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Evolving Healthcare Delivery to Face Europe’s Demographic Challenges

powrie smith

The keynote at the European Health Forum Gastein was given by Nobel prize winning economist, Paul Krugman. Entitled Greying baby boomers – a two-fold challenge, he examined the implications of an ageing population and falling birth rates for healthcare in Europe.

A United Nation population projection suggests that by 2025, there are expected to be another 1 billion people across the world, boosting the total to 9.6 billion. With most of this increase set to occur in Africa, or countries with already large populations, such as China or Brazil, you might be forgiven for thinking that the direct impact on Europe may be limited.

The problem is that Europe is sitting on a demographic time bomb of its own. The European Commission notes that by 2020, a quarter of Europeans will be over 60 years of age and the UN “World Population Prospects: 2015 Revision” report emphasises that 34 % of the European population will be above 60 by 2050.

There is also the issue of a falling, or relatively flat birth rate in Europe. In 2014, 5.1 million children were born in the EU-28, which reflects a crude birth rate – the number of live births per 1 000 persons – of 10.1. This compares with 10.6 in 2000, 12.8 in 1985 and 16.4 in 1970.

An ageing population, falling birth rate and a shrinking work-age population leaves Europe facing some difficult healthcare and economic choices. Fewer young people will be paying into the coffers – be it in tax- or insurance-based systems. At the same time, the growth in the elderly population means increased prevalence of chronic diseases such as diabetes, cancer and heart disease. Between the ages of 45 and 65, the incidence of heart disease more than doubles, and over a quarter of people aged 85 years and over lives with dementia. All this means that the sustainability of European health systems is a cause for concern.

But just before the health policy audience at Gastein began hyperventilating in to their hessian conference bags, Krugman made a couple of key points. It is his belief that healthcare spending could be stabilised as an acceptable percentage of GDP. He noted that few countries do everything right in designing healthcare and pension systems, but that these differences often have historical reasons are therefore are possible to change and reform. There is therefore great room for learning from each other, through looking at the systems that deliver the best results in the most effective way. The question on the minds of all of us in the room…… What do those policies and systems look like? Even with a Nobel prize poking out of your rucksack, its perhaps ambitious to expect Prof Krugman to provide these answers in a 30 minute session.

It is clear that these challenges need a new way of thinking about how we manage healthcare. Meeting the rising demand by focusing resources on the things that really make a difference to patients and disinvesting in the things that don’t. This is outcomes-focused healthcare, that many stakeholders, including EFPIA, believe holds the key to a healthier future for Europe.

In the subsequent panel session, Professor Fabio Pammolli made the case for investing in health IT to track technologies and to make it possible to pay for the outcomes an intervention delivers. Essentially paying for the value delivered to the patient, to the healthcare system and to society.

EFPIA is keen to engage in the debate on how we move to a more outcomes focused healthcare system. You can find out more here and we are keen to hear your views via #healthierfuture.

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