Diapositive 1

1
(No Transcript)
2
Introduction
3
Introduction

• Cercle Santé Société and the Europ Assistance
  Group have launched an annual survey to serve as
  a barometer of  the attitudes and practices of
  European citizens with respect to their
  healthcare systems .
• Nowadays, the main issue is not to debate the
  amount that is to be spent on healthcare, but to
  understand Europeans needs and expectations
  regarding healthcare. These needs are rapidly
  changing, due to the ageing of the population on
  one hand and the emergence of new technologies on
  the other, as well as the development of social
  structures both at the State and the corporate
  level. The healthcare sector also plays an
  economic role of its own How is this role
  perceived by Europeans, especially now that more
  and more borders are open and mobility has become
  an aspect of modern healthcare ?

4
Introduction

• Seven topics were covered in this first survey
• The healthcare system evaluation of the
  organisation and the quality of healthcare
  services.
• Mobility issues and expectations
• New technologies opportunities and limitations
• Social requirements and financing priorities
• Prevention needs and expectations
• Ageing care solutions and responsibility
• The place of healthcare in society How informed
  is the European public and what are their
  expectations ?

5
Introduction

• The five countries surveyed are different in the
  way they organise their healthcare systems. These
  differences may explain the various, or even
  opposing, opinions held by Europeans.
• These countries primarily differ from one another
  in
• access to Social Security
• access to Clinic Visits

6
Methodology
7
Methodology

• The sample comprises 2 011 individuals from five
  countries
• 400 German
• 407 French
• 400 Italian
• 404 British
• 400 Swedish
• These five country samples are representative of
  the national population aged 18 for each
  country, based on Eurostats data

8
Methodology

• Data collection was conducted by phone (CATI)
• Fieldworks took place in the following countries
  
• Germany From the 25th of October to the 2nd of
  November 2006
• France On the 30th of October 2006
• Italy From the 25th of October to the 2nd
  November 2006
• United Kingdom From the 25th of October to the
  3rd of November 2006
• Sweden From the 26th of October to the 2nd of
  November 2006

9
Methodology

• Sampling
• Random drawing from a list of phone subscribers
• Stratification by region
• Quotas on age and gender
• Control by SEC and dwelling

10
Results
11
1 The healthcare system
12
The healthcare system an average level of
satisfaction on organisation and a higher level
on quality of healthcare
1 The healthcare system
OVERALL
2 011
400
407
400
404
400

• Although, overall, Europeans in all the five
  countries had a mostly positive opinion of the
  organisation of their healthcare system, the
  quality of hospital services and the quality of
  clinic visits, their respective levels of
  appreciation of these different components varied
  significantly from one country to the next.
• The level of satisfaction was highest in France
  and Sweden, while the Italians appeared to be the
  least satisfied by their healthcare system.

13
European are anxious about public financing and
waiting time before being treated
1 The healthcare system
Q4. In your opinion, what are the 2 most
important threats facing our health service in
the next few years ?
Base 2 011
14
Difference in concerns about healthcare service
depending on country
1 The healthcare system

• Lack of public financing a threat in all
  countries, except in Sweden
• Waiting time to get treatment a fear
  essentially felt in Italy and Sweden
• Lack of qualified doctors a threat which
  worries French people in particular
• Risk of nosocomial infection especially in the
  UK
• Medical errors and new epidemics Lesser concern
  for all countries

Lack of public financing
61
Lack of qualified doctors
36
Base 400
Lack of qualified doctors
51
Lack of public financing
48
Base 407
Waiting time to get treatment
63
Lack of public financing
47
Base 400
Lack of public financing
48
Risk of nosocomial infection
Base 404
44
Waiting time to get treatment
63
36
Base 400
Lack of qualified doctors
15
2 Mobility
16
A global trend concerning mobility to obtain
specialised healthcare, although there are some
disparity between countries
2 Mobility
Q5. With regards to the location of healthcare
professionals, if tomorrow you needed an
operation, would you prefer to go to
OVERALL
2 011
Females 60 and above 54
A general surgeon practising in a clinic or a
hospital near your home
400
A specialist surgeon practising in a clinic or a
hospital at a distant location
407
400
DK
404
400
The image of the organisation of healthcare is
less positive in Italy and Germany. The
intentions of mobility are stronger. The other
countries have a better image about the
healthcare system and prefer the structures of
proximity. Females 60 and above are less mobile
(54 vs. 43). They are more attached to local
relationships.
17
Trust in highly qualified doctors in all European
countries
2 Mobility
Q6. Worldwide, many doctors have qualified
outside Europe. Do you think that you would
receive better, worse or the same quality of
treatment from a doctor who qualified within
Europe compared with a doctor who qualified
outside of Europe ?
Better if Qualified within Europe
Same / DK
Worse if Qualified within Europe
OVERALL
400
407
400
404
400
2 011
18
A global trend to accept patients coming from
another country for treatment
2 Mobility
Q7. If national hospitals accepted patients from
another country who would pay to receive
healthcare, would you
OVERALL
2 011
400
407
400
404
400
Rather agree
Rather disagree
DK
19
Differing opinions about the reasons why people
are being treated in other countries
2 Mobility
Q8. People also seek treatment outside of their
country. From what you have heard, for what type
of treatment do they most often go to another
country ?
Rather for plastic surgery
Rather for operations such as grafts, artificial
hip replacements, IVF, cardio-vascular surgery
DK
OVERALL
400
407
400
404
400
2 011
20
A trend towards international mobility to access
technical progress
2 Mobility
Q9. Would you yourself accept going abroad to be
treated with more advanced medical techniques not
available in your country ?
OVERALL
2 011
400
407
400
404
400
Yes
No
DK
21
Younger people are more mobile than elderly people
2 Mobility
Q9. Would you yourself accept going abroad to be
treated with more advanced medical techniques not
available in your country ?
OVERALL
2 011
400
407
400
404
400
Yes
No
DK
Yes 65 18-39 75 No 32 60 and above 45
22
Local healthcare conditions an important
criterion in the choice of holiday destination
2 Mobility
Q10. Imagine you are choosing a holiday
destination outside of your country. How much
importance would you attach to the local
healthcare conditions in deciding where to go ?
OVERALL
400
407
400
404
400
2 011
Considerable importance
Little importance
ST 69
ST 54
ST 74
ST 72
ST 88
ST 86
No importance at all
DK
23
Medical services an outstanding criterion in
the choice of a new place of residence
2 Mobility
Q11. Imagine that you had to live in another
country. What importance would you attach to the
range of available medical services (hospital,
doctor, dentist) and easy access to them from
your new place of residence ?
OVERALL
2 011
400
407
400
404
400
Considerable importance
Little importance
No importance at all
ST 84
ST 91
ST 88
ST 96
ST 94
ST 90
DK
24
3 New technologies
25
a Health and the Internet
26
The Internet a source of information for health
issues
3 New technologies Health and the Internet
Q12. Do you use the Internet for information
relating to healthcare ?
OVERALL
2 011
400
407
400
404
400
ST 47
ST 46
ST 44
ST 41
ST 36
Yes, regularly
ST 31
Yes, occasionally
No, never
27
a source of information for most younger people
3 New technologies Health and the Internet
Q12. Do you use the Internet for information
relating to healthcare ?
OVERALL
2 011
400
407
400
404
400
ST 47
ST 46
ST 44
ST 41
ST 36
Yes, regularly
ST 31
Yes, occasionally
No, never
Yes 41 18-39 55 40-59 44 No 59 60 and
above 81
28
On-line medical consultations not much
expectations, except in Sweden
3 New technologies Health and the Internet
Q13. Are you rather for or rather against the
development of on-line medical consultations ?
OVERALL
2 011
400
407
400
404
400
Rather for
Rather against
DK
29
and the youngest are more favourable to the
development of on-line medical consultations
3 New technologies Health and the Internet
Q13. Are you rather for or rather against the
development of on-line medical consultations ?
OVERALL
2 011
400
407
400
404
400
Rather for
Rather against
DK
For 38 18-39 45 Against 54 60 and above
58
30
b Remote diagnosis
31
A moderate trust in remote diagnosis, except in
Sweden
3 New technologies Remote diagnosis
Q14. Today, it is technically possible for a
General Practitioner to transmit data and results
following the medical examination of patients to
a technical platform which analyses all data and
makes a remote diagnosis. Would you trust this
type of remote diagnosis ?
OVERALL
400
407
400
404
400
2 011
Yes
No
DK
32
Remote diagnosis is more accepted by males and
elderly people
3 New technologies Remote diagnosis
Q14. Today, it is technically possible for a
General Practitioner to transmit data and results
following the medical examination of patients to
a technical platform which analyses all data and
makes a remote diagnosis. Would you trust this
type of remote diagnosis ?
OVERALL
400
407
400
404
400
2 011
Yes
Yes 39 Males 47 60 and above 43 Males
40-59 46 Males 60 and above 54
No
DK
33
A favourable opinion on video transmission during
an operation
3 New technologies Remote diagnosis
Q15. In the near future, it will also be possible
for a General Surgeon to carry out an operation
in direct liaison via video transmission with a
Specialist Surgeon who will advise him and help
direct the operation.Are you rather for or
against the development of this type of procedure
?
OVERALL
2 011
400
407
400
404
400
Rather for
Rather against
DK
34
4 Social requirements and financing priorities

