Changes in healthcare access across Europe over a decade

Background

During the last decade, healthcare access has become a particularly important policy issue across Europe. The COVID-19 pandemic highlighted both the importance and the vulnerability of healthcare systems within societies, while demographic change, professional shortages and increased fiscal pressures across welfare states have intensified concerns about the sustainability and equity of healthcare. In this study we examine changes in healthcare access across Europe during the last decade, and explore whether these trends are associated with healthcare financing characteristics.

Methods

We use repeated cross-sectional data from the European Social Survey from 2014 and 2024, combined with indicators of healthcare expenditure and financing at country level. We use descriptive analyses to examine trends in unmet healthcare need by education, income, and gender. To assess changes in socioeconomic inequalities in healthcare access over time and their association with healthcare system characteristics, we use multilevel logistic regression models.

Results

Preliminary findings show an increase in lack of healthcare access across a vast majority of European countries. In addition, this trend is markedly higher among lower-educated and lower-income groups, suggesting widening inequalities in access. Women report lack of access more frequently than men, and the most reported barriers for access are long waiting lists and lack of available appointments. Initial analyses also suggest that higher overall healthcare expenditure is not consistently associated with better access, whereas a higher public share of healthcare spending may be associated with lower inequalities in access.

Discussion

Preliminary findings suggest that healthcare access has deteriorated in many European countries and that inequalities in access have widened since 2014.

Key messages

• Since 2014, healthcare access has deteriorated across Europe.

• Since 2014, socioeconomic inequalities in healthcare access have widened.