of
70 2022, only 0.2 % of the Dutch population
In EUR 385 – which policyholders can opt to increase
60
reported unmet needs for medical care either to EUR 885 to reduce their premium. As a result,
50
due to excessive costs, travel distance or waiting the distribution of OOP expenditure across services
40 differs notably from the EU average. In 2021,
times
30
– the lowest proportion across EU countries
and dental care absorbed a relatively small proportion
20 equal to the proportion reported before the
pandemic
10 in 2019. A slightly higher proportion of of OOP spending, which can be attributed to
Dutch
0 women reported unmet needs compared the widespread adoption of complementary VHI
to men,2018 2019
with excessive 2020
waiting 2021
times being the 2022 among the Dutch
2018 2019 population.
2020 A similar
2021 pattern
2022

primary driver for both genders. The Dutch
healthcare system’s below-average reliance
on out-of-pocket (OOP) spending for funding is
reflected in the distribution of unmet medical
needs reported across income groups, with
virtually no difference between the proportion of
individuals in the top and bottom 20 % income
brackets experiencing them.
Fixed deductibles and a comparatively large
voluntary health insurance sector limit
out-of-pocket health spending
As noted in Section 4, the financing mix of the
Dutch healthcare system stands out, with an
was observed with OOP spending on brand-name
pharmaceuticals, which is capped at EUR 250 per
patient annually on top of the insurance deductible
(Figure 17). Conversely, inpatient care accounted
for 19 % of total OOP spending – a share over three
times the EU average. To reduce the financial
barrier for accessing hospital care and retain the
deterrent effect of the deductible in disincen-
tivising unnecessary care use among individuals
liable for their full deductible upfront, in 2025
the Dutch government plans to introduce a fixed
threshold of EUR 150 per specialist care service
(Government of the Netherlands, 2023a).

Figure 17. Inpatient care and pharmaceuticals account for 40 % of out-of-pocket health spending
Overall share of health Distribution of OOP Overall share of health Distribution of OOP
spending spending by function spending spending by function
The Netherlands VHI 6 % EU VHI 4 % Inpatient 6 %
Inpatient 19 % Outpatient medical
care 20 %
Outpatient medical
care 15 %
Pharmaceuticals 24 %
OOP Pharmaceuticals 21 % OOP
9% 15 % Dental care 10 %
Dental care 6 %
Long-term care 17 %
Long-term care 24 %

Others 21 % Others 15 %
Government/compulsory schemes 85 % Government/compulsory schemes 81 %

Notes: VHI also includes other voluntary prepayment schemes. The EU average is weighted.
Sources: OECD Health Statistics 2023; Eurostat Database (data refer to 2021).

State of Health in the EU | The Netherlands: Country Health Profile 2023 | 15

 The health system provides broad and accounted for 91 % of inpatient care, 86 % of
THE NETHERLANDS

comprehensive coverage, with voluntary health outpatient care and 68 % of pharmaceuticals.

insurance covering some gaps These rates align with or surpass their respective
EU averages (Figure 18). As dental care for adults
Virtually the entire Dutch population (99.9 %)
falls outside of the scope of the standard benefits
benefits from health insurance that encompasses
package, nearly 60 % of the Dutch population
a wide range of services. The benefits package
purchase supplementary VHI for dental care (CBS,
includes primary care, outpatient specialist care,
2022c). Only 0.1 % of the Dutch population reported
hospital care, maternal services, physiotherapy
unmet needs for dental care in 2022 – a markedly
for chronic illness, mental health services and
lower share than the EU average of 2.9 %.
ambulance transport. In 2021, public spending

Figure 18. The public share of financing is higher than the EU average across all areas of healthcare,
||

except dental care

Public spending as a proportion of total health spending by type of service

Outpatient Therapeutic
Inpatient care medical care Dental care Pharmaceuticals Appliances

Netherlands 91% 86% 12% 68% 46%

EU 91% 78% 34% 59% 38%

0% 50% 100% 0% 50% 100% 0% 50% 100% 0% 50% 100% 0% 50% 100%

Notes: Outpatient medical services mainly refer to services provided by generalists and specialists in the outpatient sector. Pharmaceuticals include
prescribed and over-the-counter medicines and medical non-durables. Therapeutic appliances refer to vision products, hearing aids, wheelchairs and other
medical devices.
Source: OECD Health Statistics 2023 (data refer to 2021).

