Efficient Healthcare Systems - Term Paper Example

Running head: Efficient healthcare systems Name Xxxx Course Xxxx Lecturer Xxxx Date xxxxx Efficient healthcare systems Introduction Most economies have been spending large percentages of their budget votes on health care provision. These budgets have recently come under duress over the 2008 and ongoing economic crisis across the globe. As such, the concern for efficiency cannot be overemphasised in order to accrue the most potential from the continually stressful economic situations. The world health organization defines health care efficiency with respect to the quality and quantity of health care and services output for a given level of input. This entails exploring a balance between the inputs in terms of various resources such as financial, technical, technological and human, and output in terms of the output quantity and the quality of services and products offered (World Health Organization, 2010). This is compounded by increasing and diversifying medical care needs over longer life spans and related life-long complications. This paper explores this concern for efficiency in health care systems attempting to establish the causes of inefficiencies, what gains nations may gain from efficient systems and the roles of individual countries and international community in improving efficiency. The WHO report of 2010 forms the basis of this attempt. Improving health care efficiency Health care systems are complex and adaptive systems with immense persistent pressure to deliver ever increasing demands. National and global health systems feature prominently with respect to the United Nations Millennium Development Goals due by 2015. These goals are interdependent converging and diverging at the point of health. In pursuit of the MDGS and health universal coverage, there have been increasingly extensive investments in health care in terms of technology, financial, information and human resources. Health care spending has been growing faster than GDP with the US spending as much as $4.6 trillion in 2011 towering over all other economies (The Guardian, 2012). This is three times of Japan and New Zealand whereas Norway and Switzerland spend two-thirds of this. In 2009, it spent as much as 17.4 percent of its GDP way above other OECD countries, Australia spent 8.7% and the United Kingdom 9.8%, only to cite a few (Squires, 2012). However, the WHO reports 20-40% estimates of losses and wastages due to inefficiencies. These inefficiencies are found in the major areas of spending of these funds such as primary care out-patient care, inpatient care, administration, pharmaceuticals and public health (Medicare Payment Advisory Commission, 2011; OECD, 2011). Essentially, it is the view this paper that these inefficiencies are founded on health care policy and economics issues. Of prominence in this issue is the failure of policies and strategies at national and international levels to develop adaptable assessment or measurement tools. Over a long time the measurement strategies have emphasized on efficiency with regard to the balance of costs and resources, and specific health care functions or indicators (Binder & Rudolph, 2009). This has implied less concentration on the input quality- output quality balance. According to Binder & Rudolph (2009) the quality aspects are arguably the most complex and prominent cause of increasing costs of health care. Hussey, et al. (2009) reviewed 256 health care efficiency measures and concluded that almost all the reviewed measures lacked rigorous reliability and validity over the quality of care. This has implications for both individual nations and the international community to develop standardized efficiency measures founded on the tenets of quality of care. For instance, numerous assessment reports often highlight the need for continuous improvements- continuous quality improvement (CQI). However, there lacks adequate consensus over CQI elements and use of terms (O'Neill, et al., 2011). The WHO has identified key areas in which the losses and inefficiencies are emanating. These include pharmaceuticals procurement and usage, human resources, hospitalization usage- health care services and infrastructure use, medical care errors, policy and strategic inefficiencies, and poor accountability of resources from health care systems. Pharmaceuticals budget accounts for the biggest share in healthcare spending especially in developing countries. In the US, there has been a consistent growth now projected at 3-5% in all settings, 5-7 percent in clinic administration and 0-2 percent in hospital usage (Hoffman, et al., 2012). Access to drugs form part of the millennium development goals. However, there are incapacitating inefficiencies especially in developing nations owing to problems of corruption, private suppliers’ monopolies and market liberalization in the pharmaceutical industry. This has translated to increasing market prices for new generics, some becoming unaffordable to the low-end markets that characterize developing nations. This attracts endemic inequalities in access, corruption, theft and unethical issues (World Health Organization, 2012). At worse, this has led to ploriferation of counterfeit drugs. As such, there is waste of public resources, risk of unsafe drugs and erosion of governments’ confidence amongst citizens and donors. Counterfeit drugs have been implicated to compromise healthcare systems trust, cause complications and death and cost trillions of donor and public funds (Wertheimer & Wang, 