How can some countries spend half or even a quarter of the money others spend on healthcare and produce the same or better outcomes?
While lifestyle and cultural factors impact healthcare delivery and outcomes around the world, some health systems are better equipped to get what they pay for, according to The Guardian.
The most effective health systems have five common factors in the way they manage, deliver and fund healthcare, according to the report.
1. Integrated care. Israel, which spends 7.2 percent of its GDP on healthcare and has an average life expectancy of 82 years, is a strong example of a nation that effectively balances competition with collaboration. There, healthcare is divided into four HMOs, which cover healthcare costs and operate pharmacies, primary care clinics and hospitals, effectively incentivizing collaboration to keep patients healthy.
2. Localized care with hospital leadership. Despite its rapidly aging population, Singapore, where the average life expectancy is 83 years, spends just 4.6 percent of its GDP on healthcare. In 2013, Singapore reorganized the management of all of its public providers into six clusters, with one hospital serving as the leader of each. This change, under the leadership of the Agency for Integrated Care, was part of decades worth of healthcare reforms, which aimed to improve access to healthcare across the nation.
3. Standardization. The world's most efficient health systems rely on a three-step process to provide high-quality, low-cost care, according to the report. The first step is standardizing clinical workflows by defining best practices, developing guidelines and ensuring consistent compliance. The second step is creating IT systems that incorporate these practices into daily practices, and the third step is maximizing the skill sets of all trained professionals. Danville, Pa.-based Geisinger Health System is a prime example of this.
4. Prioritized social care. Despite the clear linkage between health outcomes and social care, few nations give the latter the attention and resources it requires. Social care for senior citizens is often overlooked. But in 2000, Japan took action. It placed a 1 percent to 2 percent income tax levy on adults ages 40 and above to fund a national aged care service. The service pays for homes, community and residential care for all eligible elderly citizens, which has effectively prevented significant hospital admissions and helped support what is now the world's oldest population, according to the report.
5. Payer power. Hong Kong, Italy, Denmark, Norway, Singapore, Spain and New Zealand, which are consistently ranked among the most efficient health systems, all have a single or dominant health insurer. This model accounts for the slower rates of healthcare spending growth in these countries compared with those with numerous disparate payers, such as the U.S., Germany or the Netherlands, according to the report.