5.3 Resilience
The COVID-19 pandemic has proved to be the most
significant disruption to health systems in recent
decades. It has shed light on the vulnerabilities
and challenges within countries’ emergency
preparedness strategies and on their ability to
provide healthcare services to their populations. In
response to the enduring effects of the pandemic –
as well as other recent crises, such as cost-of-living
pressures and the impact of conflicts like the war
against Ukraine – countries are implementing
policies to mitigate the ongoing impacts on service
delivery, invest in health system recovery and
resilience,3 improve critical areas of the health
sector and fortify their preparedness for future
shocks.
Following a decline of over 13 % in 2020,
hospital admissions recovered partly in 2021
Hospital capacity in the Netherlands is lower
than in most other EU countries, owing in part to
effective outpatient care and strict gatekeeping
at the primary care level. In line with the general
EU trend, hospital bed density decreased steadily
in the decade preceding the COVID-19 pandemic,
falling from 4.0 beds per 1 000 inhabitants in 2010
to 3.0 per 1 000 in 2019 – significantly below the
EU average of 4.9 per 1 000. This trend reversed
in 2021, when bed capacity in Dutch hospitals
increased marginally from 2.9 beds per 1 000
people in 2020 to 3.0 per 1 000 in 2021. Throughout
the past decade, hospital admission rates
consistently ranked among the lowest in the EU.
Bed occupancy rates stood at approximately 10 %
below the EU average, with substantial efficiency
gains achieved through patient transfers between
hospitals.
In response to the surge in demand for acute care
prompted by the pandemic, the Netherlands took
various measures in 2020 to expand its general
hospital bed capacity and intensive care unit (ICU)
capacity, which increased temporarily by over 20 %
compared to 2019. To minimise the risk of hospital
outbreaks and establish a resource buffer of beds,
personnel and equipment, substantial volumes
of non-urgent, planned hospital services were
postponed.
These contingency measures resulted in sizeable
declines in both inpatient discharges (by over
13 %) and average bed occupancy rates (by 6.4 %)

3 In this context, health system resilience has been defined as the ability to prepare for, manage (absorb, adapt, and transform) and learn from shocks (EU
Expert Group on Health Systems Performance Assessment, 2020).

16 | State of Health in the EU | The Netherlands: Country Health Profile 2023

between 2019 and 2020 (Figure 19). The magnitude (-27 %) and non-COVID-19 respiratory diseases

of declines in hospital discharges varied markedly
across diagnostic categories. Cancers (-5 %) and
cardiovascular diseases (-8 %) saw the smallest
year-on-year declines, while infectious diseases
THE NETHERLANDS
(-34 %) witnessed the most significant ones. By
2021, the hospital discharge rate had recovered to
approximately 90 % of its 2019 level.

Figure 19. Hospital discharges in the Netherlands were roughly half the EU average in 2019

Hospital beds Hospital

Hospitaldischarges
beds Occupancy
Hospital
rate
discharges
(curative care) Occupancy
Netherlands Netherlands
Netherlands Netherlands
Netherlan…
per 1 000 population per
per100 000population
1 000 population per 100
% 000
of beds
population % of beds
EU EU EU EUEU
8 8 000
35 100
35 000 100

7 90 90
307 000 30 000
80 80
6 6
25 000 25 00070 70
5 5
60 60
20 000 20 000
4 4 50 50
15 000 15 000
3 3 40 40

