The Value of Health: Improving Outcomes

The Value of Health: Improving Outcomes multi-stakeholder initiative began in 2014 with the aim of providing a European level, health community response to debates on health system performance and reform. Confronted by the need to control public spending in the immediate aftermath of the economic crisis, governments across Europe were faced with the challenge of containing health expenditure growth whilst continuing to improve the quality and effectiveness of services provided. At European level, these objectives were reflected in EU’s economic governance process (the European Semester), which each year publishes structural reform recommendations – including on improving the cost effectiveness of health spending.

Among health stakeholders, there was concern that the policy response focused too much on cost containment, with too little attention given to the overall performance of the health system – in particular with respect to quality of care and health outcomes. Over time the European Semester has adopted a more balanced approach: a less prescriptive approach to cost savings, and a broader view of health system performance that recognises the importance of health outcomes, access to care, and quality of care. However, further improvements are still possible (see recommendations).

This final report is based on the discussions and findings of the Value of Health initiative over the past four years, including seven multi-stakeholder roundtables, and working groups on patient-centred outcomes, public health outcomes, and the analysis of health outcomes variation. While many of the case studies in the report are taken from projects and initiatives in West European countries, the findings and perspectives provided by the report are relevant to health systems in all EU Member States. The report is divided into two main chapters: the first provides a multi-stakeholder perspective on the concept of value in health systems; the second explores how health outcome measures can be used to improve value.