Hundreds of thousands of lives and billions of euro each year in Europe could be saved with better public health and prevention policies, according to a review of 36 European countries published by the European Commission and OECD.
The ‘Health at a Glance’ study finds that the premature deaths of 550,000 working age people (25-64 years) from heart attacks, strokes, diabetes and cancer, cost European economies €115 billion or almost one per cent of GDP annually.
“We cannot continue to lose half a million people of working age every year prematurely,” said Health Commissioner Vytenis Andriukaitis. This translates to a deficit of 3.4 million productive years, if you assume these people would have worked to 65, he said.
Preventable deaths and loss to economy, source: OECD 2016
It is not just a problem for the newer EU countries in central and eastern Europe. The UK and Ireland also lag behind in terms of cancer survival rates.
OECD recommends spending more on public health and prevention. “The current level of around 3 per cent of GDP on average is unacceptable. We must do better,” Andriukaitis said.
The OECD notes progress in reducing smoking in most EU countries through a mix of public awareness campaigns, regulations and taxation. Alcohol use and obesity requires more attention however.
More positively, the report finds people are living on average seven years longer than they were in 1990, with life expectancy rising from 74.2 years to 80.9 years.
Data collected from national statistics offices shows survival rates for heart attacks, strokes and several types of cancer have gone up. This is credited to more efficiency in delivering healthcare, more doctors and earlier diagnoses.
The review also finds health budgets, severely hit by the 2008 financial crisis, are recovering slowly but not evenly.
Big countries such as Germany, Sweden and France spend around twice as much, relatively speaking, than countries in the eastern of the EU such as Latvia and Bulgaria.
Ageing populations – 30 per cent of Europe’s population will be over 60 by 2060 – new technology and the high cost of drugs are straining already stretched budgets.
“Naturally, public demand for cutting-edge tech is growing,” said OECD secretary-general Angel Gurría. “And health is the only area where tech is not helping to bring down cost. Everyone wants the best. It used to be where a doctor would say, ‘Take two aspirins and see me in the morning’. Now it’s ‘Take two MRIs and see me after’.”
Patient-reported experience of access and quality of care is highest in the Benelux countries and Denmark and lowest in countries hit in recent times by austerity measures. Poland scores relatively poorly on care experience. Less than one in two patients say they have a chance to ask a doctor questions about their treatment during consultations.
Poor people are 10 times more likely to go untreated because of cost than rich people. In Italy and France, the proportion of people in the low-income bracket reporting unmet care needs due to cost ballooned by 50 per cent between 2008 and 2014. In Greece, the share of poor people reporting unmet medical care needs for financial reasons has more than doubled since 2008, rising from 7 per cent in 2008 to over 16 per cent in 2014.
The OECD praises Belgium and Slovenia in particular for developing care models which put greater emphasis on patients’ needs. In Slovenia, for instance, nurses are being given new care coordination roles, which means they have added responsibility for guiding patients through the health system. Portugal is making a big effort to record patient experience at primary care level.
Norway is singled out for its intermediate care facilities to bridge hospitals and nursing homes. The report also notes plans to introduce an integrated care model in Finland in 2019, covering primary, acute and social care needs.
Several countries are marked highly for expanding the training scope for their health workforce, so they now put a stronger focus on patient education and care management. In Finland for example, pharmacists are increasingly expected to step up and help with treatment and prevention.
Patients’ experience with doctors, source: 0ECD 2016