21 th September 2010 Presentation of the results Healthcare in Europe and in the USA

Studied countries and historical background:  :  :  2010 : 2 GermanyFranceItaly 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. GermanyFranceItalySweden GermanyFranceItalySweden UK Poland UK Technical pieces of information

3 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 Introduction

4 1 –Assessment of the healthcare system and of quality of care

5 1 – Healthcare system How would you evaluate the organisation of the health system in [FR/UK/GE/IT/PO/SU/US] today? DK Poor Average Very good Excellent Good

6 1 – Healthcare system – synthesis using the scores Score « organisation of the health system » Excellent = 5 Very good =4 Good = 3 Average = 2 Poor = 1 How would you evaluate the organisation of the health system in [FR/UK/GE/IT/PO/SU/US] today?

7 Score « quality of health care provided by a GP » Score « quality of care provided during hospital stay » Excellent = 5 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…? Very good =4 Good = 3 Average = 2 Poor = 1 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 » 1 – Healthcare system – synthesis using the scores

8 Evolution since 2006 of the opinions on the health system’s organisation Excellent = – Healthcare system Very good =4 Good = 3 Average = 2 Poor = 1

9 Evolution since 2006 of the opinions on the quality of health care provided by a GP – Healthcare system Excellent = 5 Very good =4 Good = 3 Average = 2 Poor = 1

10 Evolution since 2006 of the opinions on the quality of care provided during hospital stay – Healthcare system Excellent = 5 Very good =4 Good = 3 Average = 2 Poor = 1

11 Threats on the health system Total : % very important Lack of public funding Increase in direct costs for individuals Increase in prices for medical procedures Unequal access to health care 1 – Healthcare 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?

12 Total : % very important Waiting time before receiving treatment Shortage of general practitioners Risks of getting an infection in hospital Medical errors 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?

13 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 Pay a greater excess for each medical service DK

14 2 – Focus on training / communication: perception of doctors training and competence

15 2 – Focus on training/ communication – synthesis on doctors competence Score interpersonal skills Score technical skills (for diagnosis and treatments) Excellent = 5 Score sharing of information and the coordination of care 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? Very good =4 Good = 3 Average = 2 Poor = 1 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)?

16 Score ongoing knowledge acquisition Score training during medical studies Excellent = 5 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? 2 – Focus on training/ communication – synthesis on doctors training Very good =4 Good = 3 Average = 2 Poor = 1

17 3 – Social requirements

18 Does the current health system guarantee equal access to medical care for all citizens of FR/UK/GE/IT/PO/SU/US? 3 – Social requirements Yes DK No

19 To guarantee all citizens equal access to quality care, are you for or against an increase in contributions/taxes? Against For DK 3 – Social requirements

20 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? Current affairs – 2010 update Yes, I may be forced to do so No, it will not change anything DK Yes, I have already done so

21 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? points + 12 points + 5 points - 2 points + 12 points Current affairs – 2010 update Yes, I have already done so

Mobility

23 4 – Mobility Imagine that you need surgery. Would you prefer to go to...? …A specialised surgeon from a distant city DK … A generalist surgeon close to where you live

24 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]? 4 – Mobility Yes DK No

25 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? 4 – Mobility Considerable importance No importance at allLittle importance DK

26 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? 4 – Mobility Considerable importance No importance at allLittle importance DK

27 5 – New technologies

28 Do you use the Internet for information relating to healthcare? 5 – New technologies Yes, regularly No, neverYes, occasionally DK

29 Do you use the Internet for information relating to healthcare? points +14 points+10 points +14 points +21 points +2 points 5 – New technologies Yes, regularly Yes, occasionally

30 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 No DK 5 – New technologies

31 What do you expect from a doctor with regard to health information available on the Internet? 5 – New technologies That he provide additional information beyond what I found That he explain to me the aspects I did not clearly understand That he tell me about reliable websites

32 Are you in favour or not in favour of the development of on-line medical consultations? 5 – New technologies Not in favour In favour DK

33 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)? 5 – New technologies Not in favour In favour DK

34 Do you think that these in-home medical surveillance or monitoring resources over the telephone or Internet…? 5 – New technologies Enable more patients to be independent in their homes Will dehumanise medicine

35 In favour of websites where hospitals can be assessed ( les y.o. most in favour ) In favour of websites where doctors can be assessed?( y.o. most in favour) 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 ?

36 6 – Prevention

37 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...? Current affairs – 2010 update More DK Less No change

38 6 – Prevention Have been tested for a serious disease like cancer or AIDS overs the last five years Have been for a check-up over the last five years Have had a check-up at the dentist during the last year Are interested in a lifelong health monitoring programme

39 6 – Prevention -synthesis Not interested via the insurance Direct payment Via taxes Via the employer DK 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

Total % « yes » Back pain Stress management Detecting serious illnesses Obesity prevention Preventing risks related to tobacco, alcohol or drug use 40 In the context of your job, do you feel that you need health programmes for...? 6 – Prevention

41 7 – the 5 th risk: management of ageing and dependent persons

42 In your opinion, the care given to dependent elderly people is... 7– Ageing DK Poor Average Very good Excellent Good

43 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? 7– Ageing DK Home care Retirement homes

44 Currently in our country, the public assistance provided to help dependent or elderly people stay in their homes is... 7– Ageing DK Absolutely unsatisfactory Somewhat unsatisfactory Somewhat satisfactory Absolutely satisfactory

45 Outside of their families, which organisation provides dependent elderly people with the best support to help them stay in their homes? 7– Ageing None Public entities Private entities Non-profit organisations DK

46 To help dependent elderly people stay in their homes, do you think we must develop...? 7– Ageing Robotics which make it possible to perform daily tasks Home care jobs Remote monitoring which makes living at home safer

47 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? 7– Ageing Total coverage by taxes and compulsory public contributions Cost totally met by the individual or the family Mix of state funding and personal/ family contributions DK

48 For a compulsory private insurance For a compulsory public insurance 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? 7– Ageing

49 8 – Comparison across countries

50 Of these seven countries, where does one receive the best care? Germany UK USA France Italy Poland Sweden 8 – Comparisaon across countries 67% / 4% 46% / 6% 4% / 0% 50% / 19% 38% / 11% 28% / 3% 31% / 1% XX% / YY% : perception of country’s interviewees vs. perception other countries interviewees

51 69% / 3% 28% / 3% 2% / 0% 48% / 16% 20% / 7% 18% / 4% 27% / 1% Of these seven countries, where does one get the best reimbursement of health care spending? Germany UK USA France Italy Poland Sweden 8 – Comparisaon across countries XX% / YY% : perception of country’s interviewees vs. perception other countries interviewees

52 20% / 2% 50% / 31% 2% / 0% 18% / 9% 22% / 8% 13% / 2% 23% / 0% Of these seven countries, which one is the most advanced in new health care technology? Germany UK USA France Italy Poland Sweden XX% / YY% : perception of country’s interviewees vs. perception other countries interviewees 8 – Comparisaon across countries

53 In your opinion, the health sector, which includes activities related to hospitals, medical equipment, treatments, consultations and pharmaceuticals, is an industry that... 8 – Comparisaon across countries or is merely a burden for society Contributes to the country's economic growth DK

/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 – Comparisaon across countries or is merely a burden for society Contributes to the country's economic growth DK