INDICATORS

NETHERLANDS
Data availability by Country Report: 75% of ECHI shortlist indicators are available
as such in international data sources. The ECHI shortlist sections for which there are
most data missing are Health Services and Health Determinants.
Data availability by ECHIM Survey: 95% of ECHIM Survey indicators are available
at national level. Most of the available data for Health Status and Health Care indicators
are from registers. Most of Health Determinants indicators are from regular HIS. There
are a couple of HES indicators for which there is no known regular source.
Data availability in European context: Data availability in the Netherlands is among
the best in Europe. Also data quality can be considered good. Fine-tuning of indicator
definitions at the national level would likely further improve the availability figures.
Overall situation of data sources: The number of data gathering and producing
institutions is extremely large; there are more than 100 different organisations. Record
linkage is possible between hospital data, municipal register and causes of death
register, but it this endangered now by the breakdown of the diagnosis-related hospital
information. Data are mostly not comparable as such, recalculations are needed for e.g.
international databases. A centralised vision on data needs has been developed in the
National Institute of Public Health and Environment (RIVM, www.rivm.nl), driven by
the work on health reporting. However, for the Ministry of Health it is still not a priority
to invest in a central strategy and stewardship concerning sustained data collection.
Health reporting: RIVM is the institution primarily responsible for health reporting.
The National Public Health Compass (www.nationaalkompas.nl; in Dutch only) is
an advanced attempt in regular health reporting, pulling together data from different
sources. The Dutch National Atlas of Public Health (www.zorgatlas.nl; partly in
English) is an extensive collection of indicators from all areas of public health, and
the data are visualised by thematic maps. In addition to the online health reporting
applications, RIVM also publishes a wide range of printed reports, most notably the
Care for Health; The Dutch Public Health Status and Forecasts Report. The Ministry
of Public Health, Welfare and Sports hosts a database (www.zorggegevens.nl; in Dutch
only) with extensive data and metadata, yet with no close ties with the data providers.
Main problems: The hospital data system (ICD-based discharges etc.) is currently
most problematic. The reason is the recent introduction of the unique Dutch approach
DBC (Diagnostics-Treatment-Combination) that merges medical and administrative
information and is not properly compatible with ICD. In the Dutch situation,
primary care registers are considered the best source for the majority of diagnoses. For
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