Care and nursing explained

One of the main changes to the care funded through the Dutch Exceptional Medical Expenses Act (AWBZ) is the transition from supply-driven to demand-led care. The disadvantage of demand-led care - from the perspective of cost control - is that there is no way of knowing in advance how many people will seek to use the available care services. The Dutch Ministry of Health, Welfare and Sport therefore asked SCP to develop an instrument with a dual purpose: to estimate how many people will apply for nursing and care now and in the future, and to estimate the impact of existing and proposed policy on the demand for and use of that care. The instrument developed is an exploratory model for nursing and care; the outcomes of the model are presented in this publication.

While the rise in the use of AWBZ-funded services up to 2020 will outstrip the growth in the population, it will increase much less than might be expected if all those who might theoretically make use of these services actually did so.

In order to control the costs of care, the government is considering increasing patient contributions or reducing the standard care package. This publication makes clear that these two options are not the only possible steering instruments. It also calculates that there is a risk that people will begin using other, often more expensive, publicly funded provisions if the package of services funded through the AWBZ is reduced. This creates the possibility that a large group of people will be excluded from publicly funded care without any concomitant financial saving.