Where is the imperative in healthcare systems to ensure that the patient is receiving treatment in the best place for them?
Even looking just within Europe, regulation – and payment – for healthcare services is very markedly siloed, with little to no joined-up thinking between the likes of mental health, assisted living, domiciliary care, acute care and post-acute care. Budgets, crucially, are often siloed too.
How much better off we would all be if only we could take a holistic approach, and make decisions based on patient need (and yes, cost-effectiveness) considering all available resources?
Take hospital beds; it is eminently sensible for post-acute rehab beds to be favoured over hospital beds at the earliest appropriate opportunity. Any stay in a hospital recovering from a broken hip in a hospital bed carries a hefty price ticket and carries a higher risk of infection, as well as less active rehabilitation than available elsewhere.
How then do you encourage an environment in a competitive market to place the patient where they are best suited?
There is little imperative on the hospital here to push for a discharge to a rival for-profit group for further treatment, even where that is the best option, and, particularly where there is a full hospital market, say Dubai. That hip patient could be in their hospital bed for a while. And this is but one example. There is a similar lack of joined up thinking across a broad spectrum of healthcare services.
The pressure can only come from the payors/insurers to change this and this will require them to fully understand the benefit to the patient – and the financial benefit to them – of putting a round peg in a round hole.
An integrated approach to healthcare raises other issues, too. Improving access to patient data and medical information across all care teams is crucial, which requires the thorny issue of IT compatibility and the minefield that is data security to be tackled.
And while these issues are being tackled, there is no immediate prospect of a solution. Until there is, we’ll continue to see healthcare systems forcing round pegs into square holes, to the detriment of payors and patients alike.We would welcome your thoughts on this story. Email your views to David Farbrother or call 0207 183 3779.