European index puts The Netherlands ahead in healthcare standards


The Netherlands has come top in the 2009 Euro Health Consumer Index (EHCI), for the second year in a row. Denmark keeps its runner-up position from last year. Besides the Dutch and Danish system there is a small group of strong performers: Iceland, Austria and Switzerland.

There are general improvement trends among most of the measured healthcare systems, with examples of reform making impact not only in Netherlands but in Ireland and the Czech Republic as well. There is continuous decline in the Spanish, Portuguese and Greek healthcare systems and improvement in the Netherlands, Denmark and Iceland. Large parts of Eastern and Central Europe are affected by the financial crisis.

Research director, Dr. Arne Bjornberg, comments "The Netherlands is the best performing country by combining competition for funding and provision within a regulated framework. There are information tools to support active choice among consumers. “

The EHCI is a measurement standard for European healthcare. It ranks 33 national European health care systems across 38 indicators, covering six areas that are key to the health consumer: patients’ rights and information, e-Health, waiting times for treatment, treatment outcomes, range and reach of services provided and access to medication. The Index is compiled from a combination of public statistics, patient polls and independent research conducted by Brussels-based think tank Health Consumer Powerhouse

Johan Hjertqvist of Health Consumer Powerhouse, comments, "With patient mobility growing around Europe there is a strong need for transparency exposing the pros and cons of the national healthcare systems. The EU intends to introduce a cross border care scheme that requires significantly better information to patients. "

The individual category leaders:
* Patient rights and information: Denmark
* Waiting time for treatment: Albania, Belgium, Germany, and Switzerland
* Outcomes: Sweden
* Range and reach of services: Belgium, Luxembourg, and Sweden

While dental and cosmetic surgery tourism are driven by other factors, outbound medical tourism from European countries is driven by cost, waiting times and how good a national healthcare system is. This shows to any agency or hospital targeting Europeans that the likelihood of people travelling and what may make them become a medical tourist differs hugely between countries. 

Germany probably has the most restriction-free and consumer oriented healthcare system in Europe, with patients allowed to seek almost any type of care they wish whenever they want it. The report debunks the myth that German healthcare is excellent but expensive, German healthcare costs are in the middle of the Western European countries.

The report includes all 27 European Union member states, plus Norway and Switzerland, the EU candidate countries of Croatia and Macedonia, plus Albania and Iceland. The Netherlands has a consumer-friendly healthcare system. In Denmark, a determined political effort to improve delivery and transparency of healthcare is paying off.  Germany is improving, as are Ireland, Hungary, the Czech Republic and Lithuania.

Long waiting times are a reason for surgical tourism. In the 31 countries, the worst two are Portugal and the UK. The NHS in the UK recently spent millions on reducing waiting and introduced a target maximum of 18 weeks to definitive treatment after diagnosis. The patient survey shows it has got worse since 2008. “The UK in 2009 has showed surprisingly negative feedback from patient organizations on the waiting time situation, particularly after government spending on the NHS has been increasing heavily”, states Dr. Arne Bjornberg

After the spring 2009 EU directive on cross-border care, the indicator on cross-border mobility was reintroduced. The only three countries scoring well are Denmark, Luxembourg and the Netherlands. Denmark had its 2007 law on free mobility in the EU temporarily suspended between November 2008 and June 2009, but that has now come back into effect. Luxembourg does not have a healthcare services, it lets citizens seek care in neighbouring countries.

There are only three countries – Germany, Denmark and the UK – where the public can go online and compare outcomes at hospitals. Patients may soon be able to travel across European borders for treatment, in line with a new directive on patient mobility. This option, suggests Bjornberg, will only be used by between 3% and 5% of patients, but “It is important to have access to data showing which hospitals are best for particular operations. Once Croatia joins the EU it could become a destination for health tourism because it is relatively inexpensive and has a record of good results. There are no reasons for restrictions on cross-border care. Patient mobility seems to scare healthcare administrators but that's because they are control freaks.” 



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