Health at a Glance: Europe 2024

Foreword

Europe finds itself at a pivotal moment in the evolution of health systems across the continent. The health landscape is changing rapidly, requiring governments, healthcare providers and society at large to address new and complex health challenges while building on the successes of the past.

Several megatrends are bound to profoundly influence the future of healthcare. Demographic shifts, driven by increasing life expectancy and declining birth rates, are placing growing demands on health and long-term care services, while reducing the working-age population needed to both finance – through taxation or social security contributions – and deliver these services. At the same time, rapid advances in medical technology – from enhanced diagnostics to the digital transformation of health systems and the integration of artificial intelligence tools – offer potential to improve efficiency and expand access to care, but also raise questions about equity and necessary safeguards against misuse. Moreover, the growing health impacts of climate change, such as the increasing frequency and severity of heatwaves resulting in more heat-related illnesses and fatalities, underscore the need for both more resilient health systems and a sustainable, green transition also within health systems. We need forward-looking policy solutions that fully harness the potential of new technologies while upholding the core principles of universal access to high-quality care – a hallmark of healthcare in the EU.

This 2024 edition of Health at a Glance: Europe comes at a critical juncture, providing valuable analysis and insights to support decision-making across European countries. This year’s thematic section examines two interconnected priorities: (a) promoting healthy longevity, and (b) addressing health workforce shortages. These challenges are fundamental to managing the shifting balance between demand and supply capacity in European health systems.

Promoting healthy longevity

Healthy longevity can be defined as living a long life in good physical and mental health, without overlooking the social aspects of well-being. Demographic shifts across the EU are profound, with the proportion of the population aged 65 and above having increased from 16% in 2000 to over 21% in 2023, with projections indicating a further rise to nearly 30% by 2050. Despite overall gains in life expectancy, the quality of these additional years remains a critical concern, as evidenced by more than 40% of EU citizens aged 65 and above living with at least two chronic conditions. Promoting healthy longevity requires a change in the health systems paradigm, moving from reactive to proactive, comprehensive prevention actions implemented across the life course.

Strengthening the health workforce to build more resilient health systems

The EU faces a health workforce deficit, with an estimated shortage of 1.2 million doctors, nurses and midwives as of 2022. This shortage stems from multiple factors: demographic ageing affecting both patients and the health workforce itself, combined with difficult working conditions that contribute to staff burnout and retention difficulties – challenges that were further intensified by the COVID‑19 pandemic. Bold policy interventions are required across three key areas: expanding professional training capacity, improving workplace conditions to attract and retain talent, and leveraging innovations to increase productivity. OECD estimates indicate that strengthening the health workforce to build more resilient health systems would require additional investment equivalent to about 0.6% of GDP on average across EU countries compared to pre‑pandemic levels. While this investment is substantial, it is dwarfed by the economic and social costs of fragile and understaffed health systems. Addressing skills shortages, as underscored by the European Commission’s Skills Agenda, and optimising the use of skills within new models of care will be crucial for meeting rising demands with limited resources, while also supporting the digital and green transitions.

Health system transformation at the heart of the European Health Union

Digital transformation offers significant potential for health system efficiency, with evidence indicating that digital tools can reduce administrative workload for health professionals by up to 30%. The European Health Data Space provides a crucial framework for facilitating health data exchange and accessibility while upholding robust data protection standards. Success in this digital transition requires strengthening health data infrastructure, incorporating comprehensive cybersecurity measures and targeted training for both health workers and patients. Against this backdrop, the OECD continues to support countries’ progress in implementing the 2017 OECD Council Recommendation on Health Data Governance, including activities focused on digital security in health and the responsible use of AI in healthcare.

