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Guest Post: The new era in holistic health care delivery

In this Guest Post, Charles Dalton and Raju Narayan advocate for a shift towards a patient-centric, holistic healthcare delivery system to enhance efficiency and accessibility in emerging economies.

For much of human history, the hospital has sat squarely at the heart of health care delivery. 

However, a transformation is underway that shifts that centre not to a place but to a person: The patient.

The world’s healthcare needs are changing rapidly. Humans live longer but have fewer children, and caring for this ageing population requires a care delivery regime that is not only affordable but also accessible.

If the Covid pandemic has made one thing clear, it is that a status quo built around dispensing care through hospitals and clinics is neither efficient nor enough. Creating a holistic, integrated and personalised system for delivering care, instead of segregating services into silos, is the best way forward to build a health care system that’s sustainable and accessible for all. We call it the “decentralised integrated care delivery model.”

Nowhere is this pressure for accessible health care delivery as acute as in lower-income countries.

More than half the world’s population live in emerging economies. As recently as 2015, a staggering 96% of the eight million deaths that could be prevented through higher-quality health care occurred in low- and middle-income countries.

Deaths from non-communicable diseases like cardiovascular and respiratory illnesses, cancer and diabetes now number 41 million and account for 71% of global deaths every year, with 29 million of these deaths occurring in low- or middle-income countries.

There is an urgent need to deliver health care more efficiently and cost-effectively in emerging markets, where resource limitations, disease burdens and access challenges often intersect. But how do we move away from status quo silos to build a more holistic and personalised system for delivering care?

Preventive care and early intervention: The first step is to prioritise preventive care since early detection and prompt intervention can lead to cost savings in the long run.

By proactively managing chronic conditions and promoting healthier lifestyles, health care providers can reduce the need for costly hospitalisations further down the road. Preventive care also has the further benefit of improving the population’s overall health, slowing or even arresting the progression of chronic debilitations, thus reducing the burden on an overstretched system.

Outpatient and ambulatory care: Shifting certain medical procedures and treatments from inpatient to outpatient settings or ambulatory care centres can also help reduce costs and the