35
a Healthcare research
36
Healthcare research Investment could be
increased
4 Social requirement and financing priorities
Healthcare research
Q16. Lets talk now about healthcare research in
your country. Do you think that the amount of
investment allocated to healthcare research must
be
OVERALL
2 011
400
407
400
404
400
Really increased
Somewhat increased
ST 81
ST 77
ST 81
I do not feel that any change is needed
ST 81
ST 75
ST 91
Somewhat decreased
DK
37
Healthcare research must be financed by public
investments
4 Social requirement and financing priorities
Healthcare research
Q17. In order to increase the means allocated to
research, do you personally think that
Public investment must be used
Private investment must be used
DK
OVERALL
2 011
400
407
400
404
400
38
b Financing of healthcare
39
Differing opinion regarding the amount of
contributions and the financing of healthcare
4 Social requirement and financing priorities
Financing of healthcare
Q18. Lets now move on to the financing of the
cost of healthcare. (...) Spontaneously, would
you say that the amount of these contributions is
substantially more than, about the equivalent of,
or significantly less than the cost of the care
you have already received or could receive in the
future ?
Contributions are substantially more
About the equivalent
Significantly less
DK
OVERALL
400
407
400
404
400
2 011
Connected to the overall impression of the
healthcare system in each country
40
The financing method preferred differing
opinions depending on country
4 Social requirement and financing priorities
Financing of healthcare
Q19. Constant improvement in the quality of
healthcare involves higher spending. To pay for
this, what financing method do you prefer ?
Increasing obligatory pay contributions
Taking out optional extra health insurance
Paying extra, case by case, if desired
DK
OVERALL
400
407
400
404
400
2 011
This result relates to differing access to Social
Security
41
c The choice of healthcare professionals
42
Europeans are ready to pay to have the freedom to
choose their health professionals
4 Social requirement and financing priorities
The choice of healthcare professionals
Q20. Would you be prepared to pay to have more
freedom to choose where and by whom you are
treated ?
OVERALL
2 011
400
407
400
404
400
Yes
No
DK
43
The younger respondents and SEC attach more
importance to the freedom to choose healthcare
professionals
4 Social requirement and financing priorities
The choice of healthcare professionals
Q20. Would you be prepared to pay to have more
freedom to choose where and by whom you are
treated ?
OVERALL
2 011
400
407
400
404
400
Yes
Yes 56 18-39 61 SEC 60
No
DK
44
Reimbursement for a second medical opinion is an
expectation for four of the five European
countries
4 Social requirement and financing priorities
The choice of healthcare professionals
Q21. For you, is it justifiable to be fully
reimbursed for a second opinion with another
doctor in order to obtain another opinion for the
same problem or disease ?
OVERALL
2 011
400
407
400
404
400
Justified
Not justified
DK
45
5 Prevention
46
Differing practices of detection depending on
country
5 Prevention
Q22. Now lets talk about prevention. Have you
been tested for cancer, HIV (or another serious
condition) in the last 5 years?
OVERALL
2 011
400
407
400
404
400
ST 49
ST 46
ST 45
ST 71
ST 34
ST 2lt8
Yes, I initiated it
Yes, I was asked to
No
DK
47
and depending on gender
5 Prevention
Q22. Now lets talk about prevention. Have you
been tested for cancer, HIV (or another serious
condition) in the last 5 years?
OVERALL
2 011
400
407
400
404
400
ST 49
ST 46
ST 45
ST 71
ST 34
ST 2lt8
Yes, I initiated it
Yes with initiative 25 Females 29 Yes
without initiative 20 Females 26 No
54 Males 64
Yes, I was asked to
No
DK
48
A life-long health surveillance programme maybe
? especially if it is free
5 Prevention
Q23. Today it is possible to subscribe to a
life-long health surveillance programme including
a prevention service and individual monitoring.
Are you interested in this programme ?
OVERALL
Yes, I am interested and I am prepared to pay
2 011
400
407
400
404
400
ST 58
Yes, I am interested but I am not prepared to pay
ST 58
ST 52
ST 51
ST 40
ST 55
No, I am not interested
DK
49
6 Ageing
50
The care of the elderly people is fragile in all
countries
6 Ageing
Q24. Lets talk about how senior citizens and
people with age related problems are cared for.
According to you, is the care for old and
dependent people
OVERALL
2 011
400
407
400
404
400
51
State-provided home care for the elderly and
dependent people is inadequate
6 Ageing
Q25. More specifically, is state-provided home
care for the elderly and dependent people
currently
OVERALL
400
407
400
404
400
2 011
Rather adequate
Rather inadequate
DK
52
and depending on gender and age
6 Ageing
Q25. More specifically, is state-provided home
care for the elderly and dependent people
currently
OVERALL
400
407
400
404
400
2 011
Rather adequate
Rather inadequate
DK
Adequate 31 Males 60 and above
37 Inadequate 61 Females 40-59 68
53
The assistance of elderly people a priority for
home assistance and creation of new retirement
homes
6 Ageing
Q26. In your opinion, what should be done as a
priority to solve the problems caused by the
increase in the number of elderly and dependent
people resulting from increased life expectancy ?
Base 2 011
54
The assistance of elderly people differing
expectations depending on country
6 Ageing
32
Increase financial assistance for families

