健康・医療情報学ジャーナル

Comparison of Obstetric Care in Germany and in the Netherlands

Abstract

Birgit Arabin*,Gerard HA Visser

Germany and the Netherlands are wealthy countries in close neighborhood within Europe. They both have a general
health care insurance system and a tradition of recognized research in perinatal medicine. Nevertheless, there are
significant differences in the way how obstetric training and care are organized: Germany had two different health care
systems (East/West) from 1945 to 1990, in the Netherlands, home deliveries are still common. Today, the number of
gynecologists per patient is much higher in Germany compared to the Netherlands. In Germany, training of residents is
still not supervised whereas in the Netherlands there is a long tradition of audits of the training facilities. Amazingly, in
Germany there is no established guideline group of the professional boards whereas in the Netherlands, all guidelines
are democratically established, recognized by the boards and made transparent to patients and physicians. The
scientific output in high-impact journals is much higher in the Netherlands compared to Germany. Lessons to learn are to
adapt the number and quality of our future obstetricians including participation in research lines and interpretation of the
literature. There is a need for a standardized audit and accreditation system for training in Germany. This also implies
the establishment of competent guidelines, standards and confidential inquiries not only for pre- and postgraduate
training but also for transparency towards the patients.
Given the differences between both countries we hopefully can learn from each other to improve future care of the
fetal and maternal patient and thereby neglect harmful sides and introduce useful aspects.