REDESIGNING CARE DELIVERY: IMPROVING THE PATIENT EXPERIENCE AND SYSTEM EFFICIENCY
In light of Europe’s ageing population and increasing chronic disease , current data show that European health systems are under strain. Yet, changes in demographics cannot account for all growth of public health expenditure. Income elasticity, or the responsiveness of health expenditure to changes in income, must also be taken into account. Nevertheless, the two combined cannot explain a large part of the total growth in public health-care expenditure. The most likely factors driving continued growth in healthcare spending are technological progress and the underlying health policies and institutions in place across OECD countries. Europe might have to revisit its policies and the way in which it organizes the delivery of its care. What’s at risk? Deepening healthcare inequalities across Europe, and the possibility of care rationing.
By 2060, expenditures for long-term care will increase dramatically, from a current rate of 7% of GDP to between 10-14% of GDP, according to OECD predictions. The lower end of the spectrum (10%) represents a cost-containment scenario, in which national policies act more strongly than in the past to rein in the growth of healthcare expenditure. The upper-end (14%) corresponds to a cost-pressure scenario, in which European countries do not step up policy action.
In either scenario possible ramifications of a failure to reorganise should be taken seriously. Despite inevitable uncertainty surrounding projections, what is clear is that competing pressures in social spending programmes might deepen existing inequalities in access to healthcare across socio-economic, gender, and cultural groups. According to the European Commission, current health inequalities waste human potential and create a large potential economic loss, estimated between 1.5% and 9.5% of GDP, not to mention further exacerbate disparities. These include disparities in health across socio-economic groups, disparities in access to care, and inequality in financial means to pay for care to get or stay well.
Governments, which might be tempted to reduce healthcare allocations in order to check growth in expenditures, could end up rationing healthcare by necessity. Health, however, is a precondition for economic prosperity, and the health of citizens has an influence on economic outcomes in productivity, labour supply, and human capital. Short-term cost-cutting measures won’t achieve the long-term change necessary to preserving healthcare systems. Rethinking care delivery is a critical step in ensuring the sustainability of European health systems.
OECD: “Public Spending on Care: A New Set of Projections”, Economic Policy Papers Number 06, June 2013
European Commission, “Investing in Health”, Feb. 2013
Spotlight on Prevention: When, Who and How?
Unhealthy lifestyles and lack of physical activity are key factors in the development of chronic diseases. Early prevention and diagnosis, better education, and above all collaboration among governments, patient organizations, and industry are crucial to prevent chronic diseases from arising.