WhiteBook2_Part1 - 180

Discussion
Egypt has the highest age-standardised DALY rate for digestive diseases of the UEG member
countries which is in part due to the high burden of viral hepatitis experienced within the
country. Egypt initiated a national hepatitis C treatment programme in 2014, and made use
of low-cost direct-acting antiviral agents to treat over 4 million Egyptians between 20142020.136
Incidence rates of cirrhosis and other chronic liver diseases due to hepatitis C in
Egypt were still increasing up to 2019, however prevalence has dropped dramatically,
indicating that treatment is potentially shortening the duration of disease. Continued
monitoring will provide essential information about the impact of this programme on the
burden of chronic liver diseases and liver cancer over time.
Economic impact of digestive diseases
The economic cost of inpatient health service delivery (excluding treatment and diagnostics)
for digestive diseases was estimated for 31 UEG member countries, including 29 European
countries as well as Turkey and Israel. On average, the estimated cost of inpatient health
service delivery for digestive diseases as a percentage of GDP was 0.12% across the 31
countries. Together, gallbladder and biliary diseases, chronic liver diseases, inguinal, femoral,
and abdominal hernia, and paralytic ileus and intestinal obstruction, accounted for more than
40% of digestive disease related inpatient health service delivery costs within each country,
except Latvia.
Based on past trends (using data up to 2019), inpatient health service delivery costs for
digestive diseases are expected to decrease in many countries by the year 2035. In general,
the average length of hospital stay for all-causes (including non-digestive diseases) has
decreased since 2000 in most EU countries.137 Average length of stay in hospital is sometimes
regarded as an indicator of efficiency in health service delivery, and can be affected by
factors such as access to primary and community care services.137 Intermediate care facilities
which provide short-term care for patients who no longer require acute hospital care, and
early discharge home-based programmes are being introduced by several countries and may
help to improve care whilst reducing the need for expensive inpatient stays.138
Advancements in treatments and diagnostics may also play a role in reducing average length
of stay and the need for admission. Decreases in inpatient health service delivery costs for
digestive diseases over time may therefore be accompanied by increasing levels of
investment in other areas.
Increases in inpatient health service delivery costs for digestive diseases are anticipated for
some countries, including Ireland and Israel. It has been reported that Israel and Ireland have
relatively high occupancy rates of acute care beds - a measure which can indicate that a
country's health system is under pressure.128 Continued evaluation of policies within these
White Book 2: Part 1
176
WhiteBook2_Part1

Table of Contents for the Digital Edition of WhiteBook2_Part1
