Not enough prevention: EU health systems report

European health services

(BRUSSELS) – Only 3 per cent of EU countries’ health budgets is spent on prevention, with 80 per cent spent on treatment of diseases, the EU Commission reported on Thursday in a set of 28 ‘country health profiles’.

The reports, along with a ‘companion report’, suggest a rethinking of European health systems is needed to ‘ensure they remain fit-for-purpose and provide patient-centred care’.

“We need better access to primary care so that the emergency room isn’t people’s first port of call,” said Health Commissioner Vytenis Andriukaitis: “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.”

The reports provide an in-depth analysis of EU Member States’ health systems. They look at the health of the population and important risk factors, as well as at the effectiveness, accessibility and resilience of health systems in each EU member state. The reports clearly reflect shared objectives across the member states, and reveal potential areas where the Commission can encourage mutual learning and exchange of good practices.

A lack of context-sensitive, comprehensive analysis has been identified as a long-standing obstacle for health policy-makers. To fill this knowledge gap, this month the Commission completed the first two-year cycle of the State of Health in the EU.

Key findings

The Country Health Profiles were prepared in cooperation with the OECD and the European Observatory on Health Systems and Policies. Five cross-cutting conclusions come forward in the Companion Report:

  • 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.

National authorities are now expected to discuss the reports with experts of the OECD and the European Observatory on Health Systems and Policies. 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.

Commission website: 28 Country Health Profiles, the Companion Report and more background information

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