France, Germany, Spain and Portugal are countries with strong sanitation systems that provide comprehensive health care coverage to their citizens. However, there are specific challenges in each of them that lead their citizens to assess their health systems with low scores, which indicates that there are areas for improvement in all systems.
Spain ranks third (out of four) and is above Portugal in all dimensions except for adequacy of financing. Although it ranks third in the ranking, exceeds the German average in the indices related to transparency, fairness, innovation and technology and collaboration. The differences in the scores between France and Germany are due to their organization, financing and coverage, but, in general, their health systems are considered benchmarks, so they can serve as a model for future reforms.
This has been revealed during the day «The pulse of health in Europe. Health systems survey»in which a comparative study of the perception of European health systems in Germany, France, Spain and Portugal, carried out by Sigma Dos for the IDIS Foundation (Institute for the Development and Integration of Health) has been presented.
The survey collects the opinion of 6,000 citizens, with a sample of 1,500 from each country. The analysis of the data has been carried out by creating a IBS satisfaction index (socio-sanitary well-being index) that assesses different dimensions —from 0 to 100— . General data is extracted from it, such as the fact that quality and focus on the patient are the aspects that receive the highest scores.
As has been assured Juan Abarca, President of the IDIS Foundation, «all European health systems require a rethinking because the perception of citizens in general is quite low. The European Union (EU) has marked some lines towards which the European health systems should converge. For this reason, it is time not to promote a convergence, but a transformation of them towards a homogeneous healthcare system for all EU citizens”.
In addition, Abarca has pointed out that our health system “is going through terrible difficulties that put our health model at risk, which is why an agreement between the main parties is essential to undertake the necessary reforms and guarantee the Welfare State for the next generations”.
Transparency, collaboration and equity
Transparency reaches 46.2 points out of 100 and has been assessed through three aspects: accessibility to the results, the possibility of sharing the clinical history and the transparency of the publication of health data. As an example, it can be noted that Spain is in the second position when sharing medical history is mentioned. In the collaborative dimension, questions were asked about the degree of public-private participation and an overall average score of 41.2 points was obtained.
When you talk about efficiency it reaches 45.4 points out of 100 in IBS and to obtain it, the appropriate use of human resources, infrastructure, equipment and materials has been assessed. The relationship with professionals obtains 44.3 points and is closely followed by the equitable dimension, which obtains 43.8 points out of 100. In this dimension, questions are asked about the ease of access regardless of socioeconomic situation or area of residence .
In aspects of innovation and technology A score of 41.1 points out of 100 is achieved, having consulted citizens on process innovation to improve care or making available the latest technological, digital and therapeutic advances. The financing obtains 39.5 points out of 100, and is based on the opinion on the sufficiency of the financing and its distribution. Lastly, questions have also been asked about the number of professionals, communication and the transfer of data.
Results by country
The results suggest differences in the assessment of different dimensions of the health system in Germany, France, Spain and Portugal. In general, France is the one that obtains the best scores and it is only surpassed by Germany in quality perceived by its citizens. «In the countries of the Iberian Peninsula, both Spain and Portugal, the most valued dimensions are quality and transparency. However, in Spain the lowest scores correspond to financing, followed by innovation and technology; the same as in Portugal, although in reverse order”, explains the general director of the IDIS Foundation.
A notable aspect is the difference in the assessment of the need for collaboration and coordination at the European level. Spain and Portugal show a greater appreciation of the importance of coordination in this field. In contrast, in France and Germany, they obtain more moderate scores in these dimensions. This could be interpreted as a greater sense of self-sufficiency with their own health systems in Germany and France, while Spain and Portugal show a greater need for collaboration with other countries.
In addition, there is greater agreement with the fact that Europe assumes more powers in the Iberian countries (Spain and Portugal) compared to Germany and France. Although the average of the four countries shows that more than half of the respondents agree with this aspect, it can be interpreted that inIn Spain and Portugal the perception of the need for external support is greater than in Germany and France.
Finally, angel of benedictSecretary General of the IDIS Foundation, closed the day reiterating the importance of “reflecting on the perception that citizens have of health systems and the need to seek innovative solutions to move towards a healthier and more equitable future”.
