Chronic diseases : impact European priorities – Belgian presidency 1.07 - 31.12.2010 Bukarest 23.09.2010. Dr Jan Van Emelen (MLOZ, Independant Health Insurance Funds - Belgium ). Agenda. Chapter 1 : chronic diseases - impact & management Introduction The global problem
European priorities – Belgian presidency 1.07 - 31.12.2010
An international association
for universal principles
41 national federations
27 countries worldwide
Europe, Middle-East, Africa, Latin-America
Social services, pensions
For 240 mln citizens
Values and principles
Health and well-being
Director of healthcare
Director of care
Payer and provider
Engagement in healthcare management
Independent, Healthy Living
Skilled Nursing Facility
Cost of Care / Day
Cost of Care / Day
Source: Freely adapted from Intel (2007)
Criteria of choice:
the quality of care
safety/risk management (risk of malpractice)
collaborative health care processes
the access to care
the economic efficiency of care.
Econoshock (G. Noels) - 6 events at the same moment
Result : dramatic change needed
lnnovation is a duty
Chronic conditions leading cause of mortality and not well « managed»
Long Term care
Quality and safety
More homecare instead of hospitalisation
Lack of coordination
IT is a catastrophe
UC Atlas of Global Inequality
Literature : European Observatory on Health Systems and Policies
Tackling chronic disease in Europe. Strategies, interventions and challenges - Reinhard Busse, Miriam Blümel, David Scheller-Kreinsen, Annette Zentner
Managing chronic conditions: Experience in eight countries - Ellen Nolte, Cécile Knai, Martin McKee
Chronic conditions and diseases are the leading cause of mortality and morbidity in Europe, and research suggests that complex conditions such as diabetesand depression will impose an even greater health burden in the future. It has been estimated that in 2005 77%of all Disabiliy-Adjusted-Life-Years (DALYs) and 86% of premature deaths in the WHO European region are related to non-communicable diseases. The condition expected to increase most dramatically is dementia.
Chronic diseaseis the major causeof death in allbut the poorestcountries!
Expected RESULTS :
Expected COSTS :
Source: Velasco-Garrido, Busse and Hisashige 2003.
Mattke et al. Am J Manag Care. 2007; 13: 670-676
Financing health care systems different World Bank income categories (2002)
Payment systems can hinder implementation of new services.
NB! Based on pessimistic assumption: readmission avoidance = 0%
Readmission avoidance =10%
Break-even is achieved by
Readmission avoidance rate = 13%, or
Reduction in hospitalization by 2 days
IM3 Project (Irina Odnoletkova)
New elements of care:
Cross Border Care different World Bank income categories (2002)
Healthcare workforce in EU
Ageing and chronic diseases
Service Directive (Bolkestein) and social services of general importance
A digital agenda for EuropeCH 2 . Priorities in EU
2012 = EU year of ageing
« workandageing society pact » - conclusions
Interministerial conference 19 en 20/10, Brussels
25 en 26/11, Brussels
Member States should also remove barriers to labour market entry for newcomers, support self-employment and job creation in areas including green employment and care and promote social innovation.
Social security and pension systems must be modernised to ensure that they can be fully deployed to ensure adequate income support and access to healthcare — thus providing social cohesion — whilst at the same time remaining financially sustainable.
Member States should also actively promote the social economy and social innovation in support of the most vulnerable.