2 10
2 000 10 00030 30
20 20
1 51 000 5 000
10 10
0 0 0 0 0 0
2017 2018 2019 2020 2021 2017 201720182018201920192020202020212021 2017
2017 2018
2018 2019
2019 2020
2020 2021
2021 2017

Sources: OECD Health Statistics 2023; Eurostat Database

Hospital beds Hospital beds Hospital discharges Hospital disch

COVID-19-related hospital disruptions increased and changes in referral patterns in 2020 hindered
per 1 000 population Netherlands EU
per 1 000 population Netherlands
per 100 000 population EU per 100 000 population
Netherlands EU
patient backlogs for elective care efforts to clear patient backlogs throughout
8 8 35000 35000
2021 and 2022, as demand rebounded strongly
The deferral of a substantial volume of hospital
7 7 with the progressive restoration of
30000 elective care
30000
activities during the pandemic had an adverse
activities. This resulted in an increase in waiting
effect on waiting times for elective 6care in the
6
25000
times for planned surgeries, such25000 as hip and knee
Netherlands. The pent-up demand generated
5 5 by
replacement
20000 (Figure 20). 20000
both the reduction in elective surgical procedures
4 4
15000 15000
3 3
Figure 20. Average waiting times for elective surgical procedures increased during the pandemic
2 2 10000 10000

1
Hip replacement
1 5000
Knee replacement 5000
Mean (days) 2018 2019 2020 2021 2022
0250 0 0 0
2017 2018 2019 2020 20172021 2018 2019 2017 2020 2018 2021 2019 2020 20172021 2018 201

200

150

100

50

0
Netherlands Sweden Italy Netherlands Sweden Italy

Source: OECD Health Statistics 2023.

Hip replacement Breast cancer surgery

procedures per 100 000 population Netherlands EU
450

400

350 State of Health in the EU | The Netherlands: Country Health Profile 2023 | 17
300
 COVID-19 responses led to significant increases
THE NETHERLANDS
in public spending on health in 2020 and 2021
Between 2010 and 2019, health expenditure
financed by government and social health
insurance (SHI) schemes in the Netherlands grew
at an average annual rate of 1.2 % in real terms
– slightly below the country’s average yearly GDP
growth during the same period. The COVID-19
pandemic disrupted this trend temporarily,
causing public spending on health to surge by over
9 % in 2020, while GDP experienced a nearly 4 %
contraction (Figure 21). As GDP rebounded strongly
||
in 2021, public health expenditure continued
rising at a more moderate rate of 5.3 %, driven in
large part by COVID-19-related costs – including
vaccines, tests and increased staff expenses.
The magnitude of the impact of the pandemic on
the Dutch healthcare system was also evident
in changes to its financing mix. In the face of an
increase of over 15 % in public health expenditure
between 2019 and 2021, private health expenditure
declined by nearly 2 %, driven primarily by lower
spending funded through VHI. In 2021, 85 % of
total health expenditure in the Netherlands was
financed by government and Health insurers under
the Health Insurance Act – the highest share in the
data series available since 2000.
Figure 21. The pandemic temporarily decoupled
public health expenditure and GDP trajectories
in 2020
Public spending on health GDP
Annual change in real terms
12%
Netherlands Belgium Austria EU
10%
8%
6%
4%
2%
0%
-2%
-4%
-6%
2017 2018 2019 2020 2021
Source: OECD Health Statistics 2023.
Antibiotic consumption in the Netherlands is
the lowest
Source: in Europe
OECD Health Statistics 2023.
Antimicrobial resistance (AMR) is a major public
2 in the EU,
health concern 3 with estimates
4 of 5
approximately 35 000 deaths due to antibiot-
ic-resistant infections and healthcare costs of
18 | State of Health in the EU | The Netherlands: Country Health Profile 2023
around EUR 1.1 billion per year (OECD/ECDC, 2019).
Because antibiotic overprescription and overuse in
humans are major contributors to the development
of antibiotic-resistant bacteria, antibiotic
consumption data are a useful tool to evaluate
the risk of AMR and the efficacy of programmes to
promote their appropriate use.
In this context, the Netherlands outperforms
all other EU countries, boasting the lowest total
antibiotic consumption rate in the EU in 2021.
In the past five years, antibiotic consumption in
the Netherlands decreased at an average rate
of 3.8 % per year. This rate was only moderately
slower than the EU average, despite the fact that
the Netherlands’ total antibiotic consumption
was already less than half the EU average in
2016. This achievement reflects the country’s
longstanding commitment to enforcing stringent
regulations and guidelines to curtail inappropriate
prescribing. In 2021, antibiotic consumption in the
Netherlands was 49 % below the EU average. This
decline was primarily driven by prescriptions in
community settings, which account for over 90 %
of total antibiotic consumption. The COVID-19
pandemic played a significant role in reducing
antibiotic consumption in the community, with the
Netherlands experiencing a decline of over 12 %
between 2019 and 2021 (Figure 22). This decline is
in large part attributed to pandemic containment
measures resulting in fewer infections.
Figure 22. Outpatient antibiotic use declined at
a rate more than double the EU average over the
past decade
Netherlands Belgium Austria EU
Defined daily doses (DDDs) per 1 000 population per day
30
25
20
15
10
5
0
2012 2013 2014 2015 2016 2017 2018 2019 2020 2021
Note: Data only include antibiotic consumption in the community
(outpatient).
6 7 ESAC-Net. 8
Source: ECDC 9 10 11 12
The Dutch Recovery and Resilience Plan will infrastructure, enabling greater use of health data

