Key points

  • The Netherlands stands out as a consistently high performer in Commonwealth Fund international health policy surveys.
  • Like most countries in Western Europe, the Netherlands is facing growing pressures on health services as their population ages and cases of chronic disease grow rapidly. More broadly, they also face the challenge of meeting societal and political demands for more self-directed, less paternalistic healthcare.
  • The Netherlands has been among the pioneers of personal health budgets (persoonsgebonden budgets, or PGBs) and has been using them since 1996.
  • The drive for PGBs arose partly from limitations in the traditional healthcare system but also as an opportunity to offer patients and service users greater choice and control over their healthcare. In addition, there was a belief that delegating the control of budgets to the end user would help to control costs.
  • Implementation has not been without its difficulties, but PGBs have been highly popular with both the public and politicians, and seem to have a secure future.

The Netherlands has been using personal health budgets (persoonsgebonden budgets, or PGBs) since 1996. This case study examines how they have been adopted and the challenges along the way.

The adoption of PGBs arose partly from limitations in the traditional healthcare system, but also from a desire to offer service users more choice and control over their care. There was also a belief that handing control of budgets to the end user would help to reduce costs. Implementing PGBs has not been without its difficulties, but the system is highly popular with both the public and politicians.

 

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