Health care professionals, policy makers and politicians have urgent needs for systematic information about national health care expenditure. The study Cost of Illness in the Netherlands has been performed for the third time and presents information about the relationship between health care use, measured as costs, and what matters most: the health of the population. Previous studies reported cost of illness estimates for the years 1988 en 1994. This study provides a comprehensive overview of Dutch health care costs in 1999. Total health care costs were attributed to health care sectors and providers, diseases, age groups and gender. The results of this analysis can be used for answering questions such as: ‘On what type of health care do we spend our money?’ And: ‘How are these costs distributed among various illnesses and diseases?’ But also: ‘How much money do we need for health care in the future and for resolving waiting lists?’ Researchers and policy makers may use the information of this study as a tool to explore the desired future characteristics and volumes of the Dutch health care system. The cost of illness figures estimated in this study are also available from internet. The site contains about 400.000 ready-made tables, which allow you to pick the cost-selection of your preference (www.kostenvanziekten.nl or www.costofillness.nl). The cost of illness study was carried out as a collaborative effort by the RIVM (Department for Public Health Forecasting) and the Erasmus University Rotterdam (Department of Public Health), in co-operation with many Dutch organisations that provided data for this study. If you have any remarks or questions, do not hesitate to contact the responsible researchers (e-mail: kostenvanziekten@rivm.nl). Key findings • This cost of illness study provides a comprehensive, integrated view on health care use from a demographic and epidemiological perspective. • Most of the 36 billion euro spent on Dutch health care in 1999 relate to chronic diseases like mental disorders including dementia and mental retardation, stroke, chronic heart disease and disorders of the musculoskeletal system. • Women used 58% of Dutch health care in 1999. This can merely be explained by the costs of pregnancy and childbirth and by the higher life expectancy of women. Women get older and on average they spend more years in ill health than men. • The average costs per inhabitant of the Netherlands amounted 2.279 euro in 1999. The differences by age, however, were quite large. Costs were relatively low and stable from childhood until 60 years of age. From this age onwards costs increased sharply to over 30.000 euro for inhabitants over 95 years of age. • According to state of the art knowledge only a small part of costs could be attributed to known risk factors like high bloodpressure and smoking. Lifestyle related health care costs are higher for men than for women because of their high-risk lifestyle. Decreasing health risks is of great importance for health, but will not lead to substantial cost savings. Besides the costs of prevention as such, also the occurrence of diseases that substitute for the prevented diseases might cause increasing rather than decreasing health care costs. This study was co sponsored by the Ministry of Health,Welfare and Sport (VWS). (Author/publisher)
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