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Systemic surgery: a new social contract for health care

Busse R, Zappacosta M

Foresight – the journal of futures studies, strategic thinking and policy 3(4): 369-375





Health care systems in Europe are under mounting pressure for a number of reasons. These include increased life expectancy, rising standards of living, ageing of the population, changes in family structures, greater personal mobility, new health treatments and technological innovations, and further integration and enlargement of the EU.

At the same time, constraints on financial resources are demanding that health services become more efficient and effective, while at the same time retaining their responsiveness to citizens’ needs and expectations. The European model of health care is heading for some major changes that will involve a rethink of the roles of the state and the private sector, decentralization of the system, and more active participation by citizens in the clinical and policy decisionmaking process. The purpose of this paper is to identify science and technology research challenges and opportunities that are relevant for tackling future challenges for European health care systems. The analysis is based on the results of several recent national foresight studies and other relevant technical documents. The conclusions provide a number of research priorities for science and technology in this field.

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