Bilaga 1. How are health systems adjusting to changes in disease patterns, with more focus on chronic diseases and more focus on prevention?

This brief paper provides an overview of themes and approaches used in European health systems to help address the changing nature of chronic disease management and actions for health promotion and disease prevention. This paper does not aim to set out the scale of the challenge in any detail, it takes as a given that the reader is familiar with the broad epidemiological (increased contribution of chronic disease to overall disease burden) and demographic (in the main ageing populations) that are in part the spur for system change. It is also not meant to be representative of all European Economic Area (EEA) countries and it does not look at the situation in Sweden. Rather it is intended to give a general sense of the current state of play but it must be remembered that many actions will take place at a regional or very localised level, especially for public health and will not have been identified in background work for this paper. The paper also focuses solely on themes in actions that are being taken to address issues, rather than reflecting on the strengths and/or weakness of these approaches. While the report is brief, in addition to recent references, recent documentation with online links (where available) are provided for further information. The report has been prepared after reading the State of the Health in the EU country reports, EU Semester Reform programme reports, Health Systems and Policy Monitor Reports, the European Commission DG SANTE webpages, the Joint Action on CHRODIS (Implementing Good Practices for Chronic Diseases), material from the European Commission’s the Foresight and Behavioural Insights Unit as well as recent reports from the Commonwealth Funds supplemented by a brief review of recent literature