The European Health Care Outcomes, Performance and Efficiency (EuroHOPE) project

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The EuroHOPE project compares quality and costs of hospital care in Finland, Norway, Sweden, the Netherlands, Scotland, Hungary and some provinces in Italy. The project is financed by the European Commission. In the project we have analysed resource use and treatment results for care for myocardial infarction, stroke, hip fracture, very low birth weight infants and some forms of breast cancer. 

Aim of the project

EuroHOPE is an international project aiming at comparing costs and outcomes for a set of diseases by linking  data sources from different health care systems. Another aim of the project is to develop methods and models for benchmarking of hospital care between and within countries.

Results in brief

Initially the project concentrated on creating linkages between  patient discharge, prescribed drug and cause-of-death registries in the different countries, for patients with myocardical infarction, stroke, hip fracture, very low birth weight or breast cancer. At the same time, methods for defining care episodes and standardising for case mix were developed. The patients were then followed from discharge (for 30 and 365 days) using the same methodology and definitions in all countries.

Sweden generally has high survival rates for all the included diseases, together with Norway and some regions in Italy. The results however indicate potential for efficiency improvements. There are important differences in both costs and quality of care for the included disease groups, both between and within countries. The best results do not always have the highest costs. Another result is that the general health status in the country impacts on the outcome. The results for Hungary are worse than those for the other included countries. This appears not to be explained by access to treatment, but rather by worse overall population health status, with significantly lower life expectancy.  

Continued work

The project is finished, but partly continues in form of the BRIDGE (BRidging Information and Data Generation for Evidence-based Health policy and research) Health project. 

Reports and publications

International hospital productivity comparison: experiences from the Nordic countries.
Medin E, Häkkinen U, Linna M, Anthun K, Kittelsen S, Rehnberg C, et al
Health Policy 2013 Sep;112(1-2):80-7

Health care performance comparison using a disease-based approach: the EuroHOPE project.
Häkkinen U, Iversen T, Peltola M, Seppälä T, Malmivaara A, Belicza , et al
Health Policy 2013 Sep;112(1-2):100-9

Comparing ischaemic stroke in six European countries. The EuroHOPE register study.
Malmivaara A, Meretoja A, Peltola M, Numerato D, Heijink R, Engelfriet P, et al
Eur. J. Neurol. 2015 Feb;22(2):284-91, e25-6

Mortality and Length of Stay of Very Low Birth Weight and Very Preterm Infants: A EuroHOPE Study.
Numerato D, Fattore G, Tediosi F, Zanini R, Peltola M, Banks H, et al
PLoS ONE 2015 ;10(6):e0131685

Towards Explaining International Differences in Health Care Performance: Results of the EuroHOPE Project.
Häkkinen U, Iversen T, Peltola M, Rehnberg C, Seppälä T,
Health Econ 2015 Dec;24 Suppl 2():1-4

Costs and Quality at the Hospital Level in the Nordic Countries.
Kittelsen S, Anthun K, Goude F, Huitfeldt I, Häkkinen U, Kruse M, et al
Health Econ 2015 Dec;24 Suppl 2():140-63

European Regional Differences in All-Cause Mortality and Length of Stay for Patients with Hip Fracture.
Medin E, Goude F, Melberg H, Tediosi F, Belicza E, Peltola M, et al
Health Econ 2015 Dec;24 Suppl 2():53-64

Outcome, Use of Resources and Their Relationship in the Treatment of AMI, Stroke and Hip Fracture at European Hospitals.
Häkkinen U, Rosenqvist G, Iversen T, Rehnberg C, Seppälä T,
Health Econ 2015 Dec;24 Suppl 2():116-39

A Window on Geographic Variation in Health Care: Insights from EuroHOPE.
Heijink R, Engelfriet P, Rehnberg C, Kittelsen S, Häkkinen U,
Health Econ 2015 Dec;24 Suppl 2():164-77

Variations and Determinants of Mortality and Length of Stay of Very Low Birth Weight and Very Low for Gestational Age Infants in Seven European Countries.
Fatttore G, Numerato D, Peltola M, Banks H, Graziani R, Heijink R, et al
Health Econ 2015 Dec;24 Suppl 2():65-87

Parameter Heterogeneity In Breast Cancer Cost Regressions - Evidence From Five European Countries.
Smith J, Banks H, Campbell H, Douglas A, Fletcher E, McCallum A, et al
Health Econ 2015 Dec;24 Suppl 2():23-37

Contact person


Clas Rehnberg

Phone: +46-(0)8-524 863 29
Organizational unit: MMC/Health Economics and Policy