Healthcare overactivity by country shows data is the key
For this week’s infographic – and in the spirit of value health having attended ICHOM last week – HBI compares healthcare service usage across 25 markets, looking at hospital money-makers caesareans, hip and knee replacements. It shows a link between data-rich healthcare systems and lower activity.
The slow move to payment models based on value and outcomes was much-discussed at HBI 2019 but remains an uphill struggle. Comparing usage internationally of the above three procedures, the value of which is debated, and appropriateness often determined by financial incentives, is a good way to see which counties have moved faster than others.
The infographic below shows caesareans as a percentage of live births as well as hip and knee replacements per 1,000 over-65s for 2016. Toggle the tabs to organise the countries by the procedure (highest-lowest/left-to-right).
There are few massive surprises. Poland’s OB-GYN hospital market’s attractiveness is explained by its ranking for c-sections and Medicover’s buying activity there, while in Brazil, we might be seeing one reason why the country’s largest hospital group had 40% of its hospitals taken off UnitedHealth Brazil’s provider list. It also ranks relatively high for hip replacements but the figure will be even higher within private hospitals, as the majority of the population still use the underfunded public sector.
Norway leads the list when it comes to hip replacements. A delegate from there at HBI 2019 told us the country’s hospital sector was woefully behind its peers in adopting digital. Germany, with a reputation for over-treatment, finds itself in the top third for all three procedures, as does DACH neighbour Austria. Switzerland’s data is not available but one would suspect it would figure too.
Two countries consistently at the lower end of the activity rankings are Israel and Estonia, both of which are leaps and bounds ahead of others in digitising national health records, which they can use to spot over-activity and work on prevention.
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