THE NETHERLANDS
support development of national health data for policy making, clinical and research purposes.
infrastructure in the coming years Additionally, close to 30 % of the allocated funds
will be used to cover expenses incurred by
The Dutch healthcare system is set to receive a
hospitals at the peak of the pandemic to expand
funding boost in the upcoming years as part of
ICU capacity. This investment aims to consolidate
the Netherlands’ Recovery and Resilience Plan
the enhancements made to infrastructure and staff
(RRP), a pivotal element of the EU’s response to the
training during this period, ultimately enhancing
COVID-19 crisis. Under its RRP, the Netherlands
future pandemic preparedness. Lastly, nearly
has allocated EUR 172 million to healthcare,
30 % of the funds will be dedicated to establishing
representing around 4 % of its total grant allocation
a national reserve of healthcare professionals
from the EU Recovery and Resilience Fund. Of
and stockpiling necessary equipment to address
these funds, over 40 % will be directed towards
potential future health crises.
developing an integrated national health data

6 Spotlight on mental health

The burden of mental ill health in the Figure 23. More than one in six people Bipolarin the and schizophrenia
disorders
Netherlands is greater than in most other EU NetherlandsBipolar disorders and schizophreniaOther mental health conditions
had a mental health issue in 2019
Other mental health conditions
countries Alcohol and drug-use disorders
Alcohol and drug-use disorders
Bipolar disorders and schizophrenia Depressive disorders
As in other countries, determining the exact Depressive disorders
Other mental health conditions Anxiety disorders
proportion of the Dutch population affected by Anxiety disorders
Alcohol and drug-use disorders
a mental health disorder at any point in time is Depressive disorders 20%
20%
challenging due to methodological limitations Anxiety disorders 18%
18%
specific to mental disorders, which often result in 20%
16%
16%
undercounting their true burden. 18%
14%
14%
12%
According to prevalence estimates from the 16% 12%
10%
Institute for Health Metrics and Evaluation (IHME), 14% 10%
8%
over three million individuals in the Netherlands 12% 8%
had a mental health disorder in 2019, representing 10% 6% 6%

