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Health care and long-term care systems

Health care and long-term care systems aim at providing timely access to good quality medical care and enable people to live independently also through provisions of social care, such as for patients with disabilities. This contributes to human well-being and economic prosperity and will be crucial for longer working lives in the context of an ageing society.

Demographic ageing will have a major impact on our society and public spending, particularly health care and long-term care spending. Demand for healthcare and long-term care in the EU is sizeable. Public expenditure on health care and long-term care together accounted for 8.7% of GDP and about 15% of total government expenditure in the EU in 2015.

Given the scale of public expenditure on healthcare and long-term care and the need for fiscal responsibility throughout the EU, health care and long-term care spending is central to the policy debate on how to keep public finances sustainable in future.

Public expenditure on health care and long-term care depends on several factors affecting the supply of and demand for care.

Demand-side factors include:

  • population size
  • age and gender distribution
  • health & disability status
  • individual & national wealth
  • rules regulating access to healthcare goods & services.

Supply side factors include:

  • availability and accessibility of services
  • patients' expectations
  • technological development
  • the regulatory framework

Projecting expenditure for health and long-term care, 2013-2060

The Commission's Directorate-General for Economic and Financial Affairs (DG ECFIN) uses models to make projections of spending on healthcare and long-term care for 2013-2060. Total future spending is calculating on the basis of:

  • current spending levels
  • macro-economic development
  • policy reforms
  • population projections
  • health status and disability rates
  • age-related expenditure profiles
  • cost developments for various components of care provision

Various scenarios are used to project the budgetary effect of changes in these factors affecting public health and long-term care spending. Projections show that demographic ageing alone may push up public spending on health and long-term care in the EU to as much as 10.6% of GDP by 2060. However, the additional cost burden from ageing can be lowered, if we live longer in good health. In contrast, other factors - technological advances or higher costs of care provision - may push up spending much further. However, EU countries' future spending trends still differ considerably. With demand for and the supply of health care and long-term care services growing, health systems need to become more effective to safeguard theor positive contribution to the health of the population, while staying affordable and fiscally sustainble.

Read more in the 2015 Ageing Report.

EU health care systems - efficiency

Healthcare expenditure grew faster than national income in all EU countries for most of the second half of the 20th century. However, higher spending does not always produce better results.

Measures of good health vary considerably even among countries that spend the same amount on healthcare, suggesting that some systems are more efficient than others.

The health of a population is influenced by factors including:

  • quality of healthcare
  • education
  • income
  • environment
  • lifestyles.

All the EU countries could improve healthcare outcomes by spending more efficiently. Some have great potential for improvement in this regard.

To find out more, see: Efficiency estimates of healthcare systems

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