Dutch Health System Study Tour - Monday

Our travels today took us to two very different hospitals.  Our first stop was to the VU (Free University) Medical Center ( http://www.vumc.com/patientcare/about/). We met Dr. Fokke Rakers, Director of Real Estate for the hospital.  They are one of a handful of academic health centers in the Netherlands.  With 713 licensed beds and over 50,000 admissions in 2009, they are one of the smaller AHC's in the country.  This is an AHC whose strategy is focused on the merger with a major psychiatric hospital, a strategic alliance with the Amsterdam Medical Center, adoption of lean, centralization of imaging functions, growth of human health and life science and network development. All of these new initiatives along with the tremendous number of new buildings on the campus are funded through internal resources and not government grants or reimbursement through insurance payments.

We learned that the Netherlands spends about 10.5% of its GDP on health care with the second best clinical outcomes and health indicators in all of Europe (behind Sweden). We were informed that the lean journey began two years ago starting in the OR. Results to date have been very positive with little or no resistance by physicians and nurses.

After the presentation by Dr. Rakers, we got to visit the new pediatrics unit.  It presents a warm, welcoming and comforting environment for children undergoing treatment at the hospital and their parents.

We then traveled to the Antoni van Leeuwenhoek Comprehensive Cancer Center (http://www.nki.nl/Research/). Their total focus in on the prevention and treatment of cancer by doing both basic and clinical/scientific research.  Their in-patient hospital has 180 licensed beds and in 2011, had 7,400 in-patient admissions and 30,700 outpatient visits. The hospital will be celebrating its centennial in October 2013. Theirs is a highly patient focused experience that seeks to provide to support patients and their families.

There were a number of interesting attributes about the Cancer Center.  All of their physicians are on salary and are on the same six step salary scale.  We learned afterwards that certain clinical specialists have the potential to earn additional revenue from various sources.  The hospital is looking to grow by 70% in 2020 and partner with an academic health center in Utrecht.  In the Netherlands, data about cancer patients and their treatment is collected on a national level and as a result, the hospital has adopted a robust operations management and quality improvement program. Another interesting piece of information was that the Dutch government and the commercial insurance companies have adopted standards related to the volume of services done and the willingness to pay for these services.  Stated another way, insurance companies will pay only if a certain minimum number of procedures are done annually.

After a brief tour of the hospital, it was time to depart for the day. Tomorrow, we travel to the Hague for a meeting with representatives from the Ministry of Health.