Healthcare in Europe and
in the USA
Presentation of the results
21th September 2010
Technical pieces of information
Studied countries and historical background:
 2006 - 2007 :
Germany
France
Italy
UK
Sweden
Sweden
Poland
 2009-2010 :
Germany
France
Italy
UK
 2010 :
Germany
France
Italy
UK
Sweden
Poland
USA
Austria
Technical pieces of information:
•Telephone interviews
•Respondents profile: general public, aged18+
•Sample size: 3600 interviews : 400 per country and 800 in the USA.
•Representativeness (per country) ensured by quotas set on age, gender, SEC class and region.
2
Introduction
Studied topics:
1. Assessment of the healthcare system and of quality of care
2. Focus on doctors competence and training
3. Healthcare and social requirements
4. Patients mobility for access to treatment
5. New technologies
6. Prevention
7. Management of ageing and dependent people
8. Comparison across countries
3
1 –Assessment of the
healthcare system and of
quality of care
4
1 – Healthcare system
How would you evaluate the organisation of the health system in [FR/UK/GE/IT/PO/SU/US] today?
8%
1%
3%
10%
12%
3%
7%
7%
27%
22%
46%
30%
31%
32%
36%
20%
36%
10%
12%
6%
1%
Excellent
8%
7%
46%
44%
40%
1%
2%
17%
12%
2%
21%
8%
34%
15%
Very good
21%
Good
26%
Average
27%
Poor
44%
2%
24%
3%
36%
DK
5
1 – Healthcare system – synthesis using the scores
How would you evaluate the organisation of the health system in [FR/UK/GE/IT/PO/SU/US] today?
Score « organisation of the health system »
Excellent = 5
Very good =4
3,4
Good = 3
2,7
2,2
Average = 2
1,9
2,5
3
3
2,5
Poor = 1
Pologne
Italie
Allemagne
USA
France
Suède
UK
Autriche
6
1 – Healthcare system – synthesis using the scores
How would you evaluate the organisation of the health system in [FR/UK/GE/IT/PO/SU/US] today?
And is the quality of health care provided when consulting a general practitioner ?
And, in your opinion, is the quality of care provided during hospital stays…?
Score « organisation of the health system »
Score « quality of health care provided by a GP »
Score « quality of care provided during hospital stay »
Excellent = 5
Very good =4
Good = 3
2,8
2,6
2,7
2,5
3,5
3,4
3
3
3,4
3,1
3,4
3,1
3
3,4
3
3
3,5
3,5
3,4
2,7
2,5
2,5
2,2
Average = 2
1,9
Poor = 1
Pologne
Italie
Allemagne
USA
France
Suède
UK
Autriche
7
1 – Healthcare system
Evolution since 2006 of the opinions on the health system’s organisation
Excellent = 5
Very good =4
3,6
Good = 3
3
2,8
2,3
2,4 2,4
2,7
2,5
2,8
3
3,1
2,8
2,8
2,7
2,9
2,5
2
Average = 2
2,4
2,2
1,9
2,2
1,7
Poor = 1
06
07
09
10
06
07
09
10
06
07
09
10
06
07
09
10
06
07
09
10
09
10
8
1 – Healthcare system
Evolution since 2006 of the opinions on the quality of health care provided by a GP
Excellent = 5
Very good =4
3,7
3,4
3
3
Good = 3
3,4
3,4
3
3
3,4
3
3,2
3,2
3,4
3,1
3,1
3,1
2,8
3
2,7
2,5
2,6 2,6
Average = 2
Poor = 1
06
07
09
10
06
07
09
10
06
07
09
10
06
07
09
10
06
07
09
10
09
10
9
1 – Healthcare system
Evolution since 2006 of the opinions on the quality of care provided during hospital stay
Excellent = 5
Very good =4
3,6
3,4
2,9 2,8
Good = 3
3
3
3,4
3,5
3,1
3,1
3,1
3
3
3,2
3
3,1
2,6
2,5
2,2
2,5
2,1
2,3
Average = 2
Poor = 1
06
07
09
10
06
07
09
10
06
07
09
10
06
07
09
10
06
07
09
10
09
10
10
1 – Healthcare system
Threats on the health system
In the coming years, our health system will have to face several threats, which I am going to read to you.
For each of them, do you feel that the threat is very important, somewhat important, not really important or not at all
important?
