Transcript Title of presentation - Health Consumer Powerhouse

HOW CAN THE DUTCH TOP
PERFORMANCE WORK IN FAVOUR OF
HEALTH CONSUMERS?
Johan Hjertqvist, HCP, at CEE Prague September 24, 2012
About
Health Consumer Powerhouse
Comparing healthcare systems performance in 35 countries from
a consumer/patient view.
Since 2004, more than 40 index editions, available for free.
Index projects financed through unconditional development
grants, similar to medical faculty sponsored research.
Europe
Euro Health Consumer Index
Euro Consumer Heart Index
Euro Diabetes Care Index
Euro HIV Index
Euro Patient Empowerment Index
Nordic COPD Index
Tobacco Harm Prevention Index
Euro Headache Index
Euro Hepatitis Index
2005, 2006, 2007, 2008, 2009, 2012
2008
2008
2009
2009
2010
2011
2011
2012
Sweden, others
Health Consumer Index
Diabetes Care Index
Breast Cancer Index
Vaccination Index
Renal Care Index
Smoke Cessation Index
COPD Index
Advanced Home Care Index
Euro-Canada Health Consumer Index
Provincial Health Consumer Index
Sweden
Sweden
Sweden
Sweden
Sweden
Sweden
Sweden
Sweden
Canada
Canada
2004, 2005, 2006
2006, 2007, 2008
2006
2007, 2008
2007, 2008
2008
2009, Nordic 2010
2010
2008, 2009
2008, 2009, 2010
EHCI growth since 2005
Oooops….The DG Sanco internal design!
Upward and downward
mobility
Some countries seem to survive almost
everything we throw at them!
Netherlands, the Nordics, Belgium, …
UK less stuck in waiting time swamp!
Germany, Austria, Italy not doing too well on
new indicators?
Czech Republic, Slovakia, Croatia crawling
upward!
The Dutch example should provide inspiration!
EHCI 2012
SE
NO
ICE
FI
LU
CZ
CH
HR
AT
PT
MT
There is (and should be!) a significant
positive relationship between money
and outcomes, but some countries are
over-performers, and some are underachievers!
Healthcare somewhat affected by financial crisis?
Longer waiting times for (expensive) elective surgery most
noticeable in countries hit by financial difficulties!
A very slight tendency towards increased private
payment shares
Blue: 2009
Maroon: 2012
Healthcare quality remarkably unaffected by financial crisis?
Infant deaths (per 1000 live births), WHO HfA January 2012
20 countries out of 34 score Green – up from 9 out of 29 in 2007!
Actual medical outcomes keep improving – the
good part of ”physician civil disobedience”?
Why do we not (yet) see clearer
traces of the financial crisis?
Healthcare traditionally weak at measuring
output/outcomes.
“The good old days that never were”
Possible decline in services and access
reported as “soft” rather than “hard” data
– “patient witnesses”
Underlying improvement forces are very
strong!
”The health consumer ladder”
”I need to
navigate and
be in
control”
”I can make
a choice”
”All
healthcare is
not the
same”
”You are
somebody”
EU patient mobility
directive – one year
to go…
(Web)information to the public about which hospitals
have the best results (2012)
Accessibility of European healthcare
(EHCI 2012)
Europe is divided into
”waiting list territory”
(Red) and ”non-waiting list
territory” (Green).
This is remarkably constant
over time, and independent
of GDP/capita.
Accessibility poorly correlated with numbers of
doctors
Source: WHO Health for All database, January 2012
Access to e-Prescriptions
e-Prescriptions are
dependent on Electronic
Patient Records to be
meaningful
Source: Empirica, Bonn (2012)
Websites with comprehensive information about all
registered pharmaceuticals (OTC and Rx)
Austria: www.austriacodex.at/avmain/ http://pharmaweb.ages.at/index.jsf
Belgium: http://www.bcfi.be/, www.pharma.be
Croatia: http://www.almp.hr/?ln=hr&w=lijekovi
Czech Republic: www.zdravotnickenoviny.cz/scripts/modules/catalogue/search.php?catalogueID=2
Denmark: http://medicin.dk/
Estonia: www.raviminfo.ee
Finland: www.fimea.fi/lakemedel/produktresumeer/humpl
France: www.doctissimo.fr
Germany: www.onmeda.de
Hungary: www.ogyi.hu/drug_database/
Ireland: www.medicines.ie
Italy: www.prontuariofarmaci.com
Latvia: http://www.zva.gov.lv/index.php?id=375&sa=375&top=334
Malta: http://medicinesauthority.gov.mt/products/search.htm
Netherlands: www.cbg-meb.nl/CBG/en/human-medicines/geneesmiddeleninformatiebank/default.htm
Norway: www.legemiddelverket.no/custom/Preparatsok/prepSearch____80333.aspx?filterBy=CopyToConsumer
Portugal: www.infarmed.pt/infomed/inicio.php
Romania: www.anm.ro/en/html/pharmacopoeia.html
Slovakia: www.liekinfo.sk
Slovenia: www.zdravila.net
Sweden: www.fass.se
Switzerland: www.kompendium.ch
U.K.: http://emc.medicines.org.uk/
If anything, drug information available to patients
seems to contain drug spending (2009)!
Numbers denote
total drug sales per
capita (€/year)
(Source: EFPIA)
Dutch inspiration
Getting rid of politicians!
Separation of funding and provision
Competition
Consumer choice a driver
Transparency on offers and
performance
Thank you!
All HCP Index information at:
www.healthpowerhouse.com
An electronic version of this presentation is available at www.ceehpn.eu