Tuesday

23rd Jul 2019

Focus

Chronic diseases: forcing change in EU healthcare management

  • Only 3 percent of health care budgets is spent on prevention (Photo: Leaf)

With a growing older population and an overall increase in chronic diseases, Europe is faced with a new kind of health problem.

It is one of slow-progressing irreversible illnesses, such as diabetes, respiratory illnesses and cardiovascular diseases.

Read and decide

Join EUobserver today

Support quality EU news

Get instant access to all articles — and 18 year's of archives. 30 days free trial.

... or join as a group

Over one third of the European population above the age of 15 have a chronic disease and two out of three people reaching retirement age will have at least two chronic conditions, according to the World Health Organisation (WHO).

The number is expected to grow, leading to rising health care costs, lost productivity, and lower quality of life for the patients.

Between 70 to 80 percent of healthcare budgets across the EU are currently spent on treating chronic diseases, according to the European Commission.

And of healthcare budgets in general, 97 percent are spent on treating patients both with acute and chronic conditions.

Only 3 percent is spent on prevention, with chronic diseases being among the most preventable illnesses.

Chronic Disease Management

Traditionally, primary care has been provided by doctors, usually in small practices with few support staff focussing more on acute episodes of care rather than on recurrent cases of chronic conditions.

But chronic disease management is a way of coordinating care that focuses on the entire clinical course of a disease - across care networks and with the patient more actively involved.

The patient is the day-to-day manager of disease. But to support patients in controlling their disease, a better environment needs to be created where citizens have more ‘health literacy’.

While most European countries have already implemented some sort of strategy to control the burden of chronic disease, their approaches vary greatly.

Most chronic disease plans show that a successful management plan can benefit the care progress, increase patients’ well-being, and lower healthcare costs.

Fragmentation - a major obstacle

A report by the World Health Organisation says that Disease Management Programmes focussing on a single disease have “increasingly come under pressure”.

“Doctors and researchers admit they have focused on a straightforward disease management approach because it was relatively simple.”

The European Patients’ Forum (EPF) says that chronic-disease sufferers regularly say that a fragmented health and social care system are a “major obstacle” to quality of care.

Problems include internal resistance to change, as well as a fixed way of spending budgets.

“The result of this organisational and financial fragmentation is that patients often need to actively “fight the system” just to get the services they need”, says EPF.

While Scandinavian countries are generally considered much more advanced in dealing with chronic diseases, there has been no large-scale evaluation of the situation across Europe.

One EU project (CHRODIS) looks at chronic care plans across Europe but is focused mainly on cardiovascular diseases, strokes and type-2 diabetes.

“It is really very important to extract the best knowledge that has been developed in the past few years of experience in managing chronic diseases in order to know what we are doing in Europe,” says Juan E. Riese, director of the CHRODIS project.

“Europe is a very complicated picture - it is a sum of countries, regions, culture and traditions,” he adds.

“The aim of the whole project is really to identify what is going on in the area of chronic disease management.”

Prevention and communication

There are also differences in how EU member states fund their healthcare model.

Some are funded by taxes while others are funded through a social health insurance. The revenue source can have an impact on the integration of care models.

Another step towards improving European healthcare and chronic care management is eHealth - healthcare practice supported by electronic processes and communication - to better facilitate care to patients.

The incoming EU health commissioner Vytenis Andriukaitis has already pledged support for improving healthcare systems, although the commission has limited power in this area.

“I will support efforts to make health systems more efficient and innovative; so that they can provide equitable healthcare to all citizens,” he said.

Andriukaitis also said he will focus on “prevention” over the coming five years.

“I intend to put much focus on enhancing prevention. I believe that the more health systems invest in prevention now, the less they will pay in treatment in the future,” he added.

Chronic Diseases

Chronic diseases are the main cause of death and disability in Europe and the growing trend is straining the region’s healthcare budgets. EUobserver examines the issues.

News in Brief

  1. Agriculture MEPs elect far-right vice-chair
  2. Johnson is next British prime minister
  3. Johnson set to be announced British PM on Tuesday
  4. UK-based owners of .eu domains could keep name
  5. Weyand: EU would respond to US tariffs on cars
  6. UK foreign office minister quits ahead of Johnson as PM
  7. AKK to boost Bundeswehr budget to Nato target
  8. Police arrest 25 after Polish LGBT-march attack

Chronic Diseases

Chronic diseases are the main cause of death and disability in Europe and the growing trend is straining the region’s healthcare budgets. EUobserver examines the issues.

Stakeholders' Highlights

  1. UNESDAUNESDA reduces added sugars 11.9% between 2015-2017
  2. International Partnership for Human RightsEU-Uzbekistan Human Rights Dialogue: EU to raise key fundamental rights issues
  3. Nordic Council of MinistersNo evidence that social media are harmful to young people
  4. Nordic Council of MinistersCanada to host the joint Nordic cultural initiative 2021
  5. Vote for the EU Sutainable Energy AwardsCast your vote for your favourite EUSEW Award finalist. You choose the winner of 2019 Citizen’s Award.
  6. Nordic Council of MinistersEducation gets refugees into work
  7. Counter BalanceSign the petition to help reform the EU’s Bank
  8. UNICEFChild rights organisations encourage candidates for EU elections to become Child Rights Champions
  9. UNESDAUNESDA Outlines 2019-2024 Aspirations: Sustainability, Responsibility, Competitiveness
  10. Counter BalanceRecord citizens’ input to EU bank’s consultation calls on EIB to abandon fossil fuels
  11. International Partnership for Human RightsAnnual EU-Turkmenistan Human Rights Dialogue takes place in Ashgabat
  12. Nordic Council of MinistersNew campaign: spot, capture and share Traces of North

Latest News

  1. Macron: 14 EU states agree on a migration 'mechanism'
  2. As Johnson set to become PM, ministers pledge to resign
  3. Poland's PiS prepares 'failsafe' for October election
  4. Abortion Wars
  5. EU goes on holiday as new UK PM arrives This WEEK
  6. Survey: Half of EU staff 'don't know' ethics rules
  7. Von der Leyen signals soft touch on migrants, rule of law
  8. Timmermans: von der Leyen will be tough on rule of law

Stakeholders' Highlights

  1. Nordic Council of MinistersLeading Nordic candidates go head-to-head in EU election debate
  2. Nordic Council of MinistersNew Secretary General: Nordic co-operation must benefit everybody
  3. Platform for Peace and JusticeMEP Kati Piri: “Our red line on Turkey has been crossed”
  4. UNICEF2018 deadliest year yet for children in Syria as war enters 9th year
  5. Nordic Council of MinistersNordic commitment to driving global gender equality
  6. International Partnership for Human RightsMeet your defender: Rasul Jafarov leading human rights defender from Azerbaijan
  7. UNICEFUNICEF Hosts MEPs in Jordan Ahead of Brussels Conference on the Future of Syria
  8. Nordic Council of MinistersNordic talks on parental leave at the UN
  9. International Partnership for Human RightsTrial of Chechen prisoner of conscience and human rights activist Oyub Titiev continues.
  10. Nordic Council of MinistersNordic food policy inspires India to be a sustainable superpower
  11. Nordic Council of MinistersMilestone for Nordic-Baltic e-ID
  12. Counter BalanceEU bank urged to free itself from fossil fuels and take climate leadership

Join EUobserver

Support quality EU news

Join us