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Healthcare in Europe: Scenarios and Implications for Digestive and Liver Healthcare in Europe: Scenarios and implications for digestive and liver diseases HEALthcARE IN EUROPE 2040: HEALTHCARE IN EUROPE 2040: 2 SCENARios AND IMPLICatioNS foR DigestiVE AND LIVER Diseases SCENARIOS AND IMPLICATIONS FOR DIGESTIVE AND LIVER DISEASES 3 Healthcare in Europe 2040: Scenarios and implications for digestive and liver diseases CONTENTS Future scenarios in GI healthcare: Why do we need them? 6 Making sense of a complex world 7 Key uncertainties 8 Healthcare in Europe 2040: Our scenarios 9 Ice Age 10 Silicon Age 12 Golden Age 14 From 2014 to 2040: Scenario timelines 16 The GI patient pathway: A glimpse into the future 18 The GI doctor: Possible healthcare provision 21 Starting the conversation 22 HEALthcARE IN EUROPE 2040: HEALTHCARE IN EUROPE 2040: 4 SCENARios AND IMPLICatioNS foR DigestiVE AND LIVER Diseases SCENARIOS AND IMPLICATIONS FOR DIGESTIVE AND LIVER DISEASES 5 Of course, it is impossible to predict how Europe will look in 2040 If you hold a stake in the health of our nations, especially from a political, societal or healthcare perspective. But while we if you have an interest in digestive and liver health, may not be able to foretell the future, as a society and as clinical specialists, we can create plausible future scenarios for healthcare in please read on. Europe, enabling us to focus our thinking, sharpen our strategies and One day, could one of these scenarios become reality? inform our decision-making. Will we have a flourishing, well-coordinated and unified Europe Where will delivering high-quality healthcare to all? What might any the European Will there of this mean for healthcare even be digestive and system be in one? liver health? 2040? Will society have slipped into Will you be impoverishment prepared for the with little access consequences? to healthcare? HEALthcARE IN EUROPE 2040: HEALTHCARE IN EUROPE 2040: 6 SCENARios AND IMPLICatioNS foR DigestiVE AND LIVER Diseases SCENARIOS AND IMPLICATIONS FOR DIGESTIVE AND LIVER DISEASES 7 Future Scenarios in GI Healthcare: Making Sense of Scenarios Are of Something For Someone Why Do We Need Them? a Complex World and For a Purpose Current models for healthcare delivery in Europe are unsustainable. The world of scenario-building focuses A rapidly ageing population supported by a shrinking workforce on many complex factors. To build our healthcare scenarios for 2040, we conteXTUAL SURVEY & presents major challenges and requires new thinking. needed to look first at those factors that ENVIRONMENT APPRecIAte Gastrointestinal (GI) diseases contribute significantly to the healthcare burden in Europe, affect our everyday lives but cannot accounting for substantial morbidity, mortality and cost. GI diseases kill more than easily be influenced or changed by any geopoLitiCAL 200,000 EU citizens every year and are one of the most common reasons for primary care individual. These are the ‘contextual TRENDS consultations and hospitalisation. Over one-third of all acute hospital admissions are environment’ in which we work and INteRNatioNAL include factors such as the political maCROECONOMICS due to GI diseases, and most Europeans will visit a gastroenterologist at least once in FINANCE INteRNatioNAL their lives. landscape, legislation, environmental CommeRCE and demographic change. These ENERGY PRICes LegisLatioN Faced with inevitable change in our healthcare environments, and recognizing the need factors in turn affect the ‘transactional EXCHANGE to better anticipate and prepare for the future, UEG’s Future Scenarios Working Group environment’, which has a more Rates has been collaborating with specialist scenario planners to develop a set of plausible, immediate impact on our work as SOCIAL VALues relevant and challenging scenarios that may impact the delivery of GI healthcare in the healthcare professionals and includes DemogRaphiCS future. These are presented in the following pages of this booklet. our interactions with, for example; teCHNOLogY our investors, suppliers, employees, CompetitoRS patients, competitors and regulators. ECOLogY REGULatoRS NGOS After establishing a broad contextual and environmental framework, suppLieRS Lobbies the factors most likely to influence INVestoRS healthcare in 2040 were identified. ‘Structured imagination’ was then used empLOYees PAtieNTS to envisage how these factors might Why? What? How? evolve in the future and to develop 24 end-states. Extensive debate and discussion then generated a range of insights that became the building blocks for a range of potential scenarios. These DRIVING foRces INFLUence To focus our thinking, sharpen Three challenging yet plausible By combining expert knowledge, were extensively analysed, refined and TRANSACTIONAL & co-desIGN our