The comparison on accessibility, quality and costs revealed the following:

• Accessibility: Physical accessibility is comparable. However, the Netherlands scores higher on financial accessibility, due to lower deductibles for people with low incomes.
• Quality: The Netherlands has a more stringent legal foundation for healthcare quality and scores slightly higher on quality indicators related to customer experience (7.9 versus 7.5). However, Flanders is more advanced in measuring quality indicators.
• Cost: In the Netherlands, patients receive more care per week and stay costs are also higher per day. Here there’s a substantial difference of 35 to 40%.

In summary, accessibility is somewhat better in the Netherlands, but the quality is more or less the same. Customers in the Netherlands are slightly more satisfied with the care they receive, but the costs are considerably higher. The cost difference will further increase to around 60% due to additional planned investments of 2.1 billion euro.

Going forward, both the Netherlands and Flanders are facing a major age wave. The nursing and healthcare workforce in the Netherlands is becoming increasingly older, creating a greater challenge in attracting new staff to the sector and getting them to commit for the long term.

We have written this report in order to contribute to the substantive debate on elderly care. We’ll leave the interpretation of these insights our readers.

We see five areas where the Netherlands and Flanders can work on improving healthcare:

1. A good understanding of the relationship between quality and staffing/costs is still uncharted territory. It’s valuable to set up thorough quality, cost and staffing benchmarks per location.
2. To improve care, both the Netherlands and Flanders could benefit from exchanging insights on how they do things – including topics like employment policies, overhead/regulatory pressures and maximum time for residents, as well as attention to quality of life and personal requests.
3. The Netherlands has set an impossible task for itself: to spend 60% more time per patient than in Flanders, but with twice the older staff that’s aging 1.5 times faster. And quality should increase significantly as well. This is going to be an issue; it’s necessary to adjust expectations.
4. The extra resources in the Netherlands could also stimulate greater involvement of family members in patient care. Including a child or grandchild in the care team can improve quality of life and offer a (partial) solution to the acute staff shortage.
5. There is a major difference in needs assessments in Flanders and the Netherlands, both in terms of number (more hours of care in the Netherlands) and differentiation of needs (larger in the Netherlands). It makes sense to share information to improve needs assessments.