Managing Chronic Disease in Europe

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Chronic conditions and diseases are the leading cause of mortality and morbidity in Europe, and research suggests that complex conditions such as diabetes and depression will impose an even greater health burden in the future. It has been estimated that in 2005 77% of all Disability-Adjusted-Life-Years (DALYs) and 86% of premature deaths in the WHO European region are related to non-communicable diseases. The condition expected to increase most dramatically is dementia. The main risk factors for chronic disease are tobacco use, overweight and obesity, hypertension, alcohol abuse, and a sedentary lifestyle. Some years ago chronic diseases were meant to be a problem of the rich and elderly population. Today we know that within high income countries, poor as well as young and middleaged people are affected by chronic conditions.

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Prof. Dr. Reinhard Busse, Miriam Blümel, David Scheller-Kreinsen, Dr. Annette Zentner
Department of Health Care Management, Berlin University of Technology
Presented at ‘Securing Europe’s Healthcare Future’ conference Prague, February 18th, 2009

The economic implications are serious from a macroeconomic perspective as well as from a microeconomic perspective. Chronic diseases depress wages, earnings, workforce participation, labour productivity and hours worked – and they may also lead to early retirement, high job turnover and disability. Disease-related impairment of households’ consumption and educational performance impacts on the gross domestic product (GDP) and on its growth rate. Spending on chronic care is rising across Europe and consuming growing portions of public and private budgets.
The cost of chronic diseases and their risk factors, as measured by cost-of-illness studies, is sizeable, ranging up to 6.77% of a country’s GDP.
Policy makers in Europe need to take action if they want to improve chronic disease  management. This report aims to inform decision-making by giving an overview of the available strategies and interventions as well as empirical evidence on their effectiveness and cost-effectiveness. The report also focuses on five areas of managing chronic disease where policy makers must act, giving recommendations in each area:

• Pharmaceutical and medical innovations
• Financial incentives
• Coordination
• Information and communication technology (ICT)
• Evaluation

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