Encouraging healthy behaviour is highly beneficial to governments. If citizens play an active role in the management of their health and medical treatment, it can help relieve the financial burden on national budgets.
Paola Testori Coggi
Ageing heralds a new challenge for healthcare systems in Europe for which innovative answers must be found, writes Paola Testori Coggi, Director-General of DG Sanco…
In the current context of budget cuts and rising healthcare demands, securing universal access to quality healthcare remains a key priority. Europe is strongly determined to champion this right as one of its fundamental social values: no-one can take good health for granted. Moreover, a healthy population drives economic growth and competitiveness.
Therefore, all actors of our society – young and old, workers and pensioners, national and local authorities, companies and research centres – are called upon to pool their strengths. Together, they can shape our future sustainable healthcare systems.
This will not be a straightforward task. Increased longevity and reduced fertility rates have caused our societies to grow older. The silver generation, made up of the over 65s, puts the sustainability of our social and healthcare systems relentlessly to the test. At present, there are four people of working age to support the pension benefits and healthcare costs for every pensioner.
Unfortunately, statistical projections for 2050 predict a drastic change in that ratio. In 40 years, it will be halved: one pensioner will rely on only two people of working age. This means that a dwindling workforce will be expected to pay for twice as many pensions and health related costs. In the same vein, public expenditure on health presently accounts for a hefty 9.6 per cent of the gross domestic product (GDP) at European level. By 2030, public expenditure on acute healthcare and long-term care is likely to increase by 4 per cent of GDP, owing mostly to treatment costs of chronic diseases.
1
Ageing represents a loud wake-up call for change. It is also an opportunity to usher in 'out-of-the-box' solutions to strengthen the sustainability of our systems and tackle health issues, with the ultimate goal of restoring economic growth in Europe.
Even though healthcare is the responsibility of the individual member states, the European Union has an important role to play in promoting enhanced cooperation within and across these countries, as well as stepping up innovation in the way their health systems operate.
The European Commission stands at the forefront of several far-reaching initiatives and actions to support member states in overhauling their healthcare systems.
e-Health
Vulnerable individuals, such as older people suffering from chronic diseases, have complicated and ongoing needs (that are frequently part-medical, part-physical, part-psychological and part-social).
2They may experience difficulties in everyday living and require a mix of services delivered sequentially or simultaneously by multiple providers in home, community and institutional settings. These mostly long-term, incurable, unpredictable and costly conditions present major challenges to both patients and family carers. e-Health can play a valuable part in addressing some of these challenges.
Broadly defined as 'the range of tools based on information and communication technologies used to assist and enhance the prevention, diagnosis, treatment, monitoring and management of health and lifestyle',
3 e-health encompasses, inter alia, the use of telemedicine and telehealth. The former aims at securing access to healthcare in remote areas or in the comfort of patients' homes, thus helping to reduce admissions to hospitals. The latter ensures electronic access to health information and medical data and can greatly improve the ability and skills of citizens to better manage their own health or medical conditions – a process better known as 'patient empowerment', or self-management.
Given its innovative nature, e-health holds a central place in the Partnership on Active and Healthy Ageing. This cross-cutting European initiative seeks to harness multifaceted innovation with a view to creating a seamless system of prevention, care and independent living to benefit older people and help them live longer in good health.
Embedded in the EU directive on the application of patients' rights in cross-border healthcare, e-health also plays a major part in the delivery of safe and good quality treatment to citizens travelling across the European Union.
The directive on patients rights sets up a voluntary network of national authorities responsible for e-health. The main goal of this network is to increase the social and economic benefits of e-health through better interoperability – or compatibility – between electronic health systems and data. The directive specifies three particular priorities for the network:
• To produce guidelines on the minimum set of patients' data to be electronically exchanged cross-border;
• To work on electronic identification and authentication to ensure transferability of data in cross-border healthcare; and
• To develop methodologies for the re-use of medical data for research purposes.
All 27 member states have readily joined the network. The first meeting took place on 8th May 2012 in Copenhagen, touching upon issues such as e-identification governance for health, semantic interoperability and data protection.
Health Technology Assessment (HTA)
Investing in effective, innovative technologies and treatment solutions is one of the key factors to ensuring the long-term sustainability of our health systems. It is therefore important to strengthen the evidence base and support cooperation on evaluating the effectiveness of e-health.