18 % of the population – higher than the EU average 8% 4%

4%
of 16.7 %. Among these, anxiety disorders were 6%
2%
2%
the most prevalent, affecting around 8 % of the 0%
4% 0%
population. Depressive disorders followed, at 4 %, Netherlands
2% Netherlands EU
while alcohol and drug-use disorders affected 3 %
0%
of the population (Figure 23). During the COVID-19 Source: IHME (data refer to 2019).
Netherlands EU
pandemic, a significant increase in symptoms
associated with mental health issues was observed,
particularly among women aged 15-24 (Bosmans et more likely to report depression, with nearly 10 %
al., 2022). of men and 15.5 % of women in the lowest income
quintile compared to only 4.3 % of men and 5.3 %
Depression tends to be more prevalent among of women in the highest quintile (Figure 24). These
those on lower incomes and women findings align with the results of Nemesis-3, a
national prevalence study which reported a similar
According to survey data from 2019, more than
pattern for the 12-month prevalence of depressive
8 % of the Dutch population reported experiencing
disorder (ten Have et al., 2023). The study also
depression – a slightly higher share than the EU
found that Dutch people in employment typically
average of 7.2 %. Similar to other EU countries,
reported lower levels of depression, and that
men in the Netherlands reported lower rates of
individuals with mental health disorders were
depression (7.2 %) than women (9.3 %). However,
more likely to be unemployed.
the gender gap was noticeably narrower than the
average reported across EU countries. As in other
EU countries, individuals with lower incomes were

State of Health in the EU | The Netherlands: Country Health Profile 2023 | 19

 Figure 24. Differences in depression prevalence nurse specialists. The third level of specialist
THE NETHERLANDS

by income were greater among Dutch women mental healthcare services consists of treatment
compared to the EU average from highly specialised professionals,
Sweden often within
a multidisciplinary team operating in mental
Men Women Men
healthcare institutions. Women
% of adults Low income High income % of adults Low income High income
18
The basic
20
benefits package provided by SHI covers
16 the costs
18 for GP-based and ambulatory mental
14 healthcare.
16 The costs of inpatient care provided
12
10
by mental
14 healthcare institutions or psychiatric
8 12
departments of general hospitals are also covered,
6 10
but they are subject to the mandatory deductible
4 8
stipulated by the Health Insurance Act (see
||

2 6
0 Section
Netherlands EU Netherlands EU
Note: High income refers to people in the top income quintile (20 % of the
population with the highest income), whereas low income refers to people
in the bottom income quintile (20 % of the population with the lowest
income).
Source: Eurostat Database (based on EHIS 2019).
General practitioners serve as gatekeepers for
accessing mental health services
In 2014, the Dutch mental healthcare system
underwent a reform to introduce a stepped-care
model for mental health services. Under this
framework, GPs are the initial point of contact
for most patients, and act as gatekeepers to more
advanced mental health services. Approximately
80 % of primary care facilities are equipped
with specialist mental health nurses, who offer
diagnostic assessments, short-term treatment,
longer-term support and guidance and therapeutic
counselling. The second step of care involves basic
mental healthcare provided by psychologists,
psychotherapists, social-psychiatric nurses and
4 4). Cost-sharing arrangements for severe
patients
2 with long-term conditions is regulated by
the provisions
0 of the Long-term Care Act.
Sweden EU Sweden EU
Suicide rates in the Netherlands increased
slightly in the past decade
Suicide is significant public health problem across
the EU, including in the Netherlands. In 2021,
suicide accounted for 1.15 % of all deaths in the
country, and it was the main cause of death among
Dutch people under the age of 30. The factors
contributing to suicide are complex, but extensive
research and clinical practice have established
that mental health problems play a substantial
role as risk factors for suicide. In 2020, the suicide
rate in the Netherlands stood at 10.48 per 100 000
population, marginally above the EU average of
10.24 per 100 000. As in other EU countries, suicide
rates in Netherlands are characterised by a marked
gender split, with higher incidence among men.
Between 2016 and 2020, the average suicide rate
among Dutch men was more than double that
among women (Figure 25).

