Transitioning Healthcare Provision Across Western Europe—An Assessment of Selected Countries

Market Participants Seek to Stay Relevant by Striking Balance Between Fiscal Austerity and Changing Patient Demographics

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Europe’s Big 5 health systems are in transition. Rapidly ageing populations and budget cuts have forced governments to place greater emphasis on the efficiency of care provision. As part of this efficiency drive, the landscape of care provision in these countries will continue to evolve to meet the dual challenges of limited budgets and changing patient demographics. This research service will assess the evolution of these health systems to understand if changes in care provision reflect sound policy-making or are a knee-jerk response to changing external factors.

Table of Contents

1. Executive Summary
Research Methodology
Key Findings
Despite the Disproportionate Spending on Secondary Care, the Focus Should be on Improving Primary and LTC/HC Services
Virtualisation of Primary Care, Medication Adherence, and Digital Health Care Hold the Key for the NHS
Improvements in Hospital Efficiency Will Catalyse the Shift of Patients to Primary Care and LTC/HC Settings
The Shift of Chronic Care Patient Management to LTC/HC is Critical in Terms of Improving the Efficiency of Care Provision
The Reduction in the Number of Hospital In-patients Will Shift Care Provision to Primary Care and LTC/HC Settings
The Focus is on the Adoption of Technologies that will Better Enable the Transition of Care from Hospitals
2. United Kingdom
Out-of-Pocket Spending on Health Care is Growing as PHI Coverage Decreases
The Enhanced Role of Primary Care is Not Suitably Supported by an Increase in Funding as a Share of the Total Expenditure
The Shift in Funding from Secondary to Social Care is Paving the Way for New Models of Care Provision
With a Declining Nurse-to-In-patient Ratio, it is Critical to Adopt Systems that will Improve Care Efficiency
Primary Care Provision will Evolve from GP Recruitment to Efficiency in the Management of GP Services
Gatekeeping on Hospital Re-visits is the Only Solution to Shift PoC Outside the Secondary Care System
Enhancing the Role of Primary Care is the Ideal Long-term Solution for the NHS
NHS will Shift to a Model of Integrated Social/Primary Care Provision to Improve the Cost-effectiveness of Care
Role Revisions—Pressure Points
Role Revisions—Outcomes
Role Revisions—Past, Present, and Future
Primary Care will Assume the Overall Responsibility for the Management of Post-acute, Elderly, and Chronic Patients
Ranking of Key Stakeholders in Terms of Influence—2015 and 2025
Key Stakeholders—2015 and 2025
NHS Blueprint 2020
The Adoption of Portable Diagnostics and Technology that Enable Care Virtualisation will Drive Efficiency
IT Solutions Providers and Medical Device Manufacturers Have the Best Opportunities
3. France
Compulsory Employer-driven PHI Could Double PHI Spending in the Coming Years
Compulsory Employer-driven PHI will Alter the Health Care Market Landscape
31% of Health Care Spending is on Procurement and Administrative Services
Compulsory Employer PHI will Drive the Adoption of TPPs
The Efficiency Drive to Improve Hospital Care is Shifting Patients Towards Ambulatory and LTC/HC Settings
Elderly Care is Being Transitioned from Hospitals to LTC/HC Settings To Reduce Un-necessary Admissions and Costs
An Optimal Finance Mechanism and Provider Skill Mix Allows MGPs to Provide Quality Care
Role Revisions—Pressure Points
Role Revisions—Outcomes
Role Revisions—Past, Present, and Future
Key Stakeholders—2015 and 2025
Ranking of Key Stakeholders in Terms of Influence—2015 and 2025
France Blueprint 2020
Increased PHI Spending and Efficient GP Service Provision will Enable the Shift of Care from Hospitals to LTC/HC
IT Adoption will Drive Connectivity and Data Sharing between Primary, Secondary, and Community Care Providers
Medical Device and Medical Imaging Manufacturers Have the Best Opportunities
4. Germany
PHI Adoption will be Driven by Elderly Patients Seeking Care in LTC/HC Settings
The Emphasis is on Robust Out-patient Services, which Accounts for 50% of the Total Health Spending
The Health Budget Surplus will be Used to Increase Physician Fees, Lower Contribution Rates, and Reduce Co-payments
The Rise in Germany’s Nurse Population Has Been Unable to Meet the Growing Demand for Geriatric Care Nurses
Despite the Rising Number of In-patients, Hospital Privatisation Has Decreased Bed Occupancy Rates and the Average Length of Stay
Germany will Set up an e-health Council to Aid in the Interoperability between Different Health Care Provider-used IT Systems
Role Revisions—Pressure Points
Role Revisions—Outcomes
Role Revisions—Past, Present, and Future
Key Stakeholders—2015 and 2025
Germany Blueprint 2020
PHI Adoption will Drive the Demand for Elderly Care and Chronic Disease Management in LTC/HC Settings
Ranking of Key Stakeholders in Terms of Influence—2015 and 2025
Germany will Focus on the Adoption of Technologies that will Aid in Interoperability between Multiple IT Platforms
BDA will Play a Key Role in Germany’s Privatisation and Efficiency Improvement Drive
5. Italy
Hospital Budget Cuts and Upgraded Benefit Packages will Shift the Model of Care from Interventional to Management
While Total In-patient Numbers Continue to Decline, Nursing Shortages Persist, Especially in LTC/HC Settings
GP Shortages Prevent Italy from Completing the Shift to a Primary Care-centric Model of Care Provision
Italy has Launched a Slew of Measures to Improve Care Efficiency through Better Accountability and Transparency
Role Revisions—Pressure Points
Role Revisions—Outcomes
Role Revisions—Past, Present, and Future
Key Stakeholders—2015 and 2025
Ranking of Key Stakeholders in Terms of Influence —2015 and 2025
Italy Blueprint 2020
The Emphasis on Prevention, Early Diagnosis, and Enhanced Primary Care is Expected to Reduce the Cost Burden
Italy is in the Process of Adopting Technology that will Enable Greater Monitoring and Sharing of Health Care Data
Enhancements to the Benefits Package (LEA) will Drive the Adoption of Medical Devices and Data Analytics
6. Spain
Private Health Spending Has Increased in Response to the Budget Cuts Forced by the Autonomous Community Deficits
The Decrease in Public Health Spending Warrants Efficiency Optimisation to Support Health Care Provision
Primary Care Spending as a Percentage of Absolute Spending has Reduced, Putting a Strain on Care Provision
Primary Care Has Witnessed a Decrease in Patient Numbers Due to Reduced Funding; However, Care Efficiency Has Improved
To Cope With the Reduction in Nurse Numbers, the Role of Nurses is Set to Change
The Non-renewal of Contracts Due to Budget Cuts Has Led to the Emigration of Doctors, Thereby Exacerbating the Existing Shortages
Role Revisions—Pressure Points
Role Revisions—Outcomes
Key Stakeholders—2015 and 2025
Role Revisions—Past, Present, and Future
Ranking of Key Stakeholders in Terms of Influence—2015 and 2025
Spain Blueprint 2020
In an Era of Fiscal Austerity, Increased PHI Spending is Expected to Drive the Demand for Health Care
The Spanish Government is in the Process of Adopting IT Platforms to Monitor Health Care Provision
For the Judicious Allocation of Limited Resources and Funding, the Available Care Services Must be Mapped
7. Legal Disclaimer
8. Appendix
Definitions of Key Terms
The Frost & Sullivan Story- The Journey to Visionary Innovation


