Survey outlines disparities in EU healthcare systems


Countries that have initiated reforms, such as Austria and Estonia, have gone up in the ranking of the most user-friendly healthcare systems, according to the 2007 EuroHealth consumer index.

The 2007 EuroHealth consumer index, published on 1 October, was put together from publicly-available statistics and data from a private Swedish company, Health Consumer Powerhouse.   

It lists Austria’s public healthcare system as the most user-friendly, up from 8th in 2006  (see EURACTIV 26/06/06). Johan Hjertqvist, president of index creators Health Consumer Powerhouse (HCP) highlighted that “there are beacons of hope, since those countries that have put in place reforms, such as Austria, are now amongst the best performers.” 

He also pointed to Estonia which moved up the ranking from 20th to 12th place: “Their commitment to reform has allowed them to out-perform many better-funded services and place them far ahead of all other new member states.”

According to a WHO country report, the Estonian healthcare reform, initiated in the 1990s, established a significant degree of decentralisation in the health system. The reform introduced market incentives, outsourcing of services, increased independence for public hospitals, all of which comprised a total change of the system, outlined Kajsa Wilhelmsson of HCP. She added that these reforms were easier to implement in a small nation of 1.5m habitants such as Estonia.

Surveys and statistics outlined three groups of countries: 

  • a first group of nations performing very well, separated only by tiny differences; 
  • a middle group of adequate performers, with rapid improvers such as Estonia; and;
  • a third group of poor performers – mainly new member states.

However, overall statistics reveal the continuing weak position of European patients as, for example, three quarters of the national healthcare systems require many to wait over three weeks for cancer treatment. Moreover, medical records are inaccessible to the patient in half of member states.

The overall ranking was compiled from 27 indicators of the quality of healthcare systems, divided into five categories, including patient rights and information, waiting time for treatment and pharmaceuticals – that is, access to new treatments – and the speed at which new drugs are deployed.

Some new indicators were introduced, in particular two in the area of ‘e-Health’: ‘Electronic Patient Record penetration in primary care’ and a ‘Registry of legitimate doctors accessible by the public’. 

Following its findings, HCP put together a number of recommendations per country which it hopes decision-makers will take into account in order to improve European healthcare systems.

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