Figure 25. The Netherlands’ suicide rate exceeded the EU average in 2016

Rate per 100 000 population Netherlands Men Netherlands Women EU Men EU Women

25

20

15

10

Source: Eurostat Database.

20 | State of Health in the EU | The Netherlands: Country Health Profile 2023

In contrast to the declining trend observed across
the EU, over the past decade deaths by suicide in
the Netherlands increased by nearly 5 %, reflecting
a surge of nearly 17 % in Dutch men’s suicide rate
between 2010 and 2013 which was followed by a
gradual decline, as well as a gradual increase in
Dutch women’s suicide rate until 2018, when it was
the fifth highest in the EU. Preliminary mortality
data for 2022 indicates that the Netherlands’
suicide rates increased by 3 % compared to 2019,
with a larger increase for men (4.2 %) than for
women (3.0 %). (CBS, 2023c).
Long waiting times undermine timely access to
specialist mental health services
The Dutch mental healthcare system is struggling
to meet rising demand for mental healthcare in
the aftermath of the COVID-19 pandemic, owing
to limited care capacity and a persistent scarcity
of mental health professionals. In 2022, over 60 %
of patients referred to specialist mental healthcare
waited more than the four-week threshold for an
initial consultation, and 30 % waited longer than
the 10-week maximum for receiving treatment.
As of December 2022, nearly 84 000 people in the
Netherlands were on a waiting list for mental
health services – approximately the same number
as in December 2021 (NZA, 2023).
Aside from insufficient care capacity, an inquiry
by the Dutch Court of Auditors (2020) found that
waiting times were exacerbated by perverse
financial incentives, as the established fixed
payment scheme between mental healthcare
providers and insurers incentivised the former
to prioritise patients with less severe conditions.
Box 1. The Netherlands launched a new mental well-being initiative in 2022
Recognizing the pressing need to strengthen
mental health services in the aftermath of
the COVID-19 pandemic, in 2022 the Dutch
government introduced the Good Mental Health
for All action plan. This outlines a range of
measures aimed at enhancing public awareness
of mental health, improving the availability of
mental health services and support systems,
and facilitating the early detection of mental
health issues. Building on the groundwork
laid by previous prevention programmes, the
action plan is structured around five core areas,
which focus on fostering mental well-being
Source: Government of the Netherlands (2023b).
State of Health in the EU | The Netherlands: Country Health Profile 2023 | 21
Waiting times are more severe for child
THE NETHERLANDS
mental health services, with multidisciplinary
mental health institutions facing shortages of
psychiatrists, fragmented governance and high
staff turnover (SER, 2021).
The government is taking steps to address the
mental health patient backlog
In 2021, the Dutch government issued a plan to
address long waiting times for mental healthcare
through better co-operation among healthcare
providers, GPs, municipalities and healthcare
insurers. The plan requires the largest mental
healthcare providers that fail to meet the
maximum statutory waiting times to coordinate
an intra-regional patient transfer mechanism.
Through this mechanism, providers with the
longest average waiting times are responsible
for redirecting patients to providers with
available treatment capacity within their region.
Together with a revamped remuneration system
for mental healthcare providers, this initiative is
expected to reduce the persistent mental health
backlog of patients in the forthcoming years. In
2022, the Dutch government took further steps to
formulate an additional plan to promote mental
well-being among young people, the working
population and vulnerable groups (Box 1).
within society, local communities, educational
institutions, workplaces and online. Each of
these domains outlines specific objectives, such
as the expansion of accessible walk-in facilities
at the municipal level, the establishment of