Total : % very important
Lack of public funding
Increase in direct
costs for individuals
Increase in prices for
medical procedures
Unequal access to
health care
72
%
58
%
45
%
73
%
53
%
47
%
72
%
48
%
51
%
73
%
58
%
50
%
77
%
49
%
55
%
69
%
53
%
77
%
62
%
21
%
67
%
52
%
35
%
67
%
49
%
55
%
73
%
38
%
56
%
63
%
76
%
63
%
11
1 – Healthcare system
Threats on the health system
In the coming years, our health system will have to face several threats, which I am going to read to you.
For each of them, do you feel that the threat is very important, somewhat important, not really important or not at all
important?
Total : % very important
Waiting time before
receiving treatment
57
%
Shortage of general
practitioners
60
%
Risks of getting an
infection in hospital
56
%
Medical errors
43
%
52
%
63
%
43
%
35
%
69
%
36
%
70
%
52
%
69
%
56
%
87
%
54
%
65
%
89
%
59
%
76
%
63
%
84
%
70
%
76
%
34
%
64
%
25
%
66
%
21
%
69
%
21
%
70
%
12
1 – Healthcare system
Constant improvements in the quality of treatments are leading to additional spending. To pay for these additional costs,
what do you think is the best solution?
Increase taxes or
compulsory contributions
Increase private insurance, optional supplemental
insurance or supplemental policies from mutual
insurance companies
32%
16%
43%
61%
28%
28%
16%
17%
12%
DK
22%
26%
45%
Pay a greater excess for
each medical service
40%
23%
28%
17%
30%
25%
17%
15%
17%
40%
28%
17%
20%
23%
26%
26%
19%
12%
26%
5%
13
2 – Focus on training
/ communication: perception of
doctors training and
competence
14
2 – Focus on training/ communication – synthesis on doctors competence
Let's talk about the competency of doctors in [FR/UK/GE/IT/PO/SU/US]
At the moment how do you rate their technical skills (for diagnosis and treatments)?
At the moment, how do you rate their interpersonal skills (to inform and explain)?
How do you rate the sharing of information and the coordination of care between the hospital doctors and general
practitioners?
Score technical skills (for diagnosis and treatments)
Score interpersonal skills
Score sharing of information and the coordination of care
Excellent = 5
Very good =4
3,3
3,4
3,5
3,4
2,9
Good = 3
2,9
2,9
2,6
2,6
Average = 2
3,1
2,7
2,4
3
3,5
3,6
3
3,2
2,9
3
2,7
2,6
2,6
2,3
2,2
Suède
Pologne
Poor = 1
Allemagne
France
Italie
UK
Autriche
USA
15
2 – Focus on training/ communication – synthesis on doctors training
How do you rate the training that doctors receive during their medical studies?
How do you rate the ongoing knowledge acquisition that doctors receive throughout their careers?
Score training during medical studies
Score ongoing knowledge acquisition
Excellent = 5
3,7
Very good =4
3,5
3,2
3,3
3,4
2,9
Good = 3
2,9
2,9
2,9
Allemagne
France
Italie
3,2
2,9
3,3
3,4
3,2
3,1
2,9
Average = 2
Poor = 1
UK
Suède
Pologne
Autriche
USA
16
3 – Social requirements
17
3 – Social requirements
Does the current health system guarantee equal access to medical care for all citizens of FR/UK/GE/IT/PO/SU/US?
48%
29%
49%
70%
41%
54%
54%
35%
40%
62%
1%
29%
23%
No
DK
47%
66%
75%
6%
3%
Yes
52%
1%
5%
5%
3%
2%
18
3 – Social requirements
To guarantee all citizens equal access to quality care, are you for or against an increase in contributions/taxes?
Against
For
67%
51%
DK
72%
48%
43%
53%
28%
29%
46%
3%
25%
51%
54%
68%
4%
43%
3%
4%
1%
40%
3%
56%
4%
4%
19
Current affairs – 2010 update
Have the consequences of the economic crisis caused you to cancel or postpone health care actions such as visits to the
doctor, tests, surgical procedures, dental care or prescription drug purchases?
18%
17%
23%
33%
19%
Yes, I have
already done so
12%
8%
5%
25%
6%
2%
5%
10%
8%
24%
6%
No, it will not
change anything
47%
62%
63%
69%
86%
80%
69%
92%
DK
2%
2%
Yes, I may be
forced to do so
1%
2%
1%
1%
2%
20
Current affairs – 2010 update
Have the consequences of the economic crisis caused you to cancel or postpone health care actions such as visits to the
doctor, tests, surgical procedures, dental care or prescription drug purchases?
