HOPE
Hospitals in Europe:
Healthcare data
The figures given in the present document are providing the most updated comparative picture
of the situation of healthcare and hospitals, compared to the situation in 2006
Pascal Garel
HOPE Chief Executive
Isabella Notarangelo
HOPE Health Economist
For several years, hospitals have been required to
act more efficiently and to increase productivity.
Increased performance is indeed visible. Yet,
healthcare systems are facing conflicting trends:
short and long-term impacts of financial and
economic restrictions; increasing demand of an
ever-expanding and ageing population, which
leads to more chronic patients; increasing
requests and availability of technological
innovations; and new roles, new skills and new
responsibilities for the health workforce.
To adapt to this situation, the role of hospitals
is evolving further. Most health systems have
already moved from a traditional hospital-centric
and doctor-centric pattern of care to integrated
models in which hospitals work closely with
primary care, community care and home-care.
The figures given in this article provide the
most up-to-date comparative picture of the
situation of healthcare and hospitals, compared
with the situation in 2006. The figures aim to
increase awareness on what has changed in
hospital capacity and, more generally, in
secondary care provision within European Union
member states, generating questions and
stimulating debate, and in this way fostering
information exchange and knowledge sharing.
The main source of data and figures is OECD
Health Statistics (last update November 2018).
Data on health expenditure as a percentage of
total general government expenditure and on
hospital beds in public or private owned hospitals
have been extracted from the Eurostat Database
on Economy and Finance (last update March 2019)
and on Health (last update July 2018), respectively.
All European Union member states belonging to
OECD are considered, plus Switzerland and Serbia
(as HOPE has observer members in these
countries), when data are available. In the text,
these are reported as EU. Whenever considered
appropriate and/or possible, two groups have
been differentiated and compared: EU15, for the
countries that joined the EU before 2004 (Austria,
Belgium, Denmark, Finland, France, Germany,
Greece, Ireland, Italy, Luxembourg, Netherlands,
Portugal, Spain, Sweden and United Kingdom)
and EU13, for the countries that joined the EU
after 2004 (Bulgaria, Cyprus, Czech Republic,
Croatia, Estonia, Hungary, Latvia, Lithuania,
Malta, Poland, Romania, Slovakia and Slovenia).
When averages are reported, they result from our
own calculations. The considered trends normally
refer to the years 2006–2016. When data on 2016
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HHE 2019 | hospitalhealthcare.com
are not available, or they have not been gathered
for a sufficient number of countries, the closest
year is considered. Some figures are disputed for
not being precise enough but at least they give a
good indication of the diversity.
Financial resources for healthcare
From 2006 to 2016, about 50% of the total current
health expenditure expressed in purchasing
power parity (PPP$) per capita increased on
average in the EU. Inpatient care, out-of-pocket
payments and pharmaceutical expenditures grew
in the considered years as well.
In EU15, the range of total current health
expenditure per capita in 2017 was between 2325
PPP$ in Greece and 6475 PPP$ in Luxembourg,
whereas in EU13, this range varied from 1722
PPP$ in Latvia to 2775 PPP$ in Slovenia. In
Switzerland, this indicator reached 8009 PPP$.
Compared with 2006, the total health
expenditure per capita in 2016 varied positively
in all the countries taken into consideration in
this analysis, except in Greece, where the
decrease was –12%. Major increases have been
registered in EU13: Estonia (+110%), Lithuania
(+107%) and Poland (+103%). Smaller increases
were registered in Spain (+36%), Italy (+25%) and
Portugal (+24%), all belonging to EU15.
Current public health expenditure includes all
schemes aimed at ensuring access to basic health
care for the whole society, a large part of it, or at
least some vulnerable groups. Included are
government schemes, compulsory contributory
health insurance schemes, and compulsory
medical savings accounts. Current private health
expenditure includes voluntary health care
payments schemes and household out-of-pocket
payments. The first component includes all
domestic pre-paid health care financing schemes
under which the access to health services is at the
discretion of private individuals. The second
component corresponds to direct payments for
health care goods and services from the
household primary income or savings: the
payment is made by the user at the time of the
purchase of goods or use of service.
In 2017, the percentage of public sector health
expenditure to the total current health
expenditure was higher than 70% in most
countries, except for Latvia (55%), Greece (61%),
Portugal (67%), Hungary (67%), Lithuania (67%)
and Poland (69%) and, outside the EU, in
Switzerland (63%).