[State of the Dutch health care: need for more refined and specific indicators]

The 'World health report 2000' follows a trend towards the use of performance indicators in public services. The indicators used by WHO are in need of conceptual refinement and valid measurement, especially the more subjective ones. The use of indicators for final goals of health (care) systems makes it difficult to translate lack of performance into policy. Instrumental goals are also needed for the latter. It is concluded that the overall performance of the Dutch health care system is built up of the performance of its individual sections. The concrete areas for improvement within these sections need to be identified, while at the same time a performance paradox should be avoided.