Poor health prevention spending is crippling Slovak population’s health

Despite having one of the worst mortality rates from preventable and treatable causes in the EU, Slovakia’s non-communicable disease prevention expenditure remains among the lowest in the EU.

In the EU context, health prevention emerged as a strong pillar within the European Health Union. But health is primarily the member states’ competence and the EU remains in a supportive role.

While the majority of EU countries raised their health prevention expenditure, Slovakia is grappling with a disproportionate focus on treatment rather than prevention.

Slovakia spends less than 1% of total healthcare expenditure on health prevention, the least in the EU and well below the around 3% EU average.

While Slovakia lags behind the EU standards in many health expenditure statistics, the analysts from Value for Money explained that these records are not always accurate because healthcare expenditures also depend on the population’s age structure.

“Elderly citizens require more healthcare, but every country has a different age structure of the population. After taking into account the population’s age structure, Slovakia spends a little more than the 2004 EU enlargement member states,” the analysts noted.

Slovakia has a very high pharmaceutical and medical device expenditure but little priority is given to prevention, which remains neglected and underfunded even if up to 11,000 annual deaths from preventable causes and a high number of hospital admissions could be reduced by more investment in prevention.

Numbers reflect lack of health prevention

Around half of all Slovak deaths can be associated with behavioural risk factors, including dietary risks, tobacco and alcohol consumption, and low levels of physical activity.

Cancer incidence and high cancer mortality are among the worst in the EU, while life expectancy is almost four years below the EU average.

Particularly, the numbers show 590 cancer diagnoses per 100,000 inhabitants (incidence), while the rate of cancer mortality is the third worst in the EU, with 293 deaths per 100,000.

These numbers can be partly attributed to behavioural risk factors. At the same time, vaccination coverage remains a challenge.

Slovakia has one of the highest rates of medical consultations per citizen in the EU, yet it still struggles with very low preventive health check-up attendance.

Specifically, in most EU countries, the average number of consultations per citizen ranged between 3.5 and 7.8, but in Slovakia, the average number is 11, placing it at the top, while preventive health check-up attendance falls below 50% for the adult population.

“Slovakia has a higher avoidable mortality rate among countries with similarly high expenses,” concluded the Value for Money analysts.

Contacted by Euractiv, Daniella Kállayová, the secretary for screening of oncological diseases at the Slovak Ministry of Health, said “Implementing community health awareness for health promotion and disease prevention, especially for marginalised members and disadvantaged groups” is the first priority of the Operational Programme Slovakia.

“This means sustainable improvement of health conditions, with a focus on social determinants of health, increasing health literacy, and supporting the reduction of health inequalities. The program of health mediation through health support assistants will be implemented based on verified procedures and data outputs,” Dr Kállayová noted.

Confronted with the high number of preventable and treatable deaths, she pointed to the second topic of the Programme.

“[It] focuses on promoting a healthy lifestyle and improving disease prevention. The goal is to improve avoidable deaths by strengthening primary and secondary prevention, e.g. with early disease detection and screening programmes. A healthy lifestyle will be supported through programmes implemented by health clinics,” she noted.

Regarding the high cancer incidence and mortality, Dr Kállayová explained that in the field of secondary prevention, the goal is to build on the oncology programmes and set up a National Screening Centre.

“To support this, GPs should receive improved training in cancer screening. Additionally, the aim is also to reduce the costs of treatment and hospitalisation, including the development of infrastructure for activities focused on lifestyle risk factors,” she said.

As for budgetary improvements in health prevention, Kállayová was not aware of any major investment in health prevention in this year’s budget.

Asked what measure is needed to reduce cancer mortality, Dr Kállayová stressed that “the numbers can improve by clearly improving the implementation of organised screening programmes in the Slovak Republic, in accordance with the recommendations of the Council”.

The EU’s supportive role in health transfers into the EU funding of the Operational Programme, or, as Kállayová highlighted, the attempt to catch up with the EU’s preventive screening standards.

The direction of Slovakia’s health prevention is up to the new health minister, Zuzana Dolinková, but the priorities of her ministry are still unknown.

However, for the treatable and avoidable death rates to improve, health prevention expenditure will need to go up.

[By Filip Áč – Edited by Vasiliki Angouridi/Zoran Radosavljevic | Euractiv.com]

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