HHE HOPE 2019 - Page 3

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 3 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%).