Martin McKee Co-Director, European Observatory on Health Systems and Policies and Professor of European Public Health at the London School of Hygiene and Tropical Medicine. The European Observatory on Health Systems and Policies supports and promotes evidence-based health policy-making through comprehensive and rigorous analyzes of health systems in Europe. The European Observatory on Health Systems and Policies welcomes requests for permission to reproduce or translate its publications, in whole or in part.
The mention of specific companies or of certain manufacturers' products does not mean that they are approved or recommended by the European Observatory on Health Systems and Policies over others of a similar nature that are not mentioned. All reasonable steps have been taken by the European Observatory on Health Systems and Policies to verify the information in this publication. The European Observatory on Health Systems and Health Policies shall under no circumstances be liable for any damages arising from its use.
The opinions expressed by authors, editors or expert groups do not necessarily represent the decisions or the stated policy of the European Observatory for Health Systems and Policies or any of its partners. Martin McKee cbe is Professor of European Public Health at the London School of Hygiene & Tropical Medicine, Research Director of the European Observatory on Health Systems and Policies, and former President of the European Public Health Association.
The Changing Role of the Hospital in European
The European Observatory on Health Systems and Policies is a partnership hosted by the WHO Regional Office for Europe, which includes the governments of Austria, Belgium, Finland, Ireland, Norway, Slovenia, Spain, Sweden, Switzerland, the United Kingdom and Italy's Veneto region; European Commission; World Bank; UNCAM (French National Association of Health Insurance Funds); health foundation; London School of Economics and Political Science; and the London School of Hygiene & Tropical Medicine. The designations used and the presentation of the material in this publication do not imply the expression of any opinion whatsoever on the part of the European Observatory on Health Systems and Policies concerning the legal status of any country, territory, city or area or its authorities, or concerning the delimitation of its borders. She has published numerous publications on health systems, integrated care, European health policy and population health assessments.
The volumes in this series focus on topical issues surrounding the transformation of health systems in Europe, a process driven by a changing environment, increasing pressures and evolving needs. Using available evidence, existing experience and conceptual thinking, these studies aim to provide both practical and policy-relevant information and lessons on how to implement change to make health systems more equitable, efficient and effective. They are designed to promote and support evidence-informed policy-making in the health sector and will be a valuable resource for anyone involved in the development, assessment or analysis of health systems and policies.
In addition to health policy makers, stakeholders and researchers, key audiences outside the health sector will also find this series invaluable in understanding the complex choices and challenges facing health systems today. Edited by Michael Anderson, Michele cecchini, Elias Mossialos Achieving Person-Centered Health Systems: Evidence, Strategies, and Challenges.
Advances in the management of patients with the main problems seen in hospitals
Cross-cutting topics and technology
Along with new models of community care, the days of the large psychiatric hospital were numbered (Clifford et al., 1991). Finally, there are questions about whether publication accelerates or decelerates improvements in outcomes (Joynt et al., 2016). Transition and transfer of adolescents from pediatric to adult care should also take place in the same hospital where possible (Crowley et al., 2011).
Future technology will focus on a new generation of pumps and monitoring (Carchidi et al., 2011). Interoperability of Electronic Body Temperature Recording Systems in Hospital and Community Innovative Models of Care (Starmer et al., 2010). Most costs are incurred in the first months and years after a patient's discharge from hospital (Saka et al., 2009).
Early initiation of these therapies is also effective in reducing the risk of stroke in patients with TIA (Rothwell et al., 2007). For patients with primary intracerebral haemorrhage, there is evidence that rapid blood pressure reduction may improve functional outcomes (Anderson et al., 2013). For example, a comparative study of the consequences of stroke between six European cities (in France, Italy, Lithuania, the United Kingdom, Spain and Poland) found a threefold variation in the risk of death after a stroke (Heuschmann et al., 2011) .
Some of these differences reflect wider geographic inequalities in health service provision, such as the relative undersupply of stroke units in southern Italy compared to northern Italy (Guidetti et al., 2013). In contrast, during the same period in Sweden, 3–4% of stroke patients were treated with thrombolysis (Eriksson et al., 2010). Across Europe, frail older people account for approximately 20% of total emergency department visits (Sona et al., 2012).
HELP has been implemented in more than 11 countries in more than 100 locations (Steelfisher et al., 2013). The evidence for the effectiveness of virtual wards in frail older adults with complex multimorbidity remains mixed (Bardsley et al., 2013; National Institute for Health and Care Excellence, 2016). One of the main staffing challenges in the care of frail older persons is a shortage of medical and nursing staff in geriatric care (Kolb, Topinkova & Michel, 2011; Heinen et al., 2013).
Such a team will often work closely with other support professionals such as psychologists and psychiatrists (Fleissig et al., 2006). A recent analysis of the Directory of Radiotherapy Centers (DIRAC) database revealed differences in radiotherapy capacity and quality across the EU (Rosenblatt et al., 2013). Long-term oxygen therapy has been shown to prolong life in patients with COPD and chronic respiratory failure (hypoxia; tissue oxygen deficiency) (Stoller et al., 2010).
Palliative care should be provided for the minority of end-of-life patients (Vestbo et al., 2013).
