This autumn the European Commission and the Expert Panel on Effective Ways of Investing in Health (EXPH) launched a public consultation on the preliminary opinion on the “Access to health services in the European Union”.
The preliminary opinion addresses barriers to accessing health care and explores the policy measures needed to overcome them. Ways to improve equity could include matching health needs and financial resources, affordable and accessible health services, the availability of a sufficient number of health workers with the right skills, well-equipped facilities within easy reach, the availability of quality medicines and medical devices and services that are relevant and cost-effective.
The preliminary opinion pays special attention to access to health services for underserved groups such as members of the Roma community, undocumented migrants, and people with mental health problems.
EFA took part in the consultation, highlighting the following aspects of the access to health services:
- Access to healthcare services is twofold: it requires the existence of good quality care for patients and also its affordability.
- Respiratory allergy is a highly prevalent disease, affecting more than 20% of Europeans. Despite these numbers the burden of respiratory allergies is not adequately recognized by governments, decision-makers, healthcare workers and often by the patients themselves. There is a strong need to change the perspective of allergy as a “trivial” disease, as well as to increase healthcare professionals’ knowledge in the area of allergy.
- Access to, and cost of, chronic obstructive pulmonary disease (COPD) care differs greatly across Europe. Access to pulmonary rehabilitation and smoking cessation is unequal. Compulsory spirometry test, better coordination of healthcare services involved in COPD care, free smoking cessation programmes could significantly improve access to care for COPD patients. There also needs to be a focus on disease prevention.
- In most European countries, allergology is not recognised as a specialisation and therefore allergies are often dealt with in primary care. Due to the lack of adequate education on allergy for primary care physicians, patients often receive a late diagnosis and don’t always receive treatment in line with the most recent international evidence-based guidelines. Allergology involves a number of specialties which must work collaboratively together. Such collaboration needs to be enforced through interdisciplinary medical centres across the EU and its Member States.
- Currently asthma affects 30 million people under 45 years of age in Europe, and its burden is estimated at more than 70 billion Euro annually. The implementation of regional and national programmes, as well as the introduction of guidelines in the healthcare system, have been shown to reduce the burden of asthma. They reduce the burden in terms of patients’ quality of life, asthma-related deaths, hospitalizations, sick-leave and disability pension. EFA, through the framework of the EARIP project (www.earip.eu), conducted a literature review identifying national asthma programmes implemented in Europe and highlighting key success factors that could be adopted in other contexts. The analysis of 8 national asthma programmes revealed the following characteristics are crucial when developing asthma programmes/guidelines:
- Improving early diagnosis and introduction of first-line treatments with anti-inflammatory medications
- Improving long-term disease control
- Introducing simple means for guided self-management
- Providing effective education and networking (GPs, nurses, pharmacists
- Establishing a systematic approach (motivation, organization)
- All main stakeholders must be represented, including NGOs and patient organizations
In order to make the promotion of asthma care and prevention a reality, a change of mind-set in the EU Member States is needed.