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Mr Guenter Breithardt,
Dr. Arne Bjornberg
Presenter report:Bjornberg, Arne (Sweden)
Background: The Euro Cardiovascular Healthcare Index is an attempt to analyse and compare healthcare delivery systems for cardiovascular diseases (CVD) in 29 European countries. CVD care is graded on 28 indicators split into 5 weighted sub-disciplines: Information, consumer rights and choice (125 points out of a maximum 1000); Access (125); Prevention (250); Procedures (150); Outcomes (350). Slides available
Method: Selection of indicators and weights, as well as an analysis of the credibility of the final results, was undertaken with the assistance of an outside expert reference panel. Data was collected from public sources such as WHO and OECD databases, Eurobarometers and from other publicly published studies. This was in addition complemented by a survey to patients and patient groups in all 29 countries. The results from this data compilation were sent to national centres of expertise in each country for clarification, validation and updating. On each of the 28 indicators, countries were scored on a three-grade scale of Red (=1 point), Amber (=2 points) or Green (=3 points). The percentage of maximum (“All Green”) score was calculated for each sub-discipline and multiplied by the weight.
Findings: Countries that can afford a high level of healthcare expenditure per capita, e.g. Luxembourg, Norway and Switzerland make up the top group of countries scoring above 800 points. France makes it into this group by scoring high on Prevention. States such as Slovenia and Poland show some good results within more modest economic means.
Interpretation: Apart from affordability, cardiac care seems heavily influenced by local and national professional and administrative cultures. There is also a general shortage of Comprehensive Uniform Trustworthy Sources (“CUTS”) for data on the output and quality of European CVD care.
Discussant report:Breithardt, Guenterwebcast
This excellent report has yielded important and interesting results. As always, there is still room for improvement. For instance, for about half of all items presented, no “CUTS” data (Comprehensive Uniform Trustworthy Source, like WHO databases) were available which means that in these instances, a more subjective assessment had to be accepted. Slides available
Due to these weaknesses, of which the group is well aware, one might debate the ranking of individual countries. However, the overall picture is more important as it shows that there still is room and a need for improvement in many countries.
One of the obvious drawbacks was that not all representatives of all countries finally responded when the data were distributed for review. This lack of feed-back may have had some influence on the ranking of a given country.
Although not perfect, the Cardiovascular Healthcare Index 2008 is an important step in the right direction. Sometimes, it is better to do something even if it is not perfect, instead of merely discussing what one might do. Overall, the organizers and the contributors should be congratulated on having accomplished this huge task which, hopefully, will not remain a single event and should receive long-term support from all. This endeavor should be taken more seriously by those who are asked for advice on data and ranking. We need more reliable data on the performance of our health care systems. This report is a strong message to all responsible actors in the European health care systems. It holds the mirror up to all of us involved.
Clinical Trial Update III
This congress report accompanies a presentation given at the ESC Congress 2008. Written by the author himself/herself, this report does not necessarily reflect the opinion of the European Society of Cardiology.
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