HealthBASKET – Health Benefits and Service Costs in Europe

Health Benefits and Service Costs in Europe –HealthBASKET is a project funded by the European Commission within the Sixth Framework Research Programme (Grant: SP21-CT-2004-501588). The project has been launched in April 2004 and will be completed in March 2007. The scientific coordination of HealthBASKET is held by Prof. Reinhard Busse, from the Dept. of Health Care Management at the Technische Universität Berlin. Motivation The Kohll/Decker judgments of the European Court of Justice and more recently the Geraets-Smits/Peerbooms cases have demonstrated that health services can no longer be regarded as operating in isolation from other EU Member States. Increasingly there are flows of patients from one Member State to another, sometimes as a matter of individual choice, sometimes organised at national level through Ministries of Health.
There is widespread agreement among Member States that the “financial balance” of the health systems within the European Union should not be undermined by the movement of patients.
A basic requirement to protect this financial viability is the availability of accurate information on the basket of services offered in the different Member States and the costs and prices associated with these services. This knowledge will enable both Member States and the Commission to formulate coherent policies to order patient movements in a way in which the financial viability of existing health systems and the treasured principles of universality, equity and accessibility are not threatened. Further, if patients are to benefit from the opportunity offered by the European Union’s Internal Market, they too will need to know what services are available elsewhere, and at what cost. Policy Impact The HealthBASKET project addresses these needs of knowledge in a clear and unambiguous manner, by focusing specifically on the basket of services and by reviewing and developing methodologies to assess costs and prices of individual services across EU Member States. The project will also support a more coherent policy vision by identifying best practice in the analysis of costs at the micro-level with the scope of international comparability, and by assessing cost variations between Member Sates using a selection of inpatient and outpatient services

For rational decision-making, national and EU policy-makers need reliable comparisons about available health services, how these are defined, what their costs are and which prices they will have to pay for them.

HealthBASKET will approach these issues on a descriptive and analytical way for a sample of nine Member States (Denmark, France, Germany, Hungary, Italy, Poland, Spain, United Kingdom and The Netherlands) representing the diversity of health care systems and traditions across the European Union. In addition a second axis of research will focus on transnational comparability issues.

Country Analyses

For each of their origin countries the project partners will:

• collect and describe the ways of defining

  the services provided within the system by analysing both the structure

  and contents of benefit “catalogues” (or “baskets”) as well as the

  process of defining these benefits catalogues;

• collect and describe methodologies used to assess costs and prices of services;
• assess

  costs of individual health services using a selection of

  “case-vignettes” representing need for care in both inpatient and

  out-patient settings.

Synthesis Work

In addition, and based on the findings from the different countries, HealthBASKET will

• explore the possibilities of building an

  European taxonomy of benefits, based on the basket analysis and other

  relevant classifications, in order to enable a common language for cost

  comparisons;

• identify best practice in the analysis of costs at the micro-level with the scope of international comparability.
• develop

  a methodology which allows comparisons of the costs of individual

  health services between Member States and which allows the reasons

  underlying variations in the costs of individual services to be

  explored.

The Outcomes

The purpose of the HealthBASKET project is to provide the evidence base for establishing comparisons of the costs of individual health services between Member States. It is expected that the project will make a substantial contribution to the development of standards:

• The project will describe how services provided within the health system are defined in different countries

  
  

  A taxonomy of health benefits

• The project will review methodologies used to assess costs and prices of individual services

  
  

  Best practice in cost-analysis

HealthBASKET will provide the scientific underpinning that will allow policy makers both at national and European levels to make informed decisions concerning the free movement of patients from one Member State to another.

Upon completion of the different project phases the results will be made available through this website. The findings will also be made public through presentation at international conferences and publication in peer-reviewed journals. In the year 2007 a symposium will be held to present the final results to key decision-makers.

Lectures:

• The contribution of the Health BASKET and Health ACCESS projects [1]  (Prof. Dr. med. Reinhard Busse, MPH FFPH)

Benefit Report:

• Germany [2]

HealthBasket assembles a multinational group of researchers with recognized expertise in the areas of health system research, health care management, health economics, health technology assessment, classification systems and public health.

The project partners represent the diversity of health systems across the European Union, including national health systems with various levels of centralization and social health insurance systems with different benefit arrangements.

The scientific coordination of the project relies on the Technische Universität Berlin and the management of the project is assumed by the European Health Management Association.

Progress of the research and results will be regularly reported to an Advisory Board with representation of policy-makers and providers organisations as well as the European Observatory on Health Care Systems (WHO) and the OECD. The involvement of the professional public will ensure the quality and the impact of the research. Members of the Advisory Board are:

• Dr. David Chinitz (Braun School of Public Health, Hadassah Faculty of Medicine, Israel) [25]
• Dr. Josep Figueras (Research Director and Head of the Secretariat, European Observatory on Health Care Systems) [26]
• Mr. Pascal Garel (Secretary-General elect, Hospitals Committee of the European Union, HOPE) [27]
• Dr. Bernhard Gibis (Federal Association of SHI-affiliated Physicians, Germany) [28]
• Dr. Manfred Huber (Directorate for Employment, Labour and Social Affairs, OECD) [29]
• Prof. Martin McKee (Professor of European Public Health, London School of Hygiene and Tropical Medicine) [30]
• Dr. Willy Palm (Association Internationale de la Mutualité) [31]

In addition HealthBASKET will be coordinated with Europe for Patients, a project also funded by the Commission.