Large variation in quality of health care within and between
1 April 2014
Sweden, Italy and Norway have high quality health services
overall, according to the EuroHOPE project, but quality and costs
vary widely both between and within countries.
The EuroHOPE project compared healthcare data for five different
medical conditions in six countries and will present the results in
a conference next week in .
This EU project that has run for three years compares the quality
and cost of hospital care in Finland, Hungary, the Netherlands,
Norway, Scotland, Sweden and certain provinces in Italy. Researchers
have focused on care for heart attacks, strokes, hip fractures, very
premature infants and certain forms of breast cancer.
“The results show that there is potential to improve the
efficiency of health care. We see significant differences in both
costs and quality both within and between countries for these
diseases. However, there are no clear results that show that the
best quality is associated with the highest costs,” says Clas
Rehnberg, professor at the Department of Learning, Informatics,
Management and Ethics, Karolinska Institutet.
Researchers have linked patient records to mortality registries
in different countries and followed up patients for 30 days and one
year following discharge from the hospital. The number of deaths has
been used as a measure of quality. Using registries to make this
kind of comparison is a new approach.
“We have followed individuals who just have one disease in the
registries and this means we can draw conclusions about healthcare
for the diseases in question. But in general it is a fact that even
a country's general health status has an effect. Hungary, for
example, is worse in most areas, but it also tends to have a poorer
health status with a shorter lifespan. It is clear that it has an
effect and makes it difficult to improve results in individual
diseases no matter how many resources you can deploy.”
This is the project's final conference and researchers from
several countries have been invited to speak. The method used in
this project will also be compared with other forms of rankings of
health care systems. There will also be discussions about the causes
of the differences in quality.
“We do not know the answers to the reasons for the differences.
We see no clear differences between how healthcare is financed in
different countries. But it could, for example, be that different
medical techniques are being employed in different countries.
Another hypothesis is that it is due to the centralisation or
decentralisation of healthcare or that international guidelines for
healthcare are not being followed,” says Clas Rehnberg.
Conference: Explaining differences in European health care
outcomes performance and efficiency Time: 8 April, 2014 from 9.30am
to 2pm Location: Karolinska Institutet Campus Solna, Berzelius väg
3, Gustaf Retzius Hall, Sweden.
For the full programme, see: