Relatively high budget for mental health care services

04/12/2015 15:00

The Netherlands spends more money on short-term admissions for mental and behavioural disorders than other OECD members. Almost one-quarter of total expenditure at Dutch hospitals including mental health (GGZ) institutions is on account of mental health care services. This is more than twice the amount spent in other OECD countries, according to the OECD publication ‘Health at a glance 2015’. In comparison with other countries, the Netherlands offers a wide range and open accessibility  of treatments. The use of mental health care services has also gone up.

23 percent of expenditure at hospitals on account of mental and behavioural disorders

The international comparison of health care costs focuses on expenditure for in-patient hospital care. In the Netherlands, 23 percent of this expenditure is on account of treatments for psychological and behavioural disorders, much higher than the average in 11 surveyed OECD countries (9 percent).

In Germany the share was 13 percent, in Sweden 7 percent. The second and third highest expenditure in the Netherlands is for cardiovascular (14 percent) and cancer treatments (11 percent). These are similar to the expenditure in other OECD countries. 

Share expenditure on hospital admissions for 3 types of diseases
 

14 billion euros spent on treatment of mental  disorders

In 2011, the Netherlands spent 67 billion euros on health care under the international definition. This amount included 14 billion euros (21 percent) for mental and behaviourial disorders such as dementia, mental handicaps, depressions, mood disorders, alcohol and drugs-related disorders and personality disorders. In Germany, 11 percent of expenditure is on account of treatment for mental and behaviourial disorders.

Share in Dutch health care expenditure (international definition), 2011
 

The bulk of the amount of 14 billion euros is spent on mental and behaviourial disorders under long-term care, mainly care for patients suffering from dementia and for mentally handicapped. Another portion of the expenditure is for out-patient and ambulatory care and medicine.

International definition: treatments not exceeding one year

In the international comparison of expenditure on mental health care treatments, the OECD restricts the definition to expenditure on short-term treatments in institutions or hospitals, i.e. treatments not exceeding one year. In the Netherlands, this was 27 percent of total expenditure on mental and behaviourial disorders, which amounted to nearly 4 billion euros in 2011. The bulk of this expenditure is by specialised GGZ institutions. These are included in the hospital sector in international comparisons. General and academic hospitals only account for 3 percent of the expenditure.

Share expenditure on mental and behavioural disorders, 2011
 

Increase in treatments and number of patients

As the mental health care survey is limited to care with short-term admission to a hospital or institution only, this international comparison is mainly related to expenditure in the GGZ sector and hardly applies to expenditure on care for the elderly or handicapped. The relatively high share of 23 percent as identified by OECD for mental and behaviourial disorders is in line with developments which have been observed in the mental health care sector (GGZ) for a longer period of time.

In comparison with other countries, the Netherlands offers a wide variety and open accessibility of treatments. Ambulatory care has been on the increase since 2000, while in-patient care has not decreased. In other countries the number of beds for admission has decreased more sharply than in the Netherlands, for example. Furthermore, the use of mental health care services has increased. The growth in expenditure therefore mainly reflects the growth in number of treatments and patients.
More recent data of Statistics Netherlands on expenditure in the GGZ sector (all service providers including ambulatory and long-term care) do indicate that expenditure has been increasing less sharply since 2012.

Per capita health care expenditure, 2013
 

Dutch health care expenditure not the highest in the world

Among all OECD members, the Netherlands is not the biggest spender on health care. In contrast with Dutch expenditure of 4,252 euros per capita in 2013, the largest consumer by far was the United States, where per capita spending was 7,221 euros. Norway and Switzerland also spent more per capita than the Netherlands.

The Netherlands spent almost 60 percent more than the OECD average, however (2,682 euros) . Turkey spent least of all the OECD members at 780 euros per capita.

The international comparison is about the group of mental and behaviourial disorders which also includes dementia and mental handicaps. The OECD data on the hospital sector also include mental health care institutions.