09
10
09
10
+ 12
points
+5
points
09
10
09
10
09
10
09
10
+ 12
points
Yes, I have
already done so
+5
points
-2
points
25%
23%
18%
17%
12%
11%
13%
13%
10%
8%
6%
6%
21
4 - Mobility
22
4 – Mobility
Imagine that you need surgery. Would you prefer to go to...?
…A specialised surgeon from a distant
city
82%
68%
50%
55%
49%
39%
43%
DK
75%
60%
51%
16%
26%
6%
… A generalist surgeon close to
where you live
23%
2%
37%
52%
40%
2%
6%
3%
6%
8%
1%
23
4 – Mobility
Would you be willing to travel abroad to gain access to a medical technique that you feel to be of identical quality but at a
lower price than in [FR/UK/GE/IT/PO/SU/US]?
Yes
No
57%
39%
23%
32%
42%
17%
23%
25%
75%
75%
DK
40%
56%
75%
66%
56%
82%
3%
5%
2%
2%
2%
1%
24
4 – Mobility
Imagine that you are choosing a holiday destination abroad.
How much importance do you give to local health conditions when you are choosing your holiday destination?
Little importance
Considerable importance
30%
62%
64%
43%
42%
28%
24%
24%
11%
7%
3%
No importance at all
5%
25%
27%
21%
74%
38%
28%
38%
17%
5%
4%
40%
5%
DK
50%
33%
14%
31%
3%
3%
1%
25
4 – Mobility
Now imagine that you had to go and live in another country.
How much importance do you give to the proximity of doctors and hospitals to your new place of residence?
Little importance
Considerable importance
No importance at all
DK
45%
74%
80%
69%
77%
73%
68%
19%
21%
78%
41%
19%
5%
2%
15%
3%
2%
23%
4%
4%
13%
6%
4%
12%
2%
3%
5%
7%
14%
3%
5%
4%
26
5 – New technologies
27
5 – New technologies
Do you use the Internet for information relating to healthcare?
Yes, regularly
Yes, occasionally
14%
17%
16%
11%
45%
No, never
34%
17%
24%
16%
30%
38%
55%
17%
DK
54%
41%
43%
53%
33%
37%
41%
44%
42%
42%
34%
2%
28
5 – New technologies
Do you use the Internet for information relating to healthcare?
Yes, regularly
06
07
09
10
06
07
09
10
Yes, occasionally
06
07
09
10
06
+15 points
07
09
10
06
07
09
10
+21 points
+14 points
09
10
+2 points
14%
+14 points
17%
+10 points
17%
16%
11%
11%
26%
12%
11%
16%
9%
7%
39%
40%
37%
13%
10%
12%
7%
53%
35%
24%
17%
13%
11%
45%
36%
12%
17%
12%
26%
29%
34%
24%
27%
25%
30%
32%
36%
30%
41%
41%
33%
34%
29
5 – New technologies
Do you dare to talk with your doctor about health information that pertains to you that you saw on the Internet?
(To those who use the Internet for information relating to healthcare )
Yes
90%
91%
73%
52%
9%
1%
DK
No
27%
80%
66%
68%
43%
32%
48%
4%
5%
18%
2%
32%
56%
2%
1%
30
5 – New technologies
What do you expect from a doctor with regard to health information available on the Internet?
That he explain to me the aspects I
did not clearly understand
86%
That he provide additional
information beyond what I found
85%
80%
74%
84%
83%
80%
84%
82%
76%
75%
68%
61%
That he tell me about
reliable websites
73%
65%
64%
58%
59%
56%
48%47%
48%
55%
38%
31
5 – New technologies
Are you in favour or not in favour of the development of on-line medical consultations?
Not in favour
In favour
DK
78%
22%
40%
41%
39%
60%
55%
87%
27%
7%
61%
52%
32%
6%
3%
48%
10%
15%
75%
30%
9%
3%
32
5 – New technologies
Are you in favour or not in favour of the development of continuous in-home monitoring resources over the telephone or
Internet (e.g. measurement of blood pressure and heart rate)?
Not in favour
In favour
74%
56%
61%
60%
41%
36%
35%
57%
22%
3%
5%
68%
23%
40%
4%
3%
DK
3%
61%
35%
71%
26%
3%
9%
4%
33
5 – New technologies
Do you think that these in-home medical surveillance or monitoring resources over the telephone or Internet…?
