Filenews 9 December 2024 - by Marilena Panayi
The abuse of the General Health System in terms of inpatient services, hospital admissions and surgical and other procedures is reflected in the latest report "Health in the EU at a glance" of the European Commission. Cyprus records the second highest number of discharges and far exceeds the average number of discharges across the European Union.
The large number of discharges, however, contrasts with the small ratio of beds to population, although this fact is not necessarily a bad thing, since in several EU Member States the number of hospital beds has been decreasing in recent years, as new health technologies are utilized and primary and day care is strengthened.
On the other hand, of course, there is also the possibility that the reduced number of beds may lead to early discharge in order to serve more patients faster. As noted in the report, "hospital stays largely reflect differences in bed supply, clinical practices and payment systems that can provide incentives for hospitals to encourage bed use."
Positive data for Cyprus and the GHS are recorded and concern the percentage of unmet health needs. Specifically, Cyprus from 2019 onwards presents almost zero percentage of unmet needs, with the needs that remain unmet mainly related to dental services that are not covered by the System. "Unmet medical care needs were reported by 2.4% of the population in the EU", while the proportion of unmet dental needs was 2.2%.
At the same time, and in connection with the fact that unmet health needs are almost zero, Cyprus is not even included in the list of member states that have long waiting times for surgeries. Long waiting times are one of the reasons why citizens report unmet health needs every year.
Finally, a gap, which has also been identified during the first three-year evaluation of the GHS, is recorded in the care of long-term patients, since Cyprus' expenditure in this area does not exceed 1% of GDP.
In detail: Regarding the number of discharges, the report shows that Cyprus in the years between 2019 and 2022 recorded 259 discharges per 1,000 inhabitants, while hospital occupancy was 55% in 2022 (it is recalled that in 2022 restrictions on health services were still in place due to the pandemic). The average number of discharges per 1,000 inhabitants in the EU was the same period at 155/1000. The relevant table shows that Cyprus recorded the second highest proportion of discharges in the EU after Bulgaria (331 discharges).
For Cyprus, it is not possible to make a comparison between the pre- and post-GHS era, since before the inclusion of inpatient care in the System, in June 2020, it was not possible to securely record data in the private sector and the statistics concerned only public hospitals.
However, the latest data from the Health Insurance Organisation support the large number of discharges recorded in the European report, as in the reporting year, i.e. 2022, 105,874 GHS beneficiaries had received inpatient care services, out of a total of almost 900,000 beneficiaries. In 2023, out of a total of 969,722 beneficiaries, 83,166 surgeries were performed, with the percentage fluctuating steadily around 10%.
In second place in the ratio of beds / population
As far as the ratio of beds to population is concerned, Cyprus is in the second half of the relevant EU table, since while the EU average records a ratio of 4.7 beds per 1,000 in Cyprus the number in 2022 was 3.1/1000. The country with the highest ratio is Bulgaria with 8.2/1000 and the country with the lowest ratio is Sweden with 1.9/1000.
"Over the past decade, the number of hospital beds per capita has decreased in almost all EU countries due, in part, to increasing use of day care and a decrease in average length of stay," the report said.
"On average, the number of hospital beds per capita decreased by 10% between 2012 and 2022. The largest decrease was recorded in Finland with a drop of more than 50%."
Waiting lists in the EU from 50 days to a year
The rates of unmet health needs recorded in the EU are due to three main factors. The high costs that cannot be covered by citizens, the long waiting times and the non-coverage of dental services by health systems.
Analysing waiting times for three of the most common surgeries performed each year internationally, cataract, knee and hip arthroplasty, the European Commission points out in the report that the two years of the pandemic have led, among other things, to an accumulation of needs. However, 2023 data shows that waiting times have returned to pre-pandemic levels.
As far as knee replacement is concerned, the waiting time in the Member States ranges from 90 days to one year. For hip surgery the waiting time ranges from 50 to 200 days, while for cataract surgery the waiting time is between 40 – 200 days.
Countries where waiting times for cataract surgery exceed three months are Hungary, Sweden, Spain, Poland, Croatia, Ireland and Iceland and the United Kingdom.
Countries where waiting times for knee replacement exceed three months are Sweden, Spain, Ireland, Portugal, Hungary, Croatia and Poland (please note that the data for Sweden may be misleading as the country has a different waiting time counting system).
In total, 158 knee surgeries per 100,000 inhabitants were performed in Cyprus with an EU average of 134/100,000. The highest number was recorded in Germany with 231/100,000.
In terms of hip surgery, Cyprus performed 123 operations per 100,000 inhabitants with an EU average of 202/100,000.
The report shall also analyse data relating to the referral of patients for radiodiagnostic examinations. "Modern diagnostic technologies play an important role in health systems, allowing doctors to better diagnose health issues. However, they are also a significant cost factor in health systems, particularly if they are used excessively."
The data recorded in the report are computed tomography (CT), magnetic resonance imaging (MRI) and positron emission tomography (PET). Between 2012 and 2019, the number of these tests increased on average in EU countries by over 40%, from 162 tests per 1,000 population in 2012 to 229 tests in 2019.
In Cyprus, between 2019-2022, 179 tests per 1,000 inhabitants were recorded, with most of them related to MRI. The EU average in 2022 was 247/1000 inhabitants.
