A significant amount of evidence has been produced regarding the ability of monetary and information-based incentives to improve the quality of both primary and hospital care, demonstrating that substantial progress can be made even without financial incentives and that context is a key factor. Furthermore, selecting the right incentives is crucial to ensuring that efforts translate into better patient outcomes. Maintaining adequate quantitative and qualitative standards of care can be particularly challenging in emergency situations, such as a pandemic. A resilience index has been developed and applied retrospectively to data on hospital activity in four EU countries. This analysis was combined with a collection of information on factors that can contribute to improving the resilience of the health system.
New technologies with significant potential benefits are constantly becoming available to patients. However, innovation is increasing pressure on healthcare budgets. We have studied the complex process that leads from the development of a new health technology to its adoption at two critical stages: before it reaches the market, and at the time when payers have to decide on adoption. For the early phase, a novel participatory approach has been developed for the early evaluation of new technologies. For the adoption phase, a tool has been developed that allows payers to forecast with greater precision the budget impact of innovations over time, even in complex settings, where patients can receive multiple treatments over time.
Digital health is one of the innovations that is likely to affect large numbers of patients in the near future. However, much remains to be learned about the efficiency and equity implications of widespread use of digital technologies. An in-depth analysis of data on the use of a digital health app made available to the population of Catalonia enabled us to identify its impact on various outcomes and healthcare utilisation. Furthermore, we identified groups within the population who require support to adopt new digital technologies, as there is a risk of their exclusion from the benefits they offer. Ongoing work will enable us to extend the analysis to the impact of new technologies in other geographic areas.
Contributing to defining policies to improve equity in healthcare is an essential goal of the FLASH project. Work Package 3 (WP3) examined whether health financing systems across Europe are aligned with people’s health needs and how out-of-pocket (OOP) payments affect access to care. A detailed comparison of funding allocation rules in nine EU countries was completed, showing wide differences in how population characteristics—such as age, socio-economic conditions and health status—are taken into account. An original dataset covering European regions over more than a decade was developed to assess whether areas with greater health needs receive proportionally more resources. The results indicate that funding generally responds to need, but only to a limited extent, with marked differences across countries. Additional analyses show that cost-related unmet needs remain concentrated among vulnerable groups and that private spending plays a complex role, partly compensating for gaps in public provision while raising equity concerns.
One way to improve equity of access is to allow patients to seek care where they can get the best service for their health needs. In some cases, this may involve cross-border patient mobility. After identifying the key barriers to cross-country patient mobility, the project made fundamental progress in establishing legal and financial arrangements that could help remove geographical barriers to patients accessing high-quality healthcare.