collaborative ventures with sports organizations
targeting vulnerable populations, and the
introduction of a pilot program to prevent
burnout among healthcare professionals. The
proposed actions will be continually monitored
and revised based on their implementation
progress.
 7 Key findings
THE NETHERLANDS
• In 2022, life expectancy at birth in the
Netherlands stood one year above the EU
average at 81.7 years, reflecting gains in
line with the EU average in two decades
preceding the COVID-19 pandemic and a
slightly below-average decline throughout
the pandemic years. Cancers and diseases
of the circulatory system were the most
||
common causes of death in 2021, collectively
accounting nearly half of all deaths, while
COVID-19 was responsible for over one in
every ten fatalities. Between 2020 and 2022,
excess mortality in the country stabilised
around 13 % above pre-pandemic levels,
declining only marginally following its peak
in 2020.
• The prevalence of behavioural risk factors
was linked to more than a third of all deaths
in the Netherlands in 2019 – a share slightly
below the EU average. In recent years, new
tobacco control measures led to reduced
smoking rates in the country, which now
stand below the EU average. While alcohol
consumption declined over the past two
decades and is lower than in most other
EU countries, heavy drinking remains
prevalent, with almost 20 % of Dutch adults
reporting regular heavy consumption in
2019.
• Between 2019 and 2021, health spending
in the Netherlands rose by over 12 % in
real terms, in large part due to increased
spending from government and social
health insurance required to address the
COVID-19 crisis. In 2021, health expenditure
constituted 11.3 % of GDP – slightly above
the EU average – but in per capita terms
it was the third highest in the EU after
Germany and Austria. Nearly 28 % of health
spending was allocated to long-term care,
which exceeded the EU average both in per
capita terms and as a share of total health
spending. Private sources contributed to
15 % of total health spending, which is
below the EU average of 19 %.
22 | State of Health in the EU | The Netherlands: Country Health Profile 2023
• In 2021, the Netherlands had a slightly
lower density of doctors compared to
the EU average, while the density of
nurses was higher. Although the share of
doctors working as general practitioners is
slightly above the EU average, the Dutch
healthcare system faces a shortage of
general practitioners, which is projected to
intensify in the coming years. Shortages
of nurses in hospitals also emerged during
the pandemic, which saw a concomitant
rise in the number of nurses opting for
self-employment as a means to obtain better
working conditions.
• The Netherlands outperformed most
EU countries in averting mortality from
generally preventable and treatable causes
in 2020, with mortality rates 21 % and
36 % below their respective EU averages.
The pandemic adversely impacted cancer
screening programmes in the Netherlands,
yet its impact was comparatively limited.
Following a decline in new cancer diagnoses
in 2020, screening activity rebounded in
2021 and 2022, with observed incidence
rates suggesting a substantial clearance of
the diagnostic backlog accumulated in 2020.
• The prevalence of mental health disorders
in the Netherlands is higher than the EU
average, with an estimated 18 % of the
population affected in 2019. Depression
rates were higher among Dutch women,
whereas men were more than twice as
likely to die by suicide than women.
Suicide remains a public health concern
in the Netherlands, constituting over 1 %
of deaths in 2021 and rising slightly over
the past decade in contrast with the EU
trend. As demand for specialist mental
health services increased in the aftermath
of the pandemic, an insufficient supply of
mental health professionals resulted in
waiting times that consistently surpass the
established threshold for a large share of
patients. In 2021, the Dutch government
rolled out an action plan to alleviate waiting
lists for specialist mental healthcare
through an intra-regional mechanism of
patient transfers.
Key sources