Enable more patients to be independent in their homes
66%
Will dehumanise medicine
80%
71%
78%
71%
72%
68%
69%
39%
51%
46%
38%
51%
34%
40%
44%
34
5 – New technologies - synthesis
Are you in favour or not in favour of websites where doctors can be assessed?
Are you in favour or not in favour of websites where hospitals can be assessed ?
In favour of websites where hospitals can be assessed ( les 18- 39 y.o. most in favour )
In favour of websites where doctors can be assessed?(18- 39 y.o. most in favour)
69%
61%
54%
68%
61%
55%
51%
62%
52%
49%
46%
40%
41%
42%
37%
30%
Allemagne
France
Italie
UK
Suède
Pologne
Autriche
USA
35
6 – Prevention
36
Current affairs – 2010 update
To prevent risks stemming from the appearance of new epidemics like bird flu, mad cow or the A/H1N1 flu, do you want the
State to spend...?
31%
16%
54%
26%
16%
48%
11%
33%
36%
46%
59%
36%
7%
3%
33%
No
change
71%
42%
17%
11%
15%
3%
48%
52%
Less
8%
11%
10%
4%
37%
More
DK
5%
4%
3%
4%
37
6 – Prevention
Have had a check-up at the dentist during the last year
Have been for a check-up over the last five years
Have been tested for a serious disease like cancer or AIDS overs the last five years
Are interested in a lifelong health monitoring programme
100%
90%
91%
80%
82%
70%
69%
60%
75%
68%
71%
61%
59%
50%
50%
40%
91%
42%
67%
80%
71%
71%
65%
61%
55%
55%
44%
49%
36%
83%
80%
42%
32%
42%
30%
31%
27%
20%
42%
28%
19%
10%
0%
Allemagne
France
Italie
UK
Suède
Pologne
Autriche
USA
38
6 – Prevention -synthesis
It is now possible to purchase a lifelong health monitoring programme which includes preventive consultations and an
annual personalised check-up. Are you personally interested in this monitoring programme?
Who would pay? (Aux intéressés) / How?
Interested in and payment
4%
7%
7%
16%
Via taxes
10%
3%
5%
7%
19%
Via the employer
3%
5%
8%
11%
23%
2%
2%
7%
6%
5%
5%
7%
10%
7%
5%
5%
7%
12%
9%
11%
7%
Direct payment
10%
via the insurance
Not interested
61%
72%
63%
77%
69%
54%
52%
50%
DK
6%
4%
9%
4%
9%
12%
6%
7%
39
6 – Prevention
In the context of your job, do you feel that you need health programmes for...?
Total % « yes »
Back pain
67
%
Stress management
54
%
Detecting serious
illnesses
Obesity prevention
Preventing risks
related to tobacco,
alcohol or drug use
39
%
27
%
17
%
61
%
72
%
37
%
29
%
40
%
31
%
35
%
23
%
31
%
51
%
28
%
69
%
42
%
51
%
51
%
57
%
55
%
31
%
57
%
29
%
32
%
18
%
63
%
63
%
42
%
37
%
44
%
57
%
46
%
39
%
39
%
21
%
37
%
18
%
32
%
40
7 – the 5th risk:
management of ageing and
dependent persons
41
7– Ageing
In your opinion, the care given to dependent elderly people is...
1%
7%
30%
5%
3%
3%
1%
4%
12%
26%
24%
22%
3%
11%
32%
4%
Excellent
29%
Very good
5%
15%
1%
36%
15%
25%
Good
Average
Poor
43%
15%
4%
44%
20%
4%
34%
33%
36%
19%
6%
34%
24%
50%
4%
3%
15%
31%
DK
19%
5%
5%
32%
4%
2%
42
7– Ageing
Given the problems raised by increasing life spans and the rise in the number of dependent elderly people, which of the
following should be our priority today?
5%
78%
17%
78%
20%
2%
84%
14%
2%
5%
77%
19%
Home care
40%
9%
25%
4%
5%
6%
21%
15%
Retirement homes
51%
DK
71%
74%
79%
43
7– Ageing
Currently in our country, the public assistance provided to help dependent or elderly people stay in their homes is...
6%
4%
53%
46%
54%
31%
29%
39%
53%
4%
1%
28%
30%
7%
6%
6%
40%
Somewhat
satisfactory
46%
Somewhat
unsatisfactory
29%
Absolutely
unsatisfactory
10%
DK
54%
8%
8%
8%
5%
18%
7%
43%
7%
17%
43%
7%
6%
4%
3%
2%
10%
Absolutely
satisfactory
2%
20%
8%
44
7– Ageing
Outside of their families, which organisation provides dependent elderly people with the best support to help them stay in
their homes?
