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Clinical Articles, News & Views

Large variation in the quality of health care

Healthcare quality and costs vary widely both between and within countries, according to results from the EuroHOPE project that followed individual patients to compare healthcare for five different medical conditions.

The project has run for three years, and 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.

Researchers 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 was used as a measure of quality

“The results show that there is potential to improve the efficiency of healthcare. 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 Professor Clas Rehnberg (Karolinska Institutet, Sweden).

“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,” Professor Rehnberg added. “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.”

“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 health care or that international guidelines for health care are not being followed,” Professor Rehnberg concluded.

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Published on: April 30, 2014

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