Survey highlights differences in cardiac care in Europe

BMJ 2008; 337 doi: (Published 03 July 2008) Cite this as: BMJ 2008;337:a634
  1. Rory Watson
  1. 1Brussels

    The first comparative analysis of cardiac care in 29 European countries shows that the best treatment, ranging from prevention to rehabilitation, is in Luxembourg, France, Norway, and Switzerland.

    The findings are contained in the Euro Consumer Heart Index 2008, produced by the Health Consumer Powerhouse, a provider of healthcare information for the public, based in Stockholm and Brussels.

    The method is based on the techniques that the organisation has developed for the more general Euro Health Consumer Index it has produced since 2005.

    On this occasion, the performance of the 27 European Union countries and Norway and Switzerland was measured against 28 indicators grouped into five separate categories—information, consumer rights, and choice; access, including waiting times; prevention; procedures; and outcomes.

    The four leading performers all scored between 836 and 825 out of a possible maximum of 1000 points. They were followed by a second group of Austria, the Netherlands, Sweden, Slovenia, the United Kingdom, Finland, Italy and Denmark, which all registered more than 700 points. At the other end of the scale Romania, Bulgaria, Latvia, and Poland scored between 400 and 500 points.

    However, the authors conclude that “in all fields of heart care, there are huge variations in policy, resources, and outcomes around Europe.” They note that governments, while publicly advocating the importance of prevention, often fail to put their words into practice.

    France comes closest to having a comprehensive preventive programme, followed by Italy, Belgium, Norway, and the United Kingdom. But fewer than one third of the countries surveyed operated a national cardiac screening programme. The report calls for stronger emphasis on incentives for care providers to take preventive measures, measures to encourage people to stop smoking, promotion of exercise at school, and wider use of national screening programmes for cardiovascular disease.

    While acknowledging that Austria, Denmark, and the UK provide citizens with the latest quality information on good cardiovascular clinics, the report concludes that it is almost impossible to obtain official data on the quality of care in most European countries.

    The authors highlight the need to close the gap between treatment guidelines for cardiovascular disease and reality. They note that many patients who are supposed to take vital drugs such as statins and clopidogrel are in daily practice denied such therapy.

    The heart index, which received an unrestricted research grant from Pfizer, also emphasises the importance of rehabilitation programmes to enable those heart patients who wish to return to work to do so. It established that almost a dozen countries, including the UK and Spain, either do not offer any support at all in this area or else very little.

    “This means that many people cannot return to an active and productive life,” it notes.


    Cite this as: BMJ 2008;337:a634

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