Sustainability and Resilience in the Dutch Health System

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The Dutch health system provides broad universal health care coverage and is based on the
principles of regulated competition. According to the OECD (2022), it is one of the best health
systems in the world with regard to access to health care, equity and clinical outcomes. However,
as also concluded by the Netherlands Scientific Council for Government Policy (WRR, 2021), as with
other health systems, it faces important sustainability and resilience challenges, some of which
were exposed and exacerbated during the COVID-19 pandemic.
This report provides a comprehensive overview of the Dutch health system’s key features across
the seven domains of the PHSSR framework: health system governance, health system financing,
workforce, medicines and technology, health service delivery, population health and environmental
sustainability. For each of these domains, the aim of the report is to (1) produce a critical
assessment of the country’s most salient strengths, weaknesses and threats regarding the
sustainability and resilience of its health system and (2) derive recommendations for health care
In addition to the seven domains mentioned above, we present two case studies. The first focuses
on the resilience of the Dutch health system to the financial shock caused by the COVID-19
pandemic. The second examines whether collaboration (aimed at reducing coordination problems
and facilitating integrated health care) and competition are reconcilable in the Dutch health system.
Original languageEnglish
Number of pages94
Publication statusPublished - Mar 2023

Bibliographical note

This report was produced as part of the Partnership for Health System Sustainability and Resilience (PHSSR).


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