1.X.2. Reducing inequalities in access to care in Europe: achieving universal health coverage and more
Authors:   Organised by: European Observatory on Health Systems and Policies,   Chair persons: Ewout Van Ginneken (Germany)
Published: October 2024

Abstract

Accessibility is multi-dimensional. Universal Health Coverage emphasises the role of population coverage, the scope of services covered, and the depth of financial protection. However, there are other major barriers for patients that can inhibit universal access to health services: geographical inequalities, organisational barriers, and care denial. Health systems can provide extensive cover in some dimensions such as financial coverage or the range of services covered, but gaps in other dimensions can still act as a major barrier to care. Some groups are excluded from population coverage, other patients must navigate waiting times, medical deserts or cultural barriers in order to access care. In this session we will use an innovative filter framework outline common obstacles that patients in the European Union must overcome before they can access the care they need. We will then highlight policy responses to meet the dual goals of reducing inequalities in access to care and ensuring Universal Health Coverage. This workshop will provide a platform for sharing knowledge on reducing inequalities in access to care in EU countries. The objectives of the workshop are to i) highlight cross-cutting themes and approaches, and ii) establish opportunities for cross-country research and learning. The workshop will consist of four short presentations, followed by a broad discussion with audience interventions to bring in the experience of other Member States. Each panel member will make a short presentation in Pecha Kucha format: firstly outlining the filter framework for understanding access to health services then moving to descriptions of a policy journey to strengthening UHC in Cyprus, Estonia and Spain respectively. Bold reforms in Cyprus have expanded coverage under a new universal system; changes in Estonia have improved access to medicines; and policy-makers in Spain have sought to expand coverage of dental care. The moderated discussion will emphasise the potential for cross-country learning - identifying those policy choices of relevance for the rest of Europe. Presentations about specific policy initiatives draw on the latest Health Systems Reviews for Cyprus, Estonia and Spain. Health System Reviews underpin the Health Systems in Transition (HiT) series, a core part of country monitoring undertaken by the European Observatory on Health Systems and Policies. These Reviews are routinely updated and provide a systematic description of the functioning of health systems in countries as well as reform and policy initiatives in progress or under development. As these are in-depth descriptions which detail the intricacies of health systems and an assessment of their performance, they provide the ideal basis for understanding the true multidimensionality of accessibility.

Key messages
• Even health systems in high-income countries need to address inequalities in access to care to ensure universal health coverage.
• The workshop will identify themes and approaches to improving access to care from a cross-country perspective through a multidimensional understanding of accessibility.

Speakers/Panelists
Erica Richardson
European Observatory on Health Systems and Policies, London, UK
Cristina Hernandez Quevedo
European Observatory on Health Systems and Policies, London, UK
Yulia Litvinova
European Observatory on Health Systems and Policies, Berlin Hub, Berlin, Germany
Gemma Williams
European Observatory on Health Systems and Policies, London, UK