Abstract
Introduction
In 2015, Dutch healthcare expenditure exceeded 85 billion euros. But what about prevention? In this study we estimated national expenditure on prevention. A distinction was made between health protection, health promotion and disease prevention. In the estimation of prevention expenditures, this study is limited to universal, selective and indicated prevention, as healthcare-related prevention can hardly be distinguished from curative care. This study analyzed expenditure on preventive activities in the Netherlands in 2015 and took a societal perspective.
Methods
We used various sources to investigate spending on prevention in 2015. Insofar as costs were part of healthcare expenditure, estimates were based on the Care Accounts of Statistics Netherlands. For the remainder, we estimated expenditure using annual reports and annual accounts of governments and other organizations. We included preventive activities by consumers, industry, NGOs, insurance companies, and government.
Results
In 2015, an estimated € 12.4 billion (1.8% of the GDP) was spent on prevention: € 2.4 billion on disease prevention (19%), € 0.6 billion on health promotion (5%) and € 9.4 billion on health protection (76%). This is a decrease of 17% compared to 2007, the last year that a similar estimate was made. Within health promotion, the largest expenditure was for working conditions and safety: € 160 million. € 67 million was spent on mental disorders. The largest expenditure item within disease prevention was dental care: € 675 million. Within health protection, this was the sewer by more than € 3 billion.
Conclusions
Spending on prevention is relatively low compared to total spending on healthcare. The largest part is targeted at health protection. In the coming years there may be an increase in expenditure, due to more governmental prevention policies such as the National Prevention Agreement.
Key messages
Spending on prevention is relatively low compared to total spending on healthcare. Relatively little money for health protection.
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