Healthcare in Europe and in the USA
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- Laureen Oliver
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1 Healthcare in Europe and in the USA Presentation of the results CHAM th September 2010
2 Technical pieces of information Studied countries and historical background: : Germany France Italy UK Sweden : Germany France Italy UK Sweden Poland 2010 : Germany France Italy UK Sweden Poland USA Austria Technical pieces of information: Telephone interviews Respondents profile: general public, aged18+ Sample size: 3600 interviews : 400 per country and 800 in the USA. Representativeness (per country) ensured by quotas set on age, gender, SEC class and region. 2
3 Introduction Studied topics: 1. Assessment of the healthcare system and of quality of care 2. Focus on doctors competence and training 3. Healthcare and social requirements 4. Patients mobility for access to treatment 5. New technologies 6. Prevention 7. Management of ageing and dependent people 8. Comparison across countries 3
4 1 Assessment of the healthcare system and of quality of care 4
5 1 Healthcare system How would you evaluate the organisation of the health system in [FR/UK/GE/IT/PO/SU/US] today? Excellent Very good Good Average Poor DK 5
6 1 Healthcare system synthesis using the scores How would you evaluate the organisation of the health system in [FR/UK/GE/IT/PO/SU/US] today? Score «organisation of the health system» Excellent = 5 Very good =4 Good = 3 Average = 2 1,9 2,2 2,5 2,5 2, ,4 Poor = 1 Pologne Italie Allemagne USA France Suède UK Autriche 6
7 1 Healthcare system synthesis using the scores How would you evaluate the organisation of the health system in [FR/UK/GE/IT/PO/SU/US] today? And is the quality of health care provided when consulting a general practitioner? And, in your opinion, is the quality of care provided during hospital stays? Score «organisation of the health system» Score «quality of health care provided by a GP» Score «quality of care provided during hospital stay» Excellent = 5 Very good =4 Good = 3 Average = 2 2,8 2,7 2,6 2,5 2,2 1,9 3,5 3 3,4 3 2,5 2,5 3,4 3,1 2,7 3,4 3,4 3, ,5 3,5 3,4 Poor = 1 Pologne Italie Allemagne USA France Suède UK Autriche 7
8 1 Healthcare system Evolution since 2006 of the opinions on the health system s organisation Excellent = 5 Very good =4 3,6 Good = 3 Average = 2 2,8 2,3 2,4 2,4 2,5 2,8 2,7 2,7 2 2,2 2,4 2,2 2,8 2,8 3 2,9 3,1 2,5 3 1,9 1,7 Poor =
9 1 Healthcare system Evolution since 2006 of the opinions on the quality of health care provided by a GP Excellent = 5 Very good =4 3,7 Good = ,4 3,2 3,1 3,4 3 2,6 2,6 2,7 3,4 3,4 3,4 3,2 3,1 3 3,1 2,5 2,8 Average = 2 Poor =
10 1 Healthcare system Evolution since 2006 of the opinions on the quality of care provided during hospital stay Excellent = 5 Very good =4 3,6 3,4 Good = 3 2,9 2, ,1 3,1 3, ,1 3 3,5 3,2 3,4 2,6 Average = 2 2,2 2,3 2,5 2,5 2,1 Poor =
11 1 Healthcare system Threats on the health system In the coming years, our health system will have to face several threats, which I am going to read to you. For each of them, do you feel that the threat is very important, somewhat important, not really important or not at all important? Total : very important Lack of public funding Increase in direct costs for individuals Increase in prices for medical procedures Unequal access to health care
12 1 Healthcare system Threats on the health system In the coming years, our health system will have to face several threats, which I am going to read to you. For each of them, do you feel that the threat is very important, somewhat important, not really important or not at all important? Total : very important Waiting time before receiving treatment Shortage of general practitioners Risks of getting an infection in hospital Medical errors
13 1 Healthcare system Constant improvements in the quality of treatments are leading to additional spending. To pay for these additional costs, what do you think is the best solution? Increase taxes or compulsory contributions Increase private insurance, optional supplemental insurance or supplemental policies from mutual insurance companies Pay a greater excess for each medical service DK
14 2 Focus on training / communication: perception of doctors training and competence 14
