Bad Hofgastein, 2 October 2014 – How to improve health system efficiency on all levels, starting at the top with better organisation of health care providers such as hospitals, to individual health professionals improving their performance to the individual patient or citizens switching to a more health-conscious behaviour: These questions were on the agenda of a high-level expert discussion at the European Health Forum Gastein (EHFG). “We have evidence in certain areas that these measures work”, Emeritus Professor of Health Policy at London’s Imperial College Business School Peter Smith explained. “For instance, sharpening competition in providers can lead to improvement, better IT-systems in hospitals lead to better performance. New models of integrated services work well in particular with chronic diseases; if stroke patients are well looked after by their primary care physician it significantly improves not only life expectancy but also health costs.”
Some countries are clearly performing better than OECD average, according to rankings, “but experts struggle to understand what the exact mechanisms are”, Prof. Smith said. “In my view, the big areas that we need to tackle to improve health care efficiency are the reconfiguration of services, improving funding mechanisms and providers and tackling health-related behaviour in the general population.”
One example of successful reconfiguration of services was the reorganisation of stroke services in London, which reduced the number of hospitals offering specialist stroke care from 34 general hospitals to eight “hyper acute stroke units”, with substantial improvements in patient outcomes and reductions in costs. In Germany, successful new funding mechanisms are in place for long term disease management for chronic diseases, which include additional remuneration for documentation and the ability of patients to enrol in long-term training courses to better manage their disease.
New generation of health data
The next step on the road to improve the efficiency of health systems now is a “new generation of health data”, Francesca Colombo, Head of the OECD’s Health Division, told the EHFG. “This is a topic that all governments are working on – the huge opportunities created by linking a large variety and volume of data from medical health records, biological data and administration data.” Of course the issue of data privacy is a sensitive issue, but “let me be clear, this issue will be respected. However, it should also be understood that it is less the data themselves but the picture painted by linking them that will allow health care providers to see what level of care patients actually receive, be it in a nursing home or in hospital. This revolution in data technology poses a huge advantage for the research regarding quality and outcome of health care; the insights gained here are fundamental for improving performance.”
One of the new programs in this respect has been the ‘European Health Care Outcomes, Performance and Efficiency’ or ‘EuroHOPE’ project, launched in 2010 to evaluate the performance of European health care systems in terms of outcomes, quality, use of resources and costs of among others acute myocardial infarction (MCI) stroke or low-birth-weight infants. To quote just one of many examples: Massive differences can for instance be seen regarding the length of acute hospital days after MCI: 19,4 days in Zala, Hungary, compared to 6,2 days in the Värmlands Län region of Sweden (http://www.eurohope.info/map/atlas.html).
Francesca Colombo: „In times of crisis, governments everywhere are more careful when allocating health care budgets, they need to know if they are investing in the right things so as to avoid letting a tight budget lead to health care inequity. The right data form the basis of these difficult decisions.”
“Electing Health – The Europe We Want” is the motto for this year’s EHFG. Around 600 participants from more than 50 countries are attending the most important health policy conference in the EU to exchange view on key issues affecting European health systems. The future direction of European health policy is the key topic on the conference agenda.
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