Money flows in health care and revenues of financing schemes

What does the survey comprise?


The survey provides a description of the origin of the expenditure on healthcare. Two questions are central: 1. Where do the cash flows originate? 2. What is the nature of the money flows?

Description of domain

The flow of money (in current prices) runs from the 'funding sources' through the 'funding schemes' to the providers of health and welfare care and to the policy and management institutions in the field of health and welfare. The two questions are answered within this study by two tables.

In the table "Money flows in healthcare; final financing" (in Dutch), the money flows are traced as much as possible to their ultimate origin: households (including the self-employed), the government as redistributor, companies / employers (including the government as employer) and abroad. This makes it clear who ultimately pays the financing arrangements.

In the table "Health expenditure; revenues of health care financing schemes', the cash flows are converted by type of revenues of the financing scheme (public or private) with the following main breakdown: transfers from the government, social / compulsory / voluntary health insurance premiums, other income (households, companies and non-profit institutions (serving households)) and foreign direct transfers. The classification of revenues of financing schemes is laid down in the System of Health Accounts in the "Classification of Revenues of Health Care Financing Schemes".

A third question: "Where does the money end up in health care?" is the subject of the Care Accounts.

Target population

Resident persons and companies in the Netherlands. This concerns persons who have resided in the Netherlands for more than one year and companies established in the Netherlands, including branches of foreign companies in the Netherlands. In addition, under the financing scheme 'Rest of the world; exports' and the category 'Balances and differences', the healthcare expenditure in the Netherlands of non-residents is included (exports).

Date/year survey started

The survey has figures from 1998.



Publication strategy

The provisional figures for t-2 will be published in the first quarter of year t. The further provisional figures for t-2 and t-3 and the final figures for t-4 will be published in the second quarter of year t.

How is the survey conducted?

Main sources

The expenses per financing scheme are in accordance with the figures in the Care Accounts. The most important data sources with funding data used to determine the origin distribution by funding source and by revenue of funding scheme were published by the National Health Care Institute, Vektis, the Tax Authorities and the National Accounts of Statistics Netherlands.

Structure of integration framework

During the analysis, the totals per "financing scheme" from the Care Accounts were confronted with financing figures from other sources.

The item "Other differences" serves to reconcile the figures from the Care Accounts with the other sources. The differences arise mainly due to differences in definitions.

The 'Fund Balances' are the balances documented in the annual reports of the General Cash of the Health Insurance Fund (for the years 1998-2005 ; in Dutch: Algemene kas Ziekenfondswet)), the Health Insurance Fund (from 2006; in Dutch Zorgverzekeringsfonds (Zvf)), the General Fund for Special Medical Expenses (for the years 1998-2014; in Dutch Algemeen Fonds Bijzondere Ziektekosten (AFBZ)) and Long-term care Fund (Flz; from 2015; in Dutch Fonds langdurige zorg (Flz)).

Quality of the results

Sequential comparability

For the period 1998 to the present, the field described and the definitions and terms used are unambiguous, so that follow-up and comparability are guaranteed.


Overhaul takes place at:

  • Conceptual and methodological changes;
  • The availability of new sources;
  • Revision of existing sources.

Quality strategy

The sources are assessed for completeness, plausibility and consistency. In doing so, use is made of data from previous reporting periods. Corrections are applied where necessary.