European healthcare service on the up, but disparities between countries remain

A survey of national healthcare systems in 35 European countries shows an overall - but uneven - improvement in service delivery.

By Colin Mackay

27 Jan 2016

The Health Consumer Powerhouse, a think tank providing open comparisons of healthcare systems performance, has released the latest version of its flagship Euro Health Consumer Index (EHCI). This Index ranks the consumer friendliness of healthcare systems in 35 countries

The good news is that it shows that the overall standards of healthcare have improved steadily since the publication of the first index in 2006. Survival rates for cardiovascular disease, stroke and cancer are increasing, while infant mortality is falling.

However, the improvements have not been universal. The EHCI ranks national healthcare systems by their user-friendliness for consumers, and it appears there is an established hierarchy. Perhaps predictably, well-funded healthcare systems perform strongly, while a large number of eastern European nations regularly populate the lower reaches.


This trend is not universal however, as Spain, Portugal, Ireland, Italy and Greece all lie in the lower half of the rankings. This may partly reflect the impact of austerity and budget cuts in those countries (although Greece has never been a strong performer). However, Slovenia, Croatia and Estonia are all in the top half of the rankings, as is the Czech Republic, occupying 13th position, ahead of the UK.

The findings may come as a disappointment to Britain, which is fondly attached to its centrally-funded National Health Service model. However, the EHCI has consistently shown that for larger countries, a social insurance model - the so-called 'Bismarck system', independent of healthcare providers, provides better levels of care.

According to Johan Hjertqvist, President of the Health Consumer Powerhouse, there is cause for cautious optimism. He points out that the score that topped the inaugural index in 2006 would only rank them 13th in 2016.
This, he said, "has happened in spite of financial tensions, integration challenges and political turmoil in many countries." In addition, he felt that the gap between richer and poorer nations was gradually closing.

Hjertqvist also applauded the European Commission's announcement that it plans to begin its own assessment of the cost effectiveness of EU member state health systems.
"The HCP welcomes this engagement," he said, "the impact of the EHCI over the last ten years has demonstrated that open benchmarking does drive improvements in healthcare delivery."



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