15 2 Focus on training/ communication synthesis on doctors competence Let's talk about the competency of doctors in [FR/UK/GE/IT/PO/SU/US] At the moment how do you rate their technical skills (for diagnosis and treatments)? At the moment, how do you rate their interpersonal skills (to inform and explain)? How do you rate the sharing of information and the coordination of care between the hospital doctors and general practitioners? Excellent = 5 Score technical skills (for diagnosis and treatments) Score interpersonal skills Score sharing of information and the coordination of care Very good =4 Good = 3 Average = 2 3,3 3,5 2,9 2,9 2,6 2,6 2,9 2,7 2,4 3,4 3,4 3 3,1 3 2,7 2,6 2,3 2,2 3,5 3,6 3,2 3 2,9 2,6 Poor = 1 Allemagne France Italie UK Suède Pologne Autriche USA 15
16 2 Focus on training/ communication synthesis on doctors training How do you rate the training that doctors receive during their medical studies? How do you rate the ongoing knowledge acquisition that doctors receive throughout their careers? Score training during medical studies Score ongoing knowledge acquisition Excellent = 5 Very good =4 Good = 3 3,2 3,3 2,9 2,9 2,9 2,9 3,5 3,2 3,1 3,4 2,9 2,9 3,3 3,2 3,7 3,4 Average = 2 Poor = 1 Allemagne France Italie UK Suède Pologne Autriche USA 16
17 3 Social requirements 17
18 3 Social requirements Does the current health system guarantee equal access to medical care for all citizens of FR/UK/GE/IT/PO/SU/US? Yes No DK 18
19 3 Social requirements To guarantee all citizens equal access to quality care, are you for or against an increase in contributions/taxes? For Against DK
20 Current affairs 2010 update Have the consequences of the economic crisis caused you to cancel or postpone health care actions such as visits to the doctor, tests, surgical procedures, dental care or prescription drug purchases? Yes, I have already done so Yes, I may be forced to do so No, it will not change anything DK
21 Current affairs 2010 update Have the consequences of the economic crisis caused you to cancel or postpone health care actions such as visits to the doctor, tests, surgical procedures, dental care or prescription drug purchases? points + 12 points + 5 points + 12 points Yes, I have already done so - 2 points
22 4 - Mobility 22
23 4 Mobility Imagine that you need surgery. Would you prefer to go to...? A specialised surgeon from a distant city A generalist surgeon close to where you live DK
24 4 Mobility Would you be willing to travel abroad to gain access to a medical technique that you feel to be of identical quality but at a lower price than in [FR/UK/GE/IT/PO/SU/US]? Yes No DK
25 4 Mobility Imagine that you are choosing a holiday destination abroad. How much importance do you give to local health conditions when you are choosing your holiday destination? Considerable importance Little importance No importance at all DK
26 4 Mobility Now imagine that you had to go and live in another country. How much importance do you give to the proximity of doctors and hospitals to your new place of residence? Considerable importance Little importance No importance at all DK
27 5 New technologies 27
28 5 New technologies Do you use the Internet for information relating to healthcare? Yes, regularly Yes, occasionally No, never DK
29 5 New technologies Do you use the Internet for information relating to healthcare? Yes, regularly Yes, occasionally points +14 points +21 points +2 points points +10 points
30 5 New technologies Do you dare to talk with your doctor about health information that pertains to you that you saw on the Internet? (To those who use the Internet for information relating to healthcare ) Yes No DK
31 5 New technologies What do you expect from a doctor with regard to health information available on the Internet? That he explain to me the aspects I did not clearly understand That he provide additional information beyond what I found That he tell me about reliable websites
32 5 New technologies Are you in favour or not in favour of the development of on-line medical consultations? In favour Not in favour DK
33 5 New technologies Are you in favour or not in favour of the development of continuous in-home monitoring resources over the telephone or Internet (e.g. measurement of blood pressure and heart rate)? In favour Not in favour DK
34 5 New technologies Do you think that these in-home medical surveillance or monitoring resources over the telephone or Internet? Enable more patients to be independent in their homes Will dehumanise medicine
35 5 New technologies - synthesis Are you in favour or not in favour of websites where doctors can be assessed? Are you in favour or not in favour of websites where hospitals can be assessed? In favour of websites where hospitals can be assessed ( les y.o. most in favour ) In favour of websites where doctors can be assessed?(18-39 y.o. most in favour) Allemagne France Italie UK Suède Pologne Autriche USA 35
36 6 Prevention 36
