Today, the EU Expert Group on Health Systems Performance Assessment (HSPA) published its report titled "Tools and methodologies to assess the efficiency of health care services in Europe: an overview of current approaches and opportunities for improvement" .

National health care systems across Europe are increasingly confronted with the complex challenge of reconciling rising demand for health care services with available resources as a means to safeguard their long-term sustainability. At the same time, a consensus is emerging among researchers that up to 20% of current expenditure in modern health care systems can be categorised as either ineffective or wasteful. As European governments seek to exploit opportunities to reconfigure resources within their national health systems to deliver better-value care, the design complexity inherent to health care systems, as well as a series of methodological and data-related limitations, render the identification of specific sources of inefficiency in healthcare a difficult endeavour in practice. 

In this context, the EU Expert Group on HSPA noted that the development of tools and methodologies to assess health care efficiency in Europe is still relatively in its infancy, and that the resulting analytical shortcomings expose health policy-makers seeking to improve efficiency to the risk of misinterpreting the (partial) information at their disposal, with consequences that, at best, may fail to address inefficiency, and that, at worst, can lead to patient harm.

Devising a more advanced array of instruments to analyse, measure and assess efficiency of care – as well as spelling out their specific limitations – is therefore a crucial step to enable health policy-makers to correctly detect inefficient practice and design policy interventions that can enhance efficiency without unintended consequences on access and/or quality of care.

This report – the fourth in the series by the Expert Group on HSPA – aims at supporting national health policy-makers in their ongoing efforts to improve their set of tools and methodologies to assess the efficiency of their health care systems, as a means to help them design more effective, evidence-based policy interventions.

Based on a summary of the main theoretical concepts related to health care efficiency, an overview of country experiences gathered via an internal survey and an in-depth analysis of strategies aimed at increasing efficiency of health care services, the report presents a selection of opportunities for European countries to improve their methods (and their use) to assess the efficiency of health care services.

EU Expert Group on Health Systems Performance Assessment

Following the adoption of conclusions “Towards modern, responsive and sustainable health systems” by the Council of the European Union, in 2014 the Council Working Party on Public Health at Senior Level (WPPHSL) invited Member States and the Commission to set up an Expert Group on Health Systems Performance Assessment (HSPA) to:

• provide participating Member States with a forum for exchange of experiences on the use of HSPA at national level;
• support national policy-makers by identifying tools and methodologies for developing HSPA;
• define criteria and procedures for selecting priority areas for HSPA at national level, as well as for selecting priority areas that could be assessed EU-wide in order to illustrate and better understand variations in the performance of national health systems; and
• intensify EU cooperation with international organisations, in particular the Organisation for Economic Co-operation and Development (OECD) and the World Health Organisation (WHO).

The membership of the Expert Group is comprised of representatives from EU Member States plus Norway, the European Commission, the OECD, the WHO Regional Office for Europe and the European Observatory on Health Systems and Policies. The Expert Group is co-chaired by a Member State periodically elected by other Member States’ representatives, and the European Commission’s Directorate General for Health and Food Safety (DG SANTE).

The Expert Group on HSPA organises its work around a set of priority topics endorsed by Member States, which provides a mandate to the Expert Group to proceed with its analysis work. The activity of the Expert Group on HSPA culminates in the production of a yearly thematic report that identifies and examines tools and methodologies to support policy-makers in their task of assessing the performance of national health care systems in Europe.

After having examined the array of tools and methodologies to assess quality of care, the performance of integrated care and primary care, in 2018 the Expert Group on HSPA focused on identifying tools and methodologies to assess the efficiency of health care services. Over the course of 2019, the Expert Group will focus on the identification of tools and methodologies to assess health systems resilience.

For more information:

• Download the report
• EU action in the area of HSPA