A Dose of Dutch Health Care
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- Harriet Barnett
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1 A Dose of Dutch Health Care ACCESSing the Netherlands 4 February 2013 Presented by Chupa Coules International Health Centre The Hague Dr Christine Houser Expat Medical Advisor & Emergency Medicine Specialist Carolyn Tabak Representing ACCESS Counselling Service Network
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3 Source: Health Consumer PowerHouse / European Commission Supplied by Bronovo Hospital
4 ICP Healthcare Survey 2010 Results The Dutch health care system is: a very large, complex and political subject often perceived as uncomfortable by a newly arriving international sometimes difficult to understand when in need of care or medical attention lacking in the quality of treatment provided or in meeting expectations
5 ICP Healthcare Survey 2010 Results Key Gaps Quality of Treatment Provided Top Dissatisfiers Quality of Treatment Provided Readiness to Refer Readiness to Refer Availability Service Hours Availability Service Hours Availability Scheduling Appointments Communication in English Availability Scheduling Appointments Information about Healthcare System
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7 General Practice in Holland General Practitioner (GP) also referred to as Family Doctor or Huisarts are trained to treat most diseases themselves Trained to perform: Gynaelogical exams including PAP smears Paediatrics and well baby care Minor surgery A specialty in the Netherlands
8 The role of your GP Gatekeeper and central point of contact Guardian of all medical information & history Generally follows evidence based medical practices Gives & organises medical treatment plan Grants referrals to specialists; in urgent cases, the doctor may arrange appointment on behalf of the patient
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10 Your Role as a Resident / Patient Don t wait to be sick or be in a stressful situation. Find a doctor and An open dialogue is key get registered! Be proactive bearing in mind the culture-based and system-based differences If you are dissatisfied, deregister and change doctors
11 Mythbusters You must register with a doctor as a family
12 Mythbusters Family members may be registered with different doctors in different practices
13 Mythbusters You are obliged to register with a doctor in your postal code
14 Mythbusters There is no obligation to register with a GP in your postal code. Register wherever you like, where it is convenient and where you feel comfortable
15 Mythbusters You must have a referral to visit a specialist.
16 Mythbusters You are free to visit a specialist without a referral, however, be aware you may experience long(er) wait-times and reimbursement by your insurance may or may not be in full
17 Accessing care in an Emergency Can I go to the emergency department without a referral? What if I don t have my insurance card or my identification when I get there?
18 Accessing care in an Emergency Who staffs the emergency department? Is that different after 5 pm? Must I go to the Huisartsenpost (HAP)?
19 Emergencies Life Threatening 112 ambulance, police, and fire Multi-Lingual Assess & Assist Ambulance - Ride versus No Ride One number within EU
20 Emergencies Non-Life Threatening Stichting Mobiele Artsen Service Haaglanden For treatment by a GP between , on weekends & bank holidays* a cooperative effort of GP's (huisartsen) in: - The Hague - Leidschendam - Rijswijk - Voorburg - Voorschoten - Wassenaar
21 SMASH - other areas Huisartsenpost Zoetermeer* Huisartsenpost Delft* - Delft -Pijnacker - Nootdorp - Delfgauw - Schipluiden - Den Hoorn *before contacting SMASH or Huisartsenpost, it is preferable to call your GP first. If he/she is not available, he/she should provide his/her substitute contact details as well as the after hours care contact in their voice message
22 Aerial view: Bronovo Specialists, Hospitals & Policlinics Bronovo MCH Westeinde MCH Antoniushove HagaZiekenhuis Leyweg HagaZiekenhuis Sportlaan Juliana Kinderziekenhuis (children) Reinier de Graaf Gasthuis Delft LangeLand Zoetermeer Leiden University MC Erasmus MC Polikliniek Prins Willem ER Valet parking SMASH & 24/7 Pharmacy
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24 Accessing Specialist Care If I go to the specialist, who will I actually see? Specialists (training path may be different than expected) Doctors-in-training Doctors-not-in-training How will I know??? Referrals Insurance coverage, pricing and payment special too!