37 Current affairs 2010 update To prevent risks stemming from the appearance of new epidemics like bird flu, mad cow or the A/H1N1 flu, do you want the State to spend...? More No change Less DK 37
38 6 Prevention Have had a check-up at the dentist during the last year Have been for a check-up over the last five years Have been tested for a serious disease like cancer or AIDS overs the last five years Are interested in a lifelong health monitoring programme Allemagne France Italie UK Suède Pologne Autriche USA 38
39 6 Prevention -synthesis It is now possible to purchase a lifelong health monitoring programme which includes preventive consultations and an annual personalised check-up. Are you personally interested in this monitoring programme? Who would pay? (Aux intéressés) / How? Interested in and payment Via the employer Via taxes Direct payment via the insurance Not interested DK
40 6 Prevention In the context of your job, do you feel that you need health programmes for...? Total «yes» Back pain Stress management Detecting serious illnesses Obesity prevention Preventing risks related to tobacco, alcohol or drug use
41 7 the 5 th risk: management of ageing and dependent persons 41
42 7 Ageing In your opinion, the care given to dependent elderly people is Excellent Very good Good Average Poor DK 42
43 7 Ageing Given the problems raised by increasing life spans and the rise in the number of dependent elderly people, which of the following should be our priority today? Home care Retirement homes DK
44 7 Ageing Currently in our country, the public assistance provided to help dependent or elderly people stay in their homes is Absolutely satisfactory Somewhat satisfactory Somewhat unsatisfactory Absolutely unsatisfactory DK 44
45 7 Ageing Outside of their families, which organisation provides dependent elderly people with the best support to help them stay in their homes? Non-profit organisations Private entities Public entities None DK 45
46 7 Ageing To help dependent elderly people stay in their homes, do you think we must develop...? Home care jobs Remote monitoring which makes living at home safer Robotics which make it possible to perform daily tasks
47 7 Ageing Two solutions are possible to finance services and daily care for elderly and dependent people : public funding stemming from taxes and compulsory public contributions, or cost totally met by the individual or the family either from a personal insurance policy or direct payment. Which of the following financing options would you most support? Total coverage by taxes and compulsory public contributions Mix of state funding and personal/ family contributions Cost totally met by the individual or the family DK
48 7 Ageing Are you for or against compulsory private insurance to cover the costs of daily living for dependent elderly people? Are you for or against compulsory public insurance to cover the costs of day to day living for dependent elderly people? For a compulsory public insurance For a compulsory private insurance Allemagne France Italie UK Suède Pologne Autriche USA 48
49 8 Comparison across countries 49
50 8 Comparisaon across countries Of these seven countries, where does one receive the best care? Germany UK USA France Italy Poland Sweden 50 / / 3 67 / 4 38 / 11 4 / 0 31 / 1 46 / 6 XX / YY : perception of country s interviewees vs. perception other countries interviewees 50
51 8 Comparisaon across countries Of these seven countries, where does one get the best reimbursement of health care spending? Germany UK USA France Italy Poland Sweden 48 / / 4 69 / 3 20 / 7 2 / 0 28 / 3 27 / 1 XX / YY : perception of country s interviewees vs. perception other countries interviewees 51
52 8 Comparisaon across countries Of these seven countries, which one is the most advanced in new health care technology? Germany UK USA France Italy Poland Sweden 18 / 9 13 / 2 2 / 0 20 / 2 22 / 8 50 / / 0 XX / YY : perception of country s interviewees vs. perception other countries interviewees 52
53 8 Comparisaon across countries In your opinion, the health sector, which includes activities related to hospitals, medical equipment, treatments, consultations and pharmaceuticals, is an industry that... Contributes to the country's economic growth or is merely a burden for society DK
54 8 Comparisaon across countries 2006/2007/2009/2010: comparaison perception du secteur de la santé In your opinion, the health sector, which includes activities related to hospitals, medical equipment, treatments, consultations and pharmaceuticals, is an industry that... Contributes to the country's economic growth or is merely a burden for society DK
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