9. Development of health and social care expenditure 2022 and 2023
Health and social care expenditure rose by 2.9 percent in 2022 compared to 2021; before the revision, the growth was 2.0 percent. The main growth in 2022 was seen in the SBI subclasses which have been added with the revision, resulting in a higher revised figure for the growth of total care expenditure. In 2023, expenditure rose by €10 billion to €142.8 billion, an increase of 7.5%. The amount spent by the government remained stable; expenditure financed under the Dutch Healthcare Insurance Act and the Long-term care Act (Wlz) rose by 7.7 and 10.6 percent, respectively, in 2023. Out-of-pocket payments, including insurance excesses and personal contributions, rose by 9.2 percent.
| Jaar | Government (billion euro) | Long-term care insurance (Wlz) (billion euro) | Compulsory private insurance (Zvw) (billion euro) | HF.2.1: Voluntary health insurance schemes, out-of-pocket payments, enterprise financing schemes, other schemes (billion euro) |
|---|---|---|---|---|
| 2021* | 32.9 | 26.7 | 49.8 | 19.7 |
| 2022* | 31.6 | 28.3 | 51.2 | 21.7 |
| 2023* | 32.6 | 31.4 | 55.1 | 23.8 |
| * preliminary figures | ||||
Expenditure on preventive healthcare fell in both 2022 and in 2023, as a result of the cessation of a large part of the coronavirus-related costs, in particular expenditure on testing and vaccination and the ‘healthcare bonus’ scheme. On the other hand, expenditure on shelter care rose substantially in both years. This was primarily due to the soaring costs of asylum seeker shelters in 2022 and 2023.
| Zorgtype | 2022* (%-change compared to an earlier year) | 2023* (%-change compared to an earlier year) |
|---|---|---|
| Medical specialist care (inpatient) | -1.1 | 6.0 |
| Medical specialist care (day treatment) | 9.1 | 8.0 |
| Medical specialist care (outpatient) | 3.9 | 8.0 |
| Medical specialist care (other) | 11.3 | 5.6 |
| Mental health care | 8.6 | 8.8 |
| General practitioner care | 3.4 | 11.2 |
| Dental care | 1.4 | 8.7 |
| Paramedical care | 8.9 | 9.3 |
| Rehabilitative care | -1.7 | 9.0 |
| Perinatal care | -4.1 | 8.8 |
| Integrated care | 3.9 | 11.2 |
| Preventive care | -27.3 | -19.2 |
| Pharmaceuticals | 5.4 | 4.1 |
| Medical appliances | -2.8 | 4.8 |
| Other health care | 12.0 | 9.2 |
| Nursing and care (residential) | 1.1 | 10.6 |
| Nursing and care (home) | 0.0 | 6.0 |
| Palliative care | 3.3 | 8.2 |
| Disability care | 4.8 | 6.7 |
| Sheltered accommodation | 13.3 | 14.9 |
| Shelter care | 53.9 | 51.7 |
| Other social care | 20.0 | 11.5 |
| Youth care | 12.9 | 7.8 |
| Children's day care | 12.6 | 15.5 |
| Training | 4.8 | 9.2 |
| R&D | 4.7 | 7.1 |
| Policy and management | 2.2 | 1.8 |
| * preliminary figures | ||
9.1 Composing preliminary figures
When composing preliminary figures for the previous year (in this case 2023), a lot of data used for the Health and Social Care Accounts are not yet available or only partially so: claims under the Healthcare Insurance Act (Zvw), the Long-term care Act (Wlz) supplementary insurance schemes, data from annual Corporate Social Responsibility reports, data from CBS surveys of healthcare providers and fiscal data. For this reason, the methods used to produce quick, preliminary figures differ significantly from the methods used to produce the more detailed provisional and final figures.
For the Zvw and Wlz domain, expenditure per care act and care type are calculated using the percentage change over 2022-2023 based on the care figures from the Care Institute’s database, which, by contrast, are available in time. For SBI subclasses in which uninsured care plays a primary role, the development of wages and salaries (policy records of the Employee Insurance Agency (UWV) and the Tax Administration) is used to estimate total revenues. Because the care sector is highly labour intensive, it is assumed that this is a good approach for estimating the development of revenues. Out-of-pocket payments, supplementary insurance schemes and Child and Youth Act and Wmo revenue are estimated using various CBS data on care use (the health survey, youth policy information, Municipal Social Domain Monitor) and rate and price developments.