[Disease burden of nervous system disorders in The Netherlands]

To determine the prevalence and the burden of diseases of the nervous system in the Netherlands.

Descriptive.

Institute of Public Health Care, Rotterdam, the Netherlands.

Data from medical registrations and statistics concerning diseases of the nervous system from different tiers of health care (general practitioners, hospital, nursing homes) and effects on patient and community (mortality, sickness absenteeism, occupational disablement and costs of illness) were analysed.

In general practice, 3-5% of total consultation consisted of neurological diseases (450,000-750,000 cases per year), of which migraine and epilepsy instituted a relatively large group. Of all the hospital admissions, 7% were because of a neurological disease. Neurological disease accounted for 70% of all nursing home admissions. Cerebrovascular accident and hernia nuclei pulposi instituted the largest groups in all sectors. Diseases of the nervous system accounted for 14% of total mortality, 6% of total sickness absenteeism and 14% of total health care costs (f 3.8 billion).

Estimating the burden of diseases is difficult because of imperfect medical registration, variations in structure of patient referral and influence of secondary diagnoses. Taking into account the current aging of the population, the prevalence of some neurological diseases, such as CVA, Parkinson's disease and dementia will rise. Priority setting for care and treatment is hampered by differences in burden of illness on the individual and on the community level.