25 Having a baby prenatal care Three most common choices for pregnancy care and delivery are: Midwife care with hospital birth (poliklinische bevalling) Midwife care with home birth (thuisbevalling) Midwife care with a gynaecologist (ziekenhuisbevalling) Source: Healthcare Booklet
26 Having a baby postnatal care Kraamzorg Postnatal welfare practitioner will come to your home for the first week after the birth or your return home with the baby Helps with everything to help you adjust: cooking, cleaning, feeding, changing, bathing, child minding, etc. Register for kraamzorg as soon as possible, preferably at the beginning of your pregnancy Your insurance provider might refer to you a preferred organisation or will leave the choice to you Source: Healthcare Booklet
27 Mental Health Help is available. Multi-lingual psychiatrists, psychologists, social workers and alternative practitioners in private practice Outpatient mental health, youth issues, domestic issues, phobias, depression, addictions, ADHD, cross-cultural adjustments, challenges associated with international mobility, etc. Cost varies and may covered by insurance depending on the condition. Consult your GP for a referral letter From Own risk payment of 200 for psychiatric help (in addition to 220 own risk under standard insurance package) Source: Healthcare Guide
28 Mental Health - Resources ACCESS Counselling Service Network The Dutch Association of Psychologists (Nederlands Instituut van Psychologen, NIP) In dutch: GGZ Nederland search for provider by region, postcode, name RIAGG - called Parnassia in The Hague
29 Insurance All residents must show proof of insurance Cost streams fixed vs. transient patients Direct billing to insurance or self-pay
30 Dutch health insurance coverage Obliged to accept everyone for the standard package (basisverzekering), irrespective of gender, age and health Supplementary packages available at additional cost, no obligation to cover you Children under 18 covered under parents premium Own Risk (eigen risico) for 2012 set at 220
31 Specialist fees Pricing is regulated by the Ministry of Health and may be very different from what you are used to in your home country. Pricing is based on a diagnosis related group (DBC). Fixed price; no itemisation A weighted average Includes all respective visits/testing/treatments Varies depending on the actual situation (the length of the treatment). Bill is sent for payment at completion of the (series of) consultations.
32 Specialist fees In 2012 a few important changes: - Mild growth allowed in hospitals/clinics - Longer wait times expected - Patient may have to use a hospital/clinic chosen by their insurance (HMO model) Concerned about costs, co-payments, choice of care? - Check the conditions of your insurance cover first before seeing a specialist - Change insurance providers
33 A final dose Consultatie Bureau: Child Development / Child Vaccinations 0 4 years GP Family Vaccinations: Seasonal Flu Shot, holiday travel vaccinations or inoculations according to your home country scheme, e.g. Chicken Pox, Rotavirus Health Checks & Prevention Second Opinions Apotheek / Pharmacy vs. Drogist / Drugist Dental Care don t forget to register!
34 Please refer to the new Health Care guide for more detailed information on the topics covered today
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FROM COVERAGE TO CARE A Roadmap to Better Care and a Healthier You Step 2 Understand your health coverage Your ROADMAP to health 2 Understand your health coverage Check with your insurance plan or state
Health Care Plans - Which is the Most Deductible?
This is only a summary. If you want more detail about your coverage and costs, you can get the complete terms in the policy or plan document at www.studentplanscenter.com or by calling 1-800-756-3702.
Your guide to better health Grow healthy. Live well.
Your guide to better health Grow healthy. Live well. FREDERICK COUNTY PUBLIC SCHOOLS Look Inside Where do I go for health tools and resources? How can I get and stay healthy? What mobile applications are
Important Questions Answers Why this Matters: In-network: $2,000 Single / $4,000 Family Out-of-network: $3,000 Single / $6,000 Family
This is only a summary. If you want more detail about your coverage and costs, you can get the complete terms in the policy or plan document at www.independenthealth.com or by calling 1-800-501-3439. Important
National Guardian Life Insurance Company: Post University Student Health Insurance Plan Coverage Period: 08/14/2015-08/13/2016
This is only a summary. If you want more detail about your coverage and costs, you can get the complete terms in the policy or plan document at www.studentplanscenter.com or by calling 1-800-756-3702.
Important Questions Answers Why this Matters:
This is only a summary. If you want more detail about your coverage and costs, you can get the complete terms in the policy or plan document at www.studentplanscenter.com or by calling 1-800-756-3702.