• There is a consensus is Sweden to create new
  retirement homes specially adapted to patients
  specific conditions
• In France, in Italy and in the UK, the priority
  is to increase the number of home assistance
  programmes
• The Germans want to increase financial assistance
  for families

Increase the number of home assistance programmes
24
Base 400
Increase the number of home assistance programmes
43
Create new retirement homes specially adapted to
patients specific conditions
25
Base 407
Increase the number of home assistance programmes
38
Base 400
Increase financial assistance for families
35
Increase the number of home assistance programmes
30
Create new retirement homes specially adapted to
patients specific conditions
25
Base 404
Create new retirement homes specially adapted to
patients specific conditions
58
Improve the welcome and comfort of existing
retirement homes
17
Base 400
55
Services and care for elderly people a
preference for mixed financing
6 Ageing
Q27. Several solutions are possible to finance
services and daily care for elderly and dependent
people. Which option would you support ?
OVERALL
400
407
400
404
400
2 011
State resources financed by tax and social
contributions
Mixed  state money and personal contributions
Cost totally met by the individual or the family
DK
56
The complementary financing of daily care for
elderly and dependent people shows some disparity
between countries
6 Ageing
Q28. If a mixed contribution system, such as the
one most commonly used in Europe, were
maintained, to finance services and daily care
for elderly and dependent people, would you
favour a mandatory or an optional personal top-up
insurance ?
OVERALL
2 011
A mandatory insurance
400
An optional insurance
407
400
DK
404
400
This gap between the UK and Sweden on one side,
and Germany, Italy and France on the other can be
explained by the differences in access to social
security
57
7 The place of healthcare in society
58
Healthcare a sector which contributes to the
economic growth of the country
7 The place of healthcare in society
Q29. Would you say the healthcare sector
(hospital, medical equipment, care,
consultations, medicines) is a sector which
OVERALL
2 011
400
407
400
404
400
Contributes to the economic growth of the country
Is only a burden for society 
DK
59
The place of healthcare in election debates
some efforts are expected, especially in France
and Sweden
7 The place of healthcare in society
Q30. Do you think that healthcare occupies a
sufficiently prominent place in election debates
or not ?
OVERALL
OVERALL
2 011
400
407
400
404
400
2 011
400
407
400
404
400
Yes it does
No, it does not
DK
60
Conclusion
61
Conclusion

• Even if Europeans are generally satisfied with
  today's healthcare systems, they are all
  conscious of financing problems even if they are
  not in agreement over how these should be
  resolved.
• At the same time, the ideals of the Welfare State
  (United Kingdom and Sweden) and the system of
  "Social Security" (France and Germany) remain
  present in the collective conscience, which makes
  the topic of using private financing sensitive,
  even though other modes of financing beyond the
  State's sole participation have now become
  acceptable in principle.
• Europeans still prefer healthcare close to home,
  when it is of high quality, and are open to new
  technologies, provided they are not synonymous
  with dehumanization, and are prepared to seek
  expert advice abroad.
• Finally, Europeans attribute great importance to
  healthcare, both from an individual and a
  collective standpoint, with the idea that the
  sector plays a central role in the economic
  well-being and growth of their country. This is
  also why they wish to included more in the
  debates and political decisions related to all of
  these issues.