strategies and enable us to scenarios relating to the future quality research, hard work, merged, resulting in the three, equally ENVIRONMENT have courageous conversations delivery of healthcare for those dedication and a lot of plausible scenarios that are presented about the future of GI healthcare. with digestive and liver diseases. imagination. here. CONTROL HEALthcARE IN EUROPE 2040: HEALTHCARE IN EUROPE 2040: 8 SCENARios AND IMPLICatioNS foR DigestiVE AND LIVER Diseases SCENARIOS AND IMPLICATIONS FOR DIGESTIVE AND LIVER DISEASES 9 Key Uncertainties Facing GI Healthcare Delivery Healthcare in Europe 2040: Our Scenarios POLitiCAL CHANges CLimate CHANGE GLobaLisatioN MIGRatioN RELIGION TECHNOLogY ReseaRCH fuNDING DRUG ResistaNCE SELF-MEDICatioN HIGH NON-COMPLIANCE SOCIAL INEQuaLities AGEING popuLatioN ALCOHOL AND tobaCCO FooD INDustRY FUTURE OF famiLY AND HOME CARE Ice Age Silicon Age Golden Age Where European impoverishment will Where advancements in technology, Where a strong, well-coordinated, have led, by 2040, to two-tier medicine science and social interactions will unified Europe will, by 2040, ensure and eventually to the collapse of public have led, by 2040, to very extensive high-quality healthcare for ALL healthcare in Europe. automation of diagnoses and treatments European citizens. and redirected health behaviour, FUTURE OF the DOCTOR ChaNGING LANDSCape StaNDARDisatioN OF resulting in a positive change in OF DiagNostiCS AND HEALthCARE healthcare. TReatmeNTS HEALthcARE IN EUROPE 2040: HEALTHCARE IN EUROPE 2040: 10 SCENARios AND IMPLICatioNS foR DigestiVE AND LIVER Diseases SCENARIOS AND IMPLICATIONS FOR DIGESTIVE AND LIVER DISEASES 11 Ice Age Healthcare Provision FAILING EUROPEAN CLimate ECONOMICS IMPOVERIshMENT CHANGE LIMIted PUBLIC FINAnces Ice Age Health and Healthcare MONEY IN the HANDS OF the MINORitY OF INDIVIDuaLS/ENteRPRises During the Ice Age, depletion of The Ice Age sees the development of a two-tier healthcare system and eventually SPLIT natural resources, climate change, to the collapse of public healthcare in Europe. An ageing population with an PRIVAte HEALthcARE RICH POOR PUBLIC HEALthcARE increase in age-related chronic diseases like cancer, antibiotic resistance as socIetY the ageing population, and the well as a lack of new drugs and outbreaks of infectious disease epidemics all economic crisis have all contributed threaten the population. SOME REDistRibutioN to the widespread impoverishment of Poverty and poor healthcare have led to high rates of morbidity and mortality WINNERS OF ResouRCes LoseRS Europe. within the general population. Most individuals have little or no access to PRIVate INsuRANCE CompaNies, NEGLECteD popuLatioNS, healthcare and are also plagued by diseases associated with alcohol, tobacco ‘weLL-OFF’ MIDDLE-HIGH INCOME pubLIC seCTORS, The European Union no longer WORkeRS INCReaseD DRUG LOW-MIDDLE INCOME WORkeRS and obesity. In desperation, people are turning to alternative medicine and ResistaNCE AND exists, most of the population is poor, uncontrolled self-medication. INfeCtious Diseases unemployment is high, religious For the rich minority, there is excellent healthcare available in the private sector. HIGH-Cost ELite HEALth ChRONIC patieNTS Science is market-driven and healthcare services, primarily provided by profit- ECONOMY HEALth groups and alternative ‘health’ (ReseaRCH AND teCH DRIVEN) BECOMING pooR sects have a strong influence and hungry insurance companies, are only available to those who can pay. environmental hazards, including Healthcare workers are leaving Europe seeking better conditions and access pollution and increased exposure to to the latest technology and treatments. Patients are increasingly seeking GOOD HEALTH BAD HEALTH healthcare outside Europe or from off-shore floating hospitals. INCReaseD ELDERLY popuLatioN INCReaseD ALCOHOL/tobaCCO INtake potential carcinogens, contribute to NEW-age ILLNesses, AND RELateD Diseases this toxic mix. the ‘weLL’ siCK, DEPRessioN, maLNUTRitioN AND obesitY psYCHOLogiCAL ILLNesses COLLAPse OF DEVELopmeNT OF seLF-CARE AND PUBLIC HEALth CARE ALteRNatiVE HEALthCARE HEALthcARE IN EUROPE 2040: HEALTHCARE IN EUROPE 2040: 12 SCENARios AND IMPLICatioNS foR DigestiVE AND LIVER Diseases SCENARIOS AND IMPLICATIONS FOR DIGESTIVE AND LIVER DISEASES 13 Silicon Age Healthcare Provision ECONOMY TECHNOLOGY SOCIAL MEDIA GRowth ADVANCEMENT BEComes RELEVANT Silicon Age Health and Healthcare EU LegisLatioN wiLL GRowth RoLE OF TRY TO GOVERN the PUBLIC, PRIVate EDUCatioN During the Silicon Age, global trends Whilst inequalities in healthcare still exist, the dominance of technology in the ROLE OF INDustRY PARTNERships Silicon Age has provided a means of delivering high-tech, cost-effective care to and crises have led to changes at the majority. every level: individual
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