OECD/EU (2022), Health at a Glance: Europe 2022
– State of Health in the EU Cycle. Paris, OECD
Publishing, https://doi.org/10.1787/507433b0-en
THE NETHERLANDS
European Observatory on Health Systems and
Policies, Netherlands, Health Systems and Policy
Monitor, https://eurohealthobservatory.who.int/
monitors/health-systems-monitor/countries-hspm/
hspm/netherlands-2016

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Bosmans M et al. (2022), Kort-cyclisch
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4e gegevensrapportage jeugd (April-Juni 2022)
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mortality for the third consecutive year in 2022.
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expenditure up by 1.2 percent in 2022.
Central Bureau of Statistics (CBS) (2023c), General
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Netherlands Cancer Registry (NCR) (2023), Cancer
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Towards a smoke-free generation: Options to make
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Dutch Court of Auditors (2020), Mental healthcare: RVS [Council of Public Health & Society] (2023), De
the bigger the problem, the longer the waiting list. Basis op orde. Den Haag: Raad voor Volksgezondheid
& Samenleving [The basics in order. The Hague:
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current practice and strategies for improvement. (2021), Youth care: from systems to people https://
www.ser.nl/-/media/ser/downloads/adviezen/2021/
Government of the Netherlands (2023a), Proposal
van-systemen-naar-mensen.pdf
for a smarter use of health insurance deductible in
medical specialist care. Ten Have M et al., Prevalence and trends of common
mental disorders from 2007-2009 to 2019-2022:
Government of the Netherlands (2023b), “Good
results from the Netherlands Mental Health
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(2023), Data browser (findings from the 2021/22 COVID-19 pandemic.
international HBSC survey): https://data-browser.
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Healthcare Authority (Nza) (2022), Problems vzinfo.nl/copd
Austria
due to shortage ofAT Denmark
staff DKcare.
in care and youth Hungary HU Luxembourg LU Romania RO
Belgium BE Estonia EE Iceland ZN [Health Insurers Netherlands]
IS Malta (2022), Letter to the
MT Slovakia SK
Integraal
Bulgaria Kankercentrum Nederland (IKNL)FI(2023),
BG Finland Ireland Parliamentary Commission for
IE Netherlands NL Health, Welfare and SI
Slovenia
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France FR Italy Sports.IThttps://assets.zn.nl/p/32768/none/huisarts/
Norway NO Spain ES
Cyprus CY Germany DE Latvia ZN-brief%20commissiedebat%20Arbeidsmarkt%20
LV Poland PL Sweden SE
Czechia CZ Greece EL Lithuania LT Portugal PT
in%20de%20zorg_20220701%20(002).pdf

Country abbreviations
Austria AT Denmark DK Hungary HU Luxembourg LU Romania RO
Belgium BE Estonia EE Iceland IS Malta MT Slovakia SK
Bulgaria BG Finland FI Ireland IE Netherlands NL Slovenia SI
Croatia HR France FR Italy IT Norway NO Spain ES
Cyprus CY Germany DE Latvia LV Poland PL Sweden SE
Czechia CZ Greece EL Lithuania LT Portugal PT
State of Health in the EU | The Netherlands: Country Health Profile 2023 | 23
State of Health in the EU
Country Health Profile 2023

The Country Health Profiles are a key element of the
European Commission’s State of Health in the EU cycle,
a knowledge brokering project developed with financial
support from the European Union.
These Profiles are the result of a collaborative
partnership between the Organisation for Economic
Co-operation and Development (OECD) and the
European Observatory on Health Systems and Policies,
working in tandem with the European Commission.
Based on a consistent methodology using both
quantitative and qualitative data, the analysis covers
the latest health policy challenges and developments in
each EU/EEA country.
The 2023 edition of the Country Health Profiles
provides a synthesis of various critical aspects,
including:
• the current state of health within the country;
• health determinants, with a specific focus on
behavioural risk factors;
• the structure and organisation of the health system;
• the effectiveness, accessibility and resilience of the
health system;
• For the first time in the series, an account of the
state of mental health and related services within
the country.
Complementing the key findings of the Country Health
Profiles is the Synthesis Report by the European
Commission.

For more information, please refer to: ec.europa.eu/

health/state

Please cite this publication as:

OECD/European Observatory on Health Systems and Policies (2023),
The Netherlands: Country Health Profile 2023, State of Health in the EU,
OECD Publishing, Paris/European Observatory on Health Systems and Policies, Brussels.

ISBN 9789264434691 (PDF)

Series: State of Health in the EU
SSN 25227041 (online)