Healthcare is in the midst of a storm at the moment, with social changes wrought by ageing populations, technological changes wrought by developments in AI, mobile, genomics, data and so on, and extreme financial pressures making change difficult to fulfil.

It’s a challenge that has resulted in quite considerable variance across Europe.  Earlier this year I wrote about a report commissioned by the Estonian government that analyzed the eHealth ecosystem in five countries: Finland, Germany, Poland, Sweden and the United Kingdom (England), before gauging the public response to data sharing in those nations, and the various obstacles that might prevent sharing from occurring.

Suffice to say, that paper looked primarily at the tech landscape, but a recent EU paper has examined the whole healthcare ecosystem.  The paper provides an in depth analysis of the health systems of each of the 28 member states, including the overall health of the population and any other risk factors present.

The meat of the document are profiles of each member state, but there is also an interesting overview of the challenges facing healthcare more generally, and especially common ground across the continent, and the potential for better collaboration between health systems.

Shared objectives

“Spending only 3% of our health budgets on prevention, compared with 80% on the treatment of diseases, is simply not enough. We need better access to primary care so that the emergency room isn’t people’s first port of call. And we need to enshrine health promotion and disease prevention into all policy sectors to improve people’s health and reduce pressure on health systems. These are just a few of the diagnoses coming out from our 2017 State of Health in the EU report. By offering comprehensive data and insights, we aim to support national health authorities in tackling the challenges and in making the right policy and investment choices. I hope they will make good use of it.” the authors say.

A number of key findings emerged from the analysis:

• Health promotion and disease prevention pave the way for a more effective and efficient health system. Aside from the unbalanced investments in prevention, social inequalities need to be tackled, as illustrated by the differences in cancer screening or physical activity between people with higher and lower income and education.
• Strong primary care efficiently guides patients through the health system and helps avoid wasteful spending. 27% visit an emergency department because of inadequate primary care. Only 14 EU countries require primary care referral for consulting a specialist; 9 other countries have financial incentives for referrals.
• Integrated care ensures that a patient receives joined-up care. It avoids the situation we currently see in nearly all EU countries, where care is fragmented and patients have to search their way through a maze of care facilities.
• Proactive health workforce planning and forecasting make health systems resilient to future evolutions. The EU has 18 million healthcare professionals, and another 1.8 million jobs will be created by 2025. Health authorities need to prepare their workforce for upcoming changes: an ageing population and multimorbidity, the need for sound recruitment policies, new skills, and technical innovation.
• Patients should be at the centre of the next generation of better health data for policy and practice. The digital transformation of health and care helps capture real-world outcomes and experiences that matter to patients, with great potential for strengthening the effectiveness of health systems.

Next steps

Following the presentation to Health Ministries of all EU countries, national authorities can further discuss these reports with the experts of the OECD and the European Observatory on Health Systems and Policies. The voluntary exchanges will be able to take place from the beginning of 2018 and help Ministries to better understand the main challenges and develop the appropriate policy responses