Non-communicable diseases (NCDs) – such as cardiovascular diseases, cancer, diabetes, neurodegenerative disorders and autism – pose a significant burden on health systems in the EU. Implementing Europe’s Beating Cancer Plan and the Healthier Together Initiative, promoting preventive care, reducing lifestyle risk factors and transitioning towards more integrated models of care will be essential. The OECD provides indispensable support for these efforts through rigorous cost-benefit analyses of policy interventions and identification of best practices in health promotion, disease prevention and chronic care management. Furthermore, the forthcoming OECD Patient-Reported Indicator Surveys (PaRIS) results, scheduled for release in early 2025, will integrate patient perspectives into health system performance assessment, marking a significant advancement in measuring what matters to patients.

Mental health is a public health priority, especially due to the COVID‑19 pandemic’s significant and persistent impact on young people. Expanding access to timely and quality mental health services, using digital solutions where appropriate, and promoting mental health literacy throughout the life course, including in the education system, will be vital. The European Commission’s Comprehensive Approach to Mental Health provides a robust framework for action. In partnership with the European Commission, the OECD is working to identify best practices in mental health, including school-based programmes that foster social and emotional skills, measures to improve timely access to mental health services for those with mild to moderate issues and suicide prevention initiatives.

Combatting antimicrobial resistance (AMR) and the achievement of the 2030 targets outlined in the Council Recommendation on stepping up EU actions to combat AMR in a One Health approach is paramount. OECD economic analysis quantifies the annual cost of AMR to the EU/EEA economies at EUR 11.7 billion a year, with slightly more than half of this amount related to extra health expenditure incurred from treating resistant infections and the remainder consisting in economic losses due to reduced workforce participation and productivity. The EU’s strategic response to this pivotal challenge encompasses multiple integrated initiatives: the Serious Cross-border Threats to Health Regulation and the Pharmaceutical Strategy for Europe provide support to bolster crisis preparedness and response, strengthen supply chains for critical materials and drive innovation. Building on this foundation, the OECD is advancing its support for member countries in addressing medical supply chain vulnerabilities. As a crucial first step, the OECD will update its landscape analysis of recent initiatives aimed at securing medical supply chains, with a particular focus on international efforts.

A collaborative path forward

The structural challenges facing European health systems demand exceptional levels of collaboration – not only between health and finance ministries, but also across sectors and among countries – to build sustainable, high-performing and people‑centred health systems. It will be essential to foster competitiveness and innovation within the health sector, positioning it as a driver of economic growth and societal resilience. However, this pursuit of innovation must be balanced by a strong commitment to ensuring that all citizens can benefit from these advancements. The Commission’s priorities for an Economy that Works for People and the European Pillar of Social Rights offer a valuable framework to guide efforts at both the national and EU levels, aligning with the OECD’s 2025‑26 programme of work promoting strong, sustainable, inclusive and resilient economic growth.

This report offers a comprehensive review of population health status and the performance of health systems across Europe, encompassing successes and setbacks and delivering valuable insights for shaping forward-looking health policies tailored to diverse national contexts. The European Commission and the OECD remain committed to supporting EU countries in this crucial endeavour, underscoring a shared dedication to health equity and the recognition that robust, accessible health systems are vital for societal well-being and economic prosperity.

Through a continued focus on evidence‑based policy making, European countries can develop resilient health systems that deliver the high-quality, accessible care that all European citizens – regardless of socio‑economic status or geographic location – expect and deserve. This report marks an important step in that journey, providing a reflection and a solid evidence base for the crucial work that lies ahead.

Finally, as we look at the potential enlargement of the EU, it is crucial to support candidate countries in aligning with EU health priorities and closing gaps in health outcomes. Ensuring these nations are fully prepared will foster greater health equity across Europe and strengthen our collective ability to respond to shared challenges. This report serves as both a roadmap of progress made and a compass for future action. By addressing the pressing health challenges of today, we can shape a healthier, more resilient Europe for tomorrow.

Stefano Scarpetta,

Director for Employment, Labour and Social Affairs,

OECD

Sandra Gallina,

Director-General for Health and Food Safety,

European Commission