Background: Primary care in the Netherlands has a strong international reputation. However, this picture may
be qualified in two respects. First of all, the Dutch primary care system is less cohesive than is sometimes
suggested. Secondly, there are major challenges in the Dutch system (as is the case with other European
health care systems), which have to be resolved in order to maintain and improve primary care.
Methods: Description of primary care in the Netherlands based on nationally and internationally published
sources. Identification of challenges and trends. Narrative review of the literature.
Results: GPs have a strong position in the Netherlands. Their numbers are relatively low; they have a gatekeeping
position, and there is no cost-sharing for GP care (unlike other forms of care). The primary care
system as a whole, however, is characterised by weak coherence. Individual primary care disciplines have
their own separate modes of funding. Challenges include a growing and changing demand for primary care
services, and changes in manpower and organisation, that affect the balance between demand and supply
regarding primary care services.
Conclusions: Among the threats to strong primary care are the risk of increasing fragmentation of care,
negative side effects of a transformation process from cottage industry to service industry, and reluctance to
invest in integrated primary care. An opportunity lies in the consensus among stakeholders that integrated
primary care has a future. Technological developments support this, especially the development of electronic
patient records.
Background: Primary care in the Netherlands has a strong international reputation. However, this picture maybe qualified in two respects. First of all, the Dutch primary care system is less cohesive than is sometimessuggested. Secondly, there are major challenges in the Dutch system (as is the case with other Europeanhealth care systems), which have to be resolved in order to maintain and improve primary care.Methods: Description of primary care in the Netherlands based on nationally and internationally publishedsources. Identification of challenges and trends. Narrative review of the literature.Results: GPs have a strong position in the Netherlands. Their numbers are relatively low; they have a gatekeepingposition, and there is no cost-sharing for GP care (unlike other forms of care). The primary caresystem as a whole, however, is characterised by weak coherence. Individual primary care disciplines havetheir own separate modes of funding. Challenges include a growing and changing demand for primary careservices, and changes in manpower and organisation, that affect the balance between demand and supplyregarding primary care services.Conclusions: Among the threats to strong primary care are the risk of increasing fragmentation of care,negative side effects of a transformation process from cottage industry to service industry, and reluctance toinvest in integrated primary care. An opportunity lies in the consensus among stakeholders that integratedprimary care has a future. Technological developments support this, especially the development of electronicpatient records.
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