State of Health in the EU 2019 – the Companion Report

The European Commission has recently published Country Health Profiles and a Companion Report. While the Country Health Profiles provide an in-depth analysis of specific health systems, looking at the health of the population and important risk factors, as well as the effectiveness, accessibility and resilience of health systems in each EU Member State, the Companion Report focuses on horizontal observations. It shows the trends that can be found in most, if not all, EU Member States, including demographic and technological changes, the shift towards primary care and prevention, and the burden put upon the health workforce.

The Companion Report

The Companion Report is structured along the triple objectives of effectiveness (Chapter 1 and 2), accessibility (Chapter 3) and resilience (Chapters 4 and 5).
Chapter 3 – ‘Strengthening the evidence base on access to health care’ is particularly relevant for patients. It argues that when  measuring  access  to  health  care  and  its barriers the clinical needs and socioeconomic characteristics of patients  need  to  be taken into account.

Key findings regarding transformation of health systems include:

  • Vaccine hesitancy is a major public health threat all across Europe, which can be tackled by improving health literacy, countering disinformation and actively involving health workers.
  • The digital transformation of health promotion and disease prevention can result in winners and losers. People who would most benefit from mobile health and other digital tools may be the least likely to have easy access to it.
  • Gaps in health care accessibility are still very much a reality in the EU. Both the clinical needs and socioeconomic characteristics of patients need to be accounted for when measuring access to health care and its many barriers.
  • Skill mix innovations among the health workforce show great potential for increasing the resilience of health systems. Promising examples of task shifting among health workers are found across the EU, particularly when it comes to enhancing the role of nurses and pharmacists.
  • The product life cycle of medicines reveals ample scope for Member State cooperation in ensuring safe, effective and affordable therapies, including everything from rational spending to responsible prescribing.

Read the Companion Report


The State of Health in the EU gathers the latest evidence on health and captures it in a series of reports. It is managed by the European Commission but benefits from the work of the Organisation for Economic Co-operation and Development (OECD) and of the European Observatory on Health Systems and Policies (Observatory).

The recurring State of Health in the EU cycle consists of four main stages:

  • The joint OECD-Commission report Health at a Glance: Europe kicks off each State of Health in the EU cycle with a horizontal, cross-country assessment of national health systems’ performance in the EU. The latest one was issued in 2018.
  • Individual Country Health Profiles, adapted to the context and specificities of each EU country, assess the strengths and challenges in their respective health systems.
  • A Companion Report, published alongside the Country Health Profiles, showcases some of the biggest trends in the transformation of our health systems.
  • At the close of the two-year cycle, health authorities in EU countries can request voluntary exchanges with the experts behind the State of Health in the EU, to discuss findings and potential policy responses.