Prevention care at its apex in 2021, due to COVID-19 crisis

We all know how much the COVID-19 crisis has affected on our lives and health. Numbers from Eurostat can only confirm this. 6% of total health expenditure in 2021 was allocated to public and private preventive care, compared to 2019 and 2020, which respectively reached 2.9% and 3.5%. As a result, preventive healthcare expenditure in the EU increased 88.2% in current price terms between 2020 and 2021. Such increase is for the COVID-19 to blame.

A definition from the WHO

The World Health Organization (WHO) defines the disease prevention as “population-based and individual-based interventions for primary and secondary (early detection) prevention, aiming to minimize the burden of diseases and associated risk factors”. According to this definition, there are two different level of prevention, and they refer respectively to the aim to avoid the manifestation of a disease and to the early detection when this improves the chances for positive health outcomes.

The prevention for the pandemic situation from March 2020 until May 2023 is part of the primary prevention, which includes “clinical preventive services such as immunization and vaccination of children, adults and the elderly, as well as vaccination or post-exposure prophylaxis for people exposed to a communicable disease”.

Some statistics

Due to the pandemic, countries were obliged to organise their resources and invested in preventive care, especially in “Immunisation Programmes”, as vaccination campaigns spread throughout the EU.

In absolute terms, total expenditure on preventive healthcare for all EU Member States amounted to €95.3 billion in 2021. Germany was the only one to spend more than €20.0 billion on preventive healthcare, up to €30.0 billion, followed by France (€16.9 billion) and Italy (€11.4 billion). Cyprus (€49.6 million) and Malta (€19.4 million) had the lowest figures in the entire EU; they were the only Member States to spend less than EUR 100 million.

But let’s get deeper with these numbers. Some countries spent more than others on preventive care, such as Austria (with 10.3%), which achieved the highest share, followed by Denmark (8.9%) and the Netherlands (8.7%). In contrast, the lowest share was recorded in Malta (1.2%), followed by Slovakia (1.6%) and Poland (2.1%).

In relation to population size, in 2021, among the EU countries, only 14 countries spent more than 100 euro per inhabitant on preventive healthcare, with Poland reaching the lowest point with €20.6, Slovakia (€23.0) and Bulgaria (€28.7). On the other hand, spending on prevention was highest in Austria (€566.4 per inhabitant), Denmark (€555.1) and the Netherlands (€476.9).

Where did the care come from?

Who provided the healthcare during the pandemic?

For 13 Member States, these were mainly providers of preventive care, which include ‘organisations that primarily provide collective prevention/public health programmes and campaigns for specific groups of individuals or for the population as a whole, such as health promotion and protection agencies or public health institutes, as well as specialised facilities that provide primary preventive care as their main activity’ and providers of outpatient health care, which includes both practices of general practitioners and medical specialists as well as facilities specialising in day care and the provision of home care services.

The situation is different for three other states. As Eurostat states, “households as home healthcare providers and other industries as secondary providers accounted for 43.5% of preventive healthcare expenditure in Bulgaria. By comparison, the average share in the EU was 4.3%. Healthcare administration and financing providers accounted for 38.0% of preventive healthcare expenditure in Poland. The average share in the EU was 2.3%. In Greece, the highest share of preventive healthcare expenditure was for hospitals, at 34.7%. The EU average was 2.4%”.