List of Figures & Charts

1. Percent Share of Total Health Budget , 2014
2. Healthcare Spending, 2014- United Kingdom
3. Out of Pocket Spending- United Kingdom
4. Community Care Services is Experiencing the Highest Growth in Terms of Funding at the Cost of Secondary Care- United Kingdom
5. In-patients/100,000 People, 2009–2013- United Kingdom
6. Nurses/100,000 People, 2009–2013- United Kingdom
7. Doctors/100,000 People, 2010–2014- United Kingdom
8. Total In-patient Visits, 2010–2014- United Kingdom
9. Total Out-patient Visits, 2010–2014- United Kingdom
10. Ranking of Key Stakeholders in Terms of Influence—2015 and 2025- United Kingdom
11. Health Care Spending, 2014- France
12. PHI Spending, 2014- France
13. PHI Turnover, 2014- France
14. Funding of Care ($ Billion)- France
15. In-patient and Out-patient Admissions, 2009–2013- France
16. Hospital Beds/100,000 People, 2009–2013- France
17. Ranking of Key Stakeholders in Terms of Influence—2015 and 2025- France
18. Health Care Spending, 2014- Germany
19. Funding of Care ($ Billion)- Germany
20. Health Budget Surplus, 2011–2013- Germany
21. Federal Subsidy, 2011–2017- Germany
22. Patients in LTC/HC Facilities, 2009–2013- Germany
23. Nurse Population, 2009–2013- Germany
24. Hospital In-patients, 2009–2013- Germany
25. Average Length of Stay, 2005–2013- Germany
26. Ranking of Key Stakeholders in Terms of Influence—2015 and 2025- Germany
27. Funding Cuts, 2012–2014- Italy
28. Public Funding on Health, 2014–2016- Italy
29. LTC/HC and Hospital In-patients, 2010–2013- Italy
30. Nurse Population, 2011–2013- Italy
31. GPs and Specialists, 2009–2013- Italy
32. Hospital In-patients, 2009–2013- Italy
33. Ranking of Key Stakeholders in Terms of Influence —2015 and 2025- Italy
34. Funding of Care ($ Billion)- Spain
35. Nurse Population, 2009–2013- Spain
36. Specialists and GPs/100,000 People, 2009–2013- Spain
37. Ranking of Key Stakeholders in Terms of Influence—2015 and 2025- Spain



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