The EHCI, the 2008 version of which was published on 13 November, is compiled annually. It is based on publicly-available statistics and data from a private Swedish company, Health Consumer Powerhouse (HCP). From 34 indicators of quality, the overall ranking was divided into six categories: e-Health, patient rights, patient information, waiting time for treatment, waiting time for pharmaceuticals, and the speed at which new drugs are deployed.
The EHCI praised the Dutch effort, describing the winning margin as "the biggest since this 31-country ranking started in 2005". The Netherlands was also paraded as "the truly stable top performer" in the EU, primarily due to its successful patient empowerment track record.
The HCP report went on to single out Denmark, Ireland, Czech Republic and Hungary for praise due to their noteworthy improvement ratings. As in 2007, Estonia's cost-effectiveness was highlighted as a "beacon of potential," showing how to deliver "quality performance with relatively low levels of expenditure".
However, a number of repeat offenders were also highlighted in the report, as Central and Eastern European countries – with the "notable exception" of Hungary - again came under fire. Western countries like Portugal, Malta and Cyprus were also criticised for "struggling to deliver adequate levels of care".
The report also gave a damning warning that standards may be falling, particularly in terms of patient waiting times. In 2007, statistics indicated that in almost 55% of the countries surveyed, families were seen by a doctor on the same day that they sought medical care. However, in 2008 this figure had fallen to just 45%. "The same tendency is noticeable regarding cancer treatment within three weeks," warned HCP.
According to HCP, the single greatest reform measure required is better education, both of patients and the general public. This "would provide a marked improvement in care and outcomes," said the report.
Intriguingly, HCP President Johan Hjertqvist urged the future Obama administration in the US to take their cue from the Dutch in healthcare reform: "It is justified to say that the Dutch have the best healthcare system in Europe. When the Obama healthcare policy team looks at Europe for inspiration, it seems to be the right system to study."