The upcoming European network on Health Technology Assessment (HTA), which will be formally established in 2013, aims to provide member states with well-founded information about the development, use, acquisition, funding and regulation of technology. In short, HTA cooperation at European level avoids duplication of research and investment efforts and allows for a shift of significant resources in the health sector to the most innovative and valuable products and services. At the same time, it can offer the best market potential and cost savings in the longer term.
Patient empowerment: from prevention to self-management of a disease
The World Health Organization (WHO) noted in 2010 that non-communicable diseases, like stroke, diabetes and cancer, account for 77 per cent of the health burden and cause 86 per cent of all mortality cases in the European Region.
4 Healthy eating habits combined with physical activity and not smoking can prevent 80 per cent of premature heart diseases, 80 per cent of Type 2 diabetes cases and 40 per cent of cancers.
Lifestyle habits start at an early age and must be considered as a lifelong process maintained through a combination of policy tools. These include public education, pricing, taxation and sharing best practice. ICT can also help to bring about a greater degree of personal responsibility, fostering the sharing of information between experts and patients, and among patients themselves.
Encouraging healthy behaviour is highly beneficial to governments. If citizens play an active role in the management of their health and medical treatment, it can help relieve the financial burden on national budgets.
Dementia and Alzheimer's disease: ongoing European actions
Dementia belongs to the category of chronic diseases. It is a neurodegenerative disease characterised by a decline in mental ability in which memory, thinking and judgment are impaired, and personality may deteriorate. It mainly affects people aged over 60. In 2011, the number of European citizens suffering from dementia amounted to 10 million people. This figure is set to double to about 19 million by 2050.
The EU policy on dementia and Alzheimer's disease primarily rests on the following two actions:
• The EU Health Programme
5 – a programme with €321.5m specifically earmarked for addressing public health objectives – co-funds a Joint Action 'Alzheimer Cooperative Valuation in Europe' (ALCOVE), which brings together EU countries to implement prevention and care-oriented measures. These actions include mapping existing and emerging good practices related to early diagnosis and pharmaceutical treatment of persons suffering from Alzheimer's and other forms of dementia;
• The Joint Programme in Neurodegenerative Disease Research is an initiative set up in 2012 to tackle neurodegenerative diseases such as Alzheimer's and Parkinson's,
6 following recommendations from EU governments.
7 25 European countries will work together in an unprecedented collaborative initiative to try and align their scientific competencies, medical strengths and social approaches in the fight against these diseases. The ultimate goal of this project is to find cures for neurodegenerative diseases and to enable diagnosis for early targeted treatments.
Europe has clearly chosen the paths of cooperation and innovation to redesign its healthcare systems, and to equip them for the increased healthcare burden created by ageing populations. We all agree that universal healthcare coverage is the correct goal to strive for and a model must be found to deliver on that commitment in a sustainable way. This is a significant task and the challenges ahead are numerous. The European Commission remains committed to finding new and innovative solutions to match evolving healthcare demands and ensuring better health for all the EU's citizens.
1 www.eufutureofhealthcare.com/sites/default/files/EIU-Janssen%20Healthcare_Web%20version.pdf
2 www.ncbi.nlm.nih.gov/pmc/articles/PMC1480401
3 ec.europa.eu/health-eu/care_for_me/e-health/index_en.htm
4 www.euro.who.int/en/what-we-do/event/regional-high-level-consultation-on-noncommunicable-diseases
5 ec.europa.eu/health/programme/policy/index_en.htm
6 www.neurodegenerationresearch.eu/news-events/press-releases/press-release-story/?no_cache=1&tx_ttnews%5Btt_news%5D=62&cHash=423ff02e25b1700250f211a8bcc85227
7 www.neurodegenerationresearch.eu/index.php?id=27&tx_ttnews%5Btt_news%5D=2
This article originally appeared on Publicservice.co.uk: Solutions for the silver generation
As we are not nocturnal animals by nature, then we must benefit from sunlight, in several ways. It then follows that we can deal with sunlight - maybe we need to be more in touch with how to deal with exposure. This research shows that we do not know all the ways that we use sunlight naturally, which is probably true of other environmental factors. I will be very interested in outcomes of further research. Is there any research about sunlight and cognition?
