Emergency treatment in Dutch hospitals 10 times cost at GP

Tens of thousands of patients in the Netherlands are treated in hospital emergency departments at sometimes 10 times the cost of the same treatment at their local general practitioner (GP), and end up with larger medical bills as a result.

Closing a wound with sutures at a hospital can cost 405 euros, staunching a nosebleed can be 410 euros, while placing an IUD goes up to 505 euros. By contrast, the cost of fitting an IUD at a GP is only 56 euros.

Nor will all of these costs necessarily be paid by the patient's health insurance; if they have a high deductible on their insurance, they may have to pay part or all of the cost.

This comes from the first survey of all hospital treatments in the Netherlands, put online by Dutch organisation DBC Onderhoud.

GPs much cheaper

Experts agree that going to a GP for minor treatment rather than an emergency department can be much cheaper.

"IUDs can be inserted by a general physician, in many cases," says Hugo Keuzenkamp, director of Westfriesgasthuis Hospital in Hoorn. The same is true, he said, for binding wounds with adhesive plasters or treating cuts.

A spokeswomen for DBC Onderhoud also thinks savings are possible in many areas, saying a nosebleed can usually be treated a lot more cheaply by a GP.

The problem can lie in the fact that may patients think that for acute injuries they should go to an emergency room, but actually their GP is a better option.

In 2012, more than 60.000 patients went to an emergency department for a wound suturing and disinfection at around 405 euros each, while another 21.000 had a cut glued with adhesive plaster in the hospital for an average of 165 euros each.

"If a patient comes in with a bleeding gash for first aid treatment, of course he cannot be referred back to a GP," says Keuzenkamp. "Patients do not accept that."

Insurance cost risk

Often it is only after they have been treated that people realise that would have been better off going to their GP.

All Dutch residents have a mandatory own risk or excess of at least 360 euros per year for their health insurance, which must be paid by the policy holder before the insurer pays.

Going to a hospital to have a cut treated may result in paying the entire 165 euros youself, unless you have already paid the excess that year for other treatments.

A study of patients by research company NPCF found that they have not really been monitoring the cost of their care, because bills usually go directly to the insurance companies.

Hospital treatment facts now online

Until DBC Onderhoud set up this site to publish the costs of treatments, this information could only be obtained through a Freedom of Information request.

By disclosing of the cost of treatments, DBC Onderhoud hopes to make patients more aware of the costs they may be incurring by choosing a hospital over their local doctor.

Also in May, Dutch hospitals began publishing their own treatment information on their websites. Patients are now able to see how institutions score in ten categories ranging from waiting times and mortality rates to patient experiences and the risk of infection, although not the costs.

The initiative, called Kwaliteitsvenster (Quality Window), comes from the Dutch Association of Hospitals (NVZ) and almost all hospitals in the Netherlands are participating.

Source: Volkskrant