2012). In addition to corruption and counterfeits, the pharmaceutical inefficiencies also detail their usage. There inefficiencies due to overuse, underuse, inappropriate prescriptions and usage, as well as poor usage of advanced technologies (World Health Organization, 2010). The problem of corruption goes beyond the pharmaceuticals to touch other areas such as administration, procurement of medical equipment, inspections and management of funds. The WHO report has mentioned of ineffective health care planning and delivering strategy. One of the key areas that require an address across the globe is the role of information technology. The other is economic policy. The information age we are in today is characterized by technological advances. These advances have infiltrated healthcare systems to an extent of becoming a central pillar to delivery and management of health care services. Technological advancements now feature in the development and implementation of innovative diagnoses, research, drug generics and administration as well as in records management. There are inefficiencies when systems fail to use proper systems; little or no use of technology, out-dated technology, and/or mismatches between technology and other resources especially human resources (Varshney, 2009; Champy & Greenspun, 2010). There have been endeavours to transform technological systems in various countries. The most prominent developments are in health records management with the US leading (Stair & Reynolds, 2010). However, technological advancements are rendered inefficient if users are uncomfortable. The common mistake is to implement new systems and then conduct post-installation training. It is recommended that users are motivated and involved from the initial stages to enhance bridge the technological gap. As demonstrated, the impacts of inefficiency are many and wide spread touching on all stakeholders: consumers, providers, governments, regulators and the international community. All the stakeholders have a role in improving efficiency to acceptable standards of quality and quantity output. The benefits of efficient healthcare systems include safety and trust with health care consumers, financial savings for national and international funders as well as the final consumer of health care products and services (Champy & Greenspun, 2010; Vest & Gamm, 2010). In (Weinstein & Skinner, 2010), literature emphasises on improvements with regard to comparative effectiveness rather than cost effectiveness. This implies that efficient health care systems should be a reflection of both comparative and cost effectiveness where quality and quantity is dwelt upon. This requires a paradigm shift at local and international aspects of efficiency measurements in order to alleviate consumers from problems related to the negative interaction between costs and outcome (Weinstein & Skinner, 2010). At the national level the government have the more prominent role of stimulating change to improve efficiency and reduce wastage of resources. Firstly, this may be reflected in policy making and decision making which has a direct impact on healthcare planning and delivery of quality outputs. Policy issues should prioritize on resource allocation in areas such as technological advancements, human resources, health care infrastructure and objective spending on pharmaceuticals. The other area that governments may focus upon is in development of integrated health care. This refers to coordination of healthcare providers and systemic structures formally or informally (KPMG, 2010). In addition, it entails coordinating public and private sector in order to gain from the quasi-public potential. There are relative efficiencies in the delivery the private and public sector (Hsu, 2010). More specifically, the governments should enhance their role given the extent of health care market liberalization and rising costs of access. The international community has been prominent in funding health care systems especially in developing nations in a bid to promote universal coverage. This should be continued but with a focus on quality of care rather than just cost effectiveness. With this funding and the dependence on donor funding by most nations, the international community has leverage to hold accountable individual systems over acceptable standardized international standards (Flessa, 2009). Conclusively, health care systems efficiency should be concern of all stakeholders at whichever level, and each has a role to play. They have numerous avenues, most of which are preventable. Inadequate health care policies and economic decisions are prominent in the mentioned inefficiencies. They result, directly or indirectly to failing systems. In addition, it is vital to focus on both cost and comparative effectiveness. References Binder, L., & Rudolph, B. (2009). Commentary: A Systematic Review of Health Care Efficiency Measures. Health Services Research, 44 (3), 806-811. Champy, J., & Greenspun, H. (2010). Reengineering health care : a manifesto for radically rethinking health care delivery. Upper Saddle River: FT Press. Flessa, S. (2009). Costing of health care services in developing countries : a prerequisite for affordability, sustainability and efficiency. Frankfurt: Lang. Hoffman, J., Li, E., Doloresco, F., Matusiak, L., Hunkler, R., Shah, N., . . . Schomock, G. (2012). Projecting future drug expenditures. American Journal of Health-System Pharmacists, 69 (2012), 65-21. Hsu, J. (2010). 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