22%
36%
33%
43%
20%
15%
56%
34%
3%
11%
5%
5%
26%
25%
19%
31%
15%
20%
6%
12%
Private
entities
26%
16%
34%
31%
47%
16%
21%
Non-profit
organisations
33%
4%
38%
4%
14%
26%
1%
14%
Public
entities
15%
None
23%
DK
45
7– Ageing
To help dependent elderly people stay in their homes, do you think we must develop...?
93%
74%
29%
97%
86%
52%
69%
73%
74%
14%
62%
75%
74%
28%
62%
83%
92%
Home care jobs
95%
92%
91%
Remote
monitoring
which makes living at
home safer
94%
93%
Robotics which make it
possible to perform daily
tasks
90%
89%
46
7– Ageing
Two solutions are possible to finance services and daily care for elderly and dependent people : public funding stemming
from taxes and compulsory public contributions, or cost totally met by the individual or the family either from a personal
insurance policy or direct payment.
Which of the following financing options would you most support?
Total coverage by taxes and compulsory
public contributions
4%
6%
17%
31%
6%
27%
Mix of state funding and personal/
family contributions
4%
4%
3%
31%
32%
Cost totally met by the
individual or the family
3%
DK
12%
23%
15%
49%
79%
61%
63%
64%
60%
72%
70%
2%
3%
45%
2%
4%
4%
2%
2%
47
7– Ageing
Are you for or against compulsory private insurance to cover the costs of daily living for dependent elderly people?
Are you for or against compulsory public insurance to cover the costs of day to day living for dependent elderly people?
For a compulsory public insurance
For a compulsory private insurance
62%
57%
44%
52%
45%
52%
49%
46%
46%
40%
33%
30%
27%
Allemagne
France
Italie
UK
Suède
36%
32%
Pologne
37%
Autriche
USA
48
8 – Comparison across
countries
49
8 – Comparisaon across countries
Of these seven countries, where does one receive the best care?
Germany
UK
USA
France
Italy
Poland
Sweden
50% / 19%
4% / 0%
28% / 3%
38% / 11%
67% / 4%
31% / 1%
46% / 6%
XX% / YY% : perception of country’s interviewees vs. perception other countries interviewees
50
8 – Comparisaon across countries
Of these seven countries, where does one get the best reimbursement of health care spending?
Germany
UK
USA
France
Italy
Poland
Sweden
48% / 16%
2% / 0%
18% / 4%
20% / 7%
69% / 3%
27% / 1%
28% / 3%
XX% / YY% : perception of country’s interviewees vs. perception other countries interviewees
51
8 – Comparisaon across countries
Of these seven countries, which one is the most advanced in new health care technology?
Germany
UK
USA
France
Italy
Poland
Sweden
18% / 9%
13% / 2%
2% / 0%
22% / 8%
20% / 2%
23% / 0%
50% / 31%
XX% / YY% : perception of country’s interviewees vs. perception other countries interviewees
52
8 – Comparisaon across countries
In your opinion, the health sector, which includes activities related to hospitals, medical equipment, treatments,
consultations and pharmaceuticals, is an industry that...
Contributes to the country's economic
growth
or is merely a burden for society
77%
59%
62%
57%
14%
31%
10%
36%
22%
9%
73%
66%
66%
24%
24%
10%
10%
49%
12%
15%
37%
16%
7%
DK
14%
53
8 – Comparisaon across countries
2006/2007/2009/2010: comparaison perception du secteur de la santé
In your opinion, the health sector, which includes activities related to hospitals, medical equipment, treatments,
consultations and pharmaceuticals, is an industry that...
Contributes to the country's economic
growth
06
07
09
68%
72%
70%
24%
8%
18%
10
07
09
10
06
72%
59%
60%
52%
59%
12%
10%
38%
45%
34%
07
71%
57%
18%
31%
10%
06
or is merely a burden for society
21%
17%
8%
12%
36%
09
3%
7%
06
07
63%
68%
77%
63%
25%
14%
09
10
61%
62%
12%
24%
25%
9%
12%
7%
2%
10
22%
21%
12%
15%
16%
DK
06
07
68%
72%
17%
09
09
10
43%
49%
73%
58%
12%
13%
29%
15%
10
16%
15%
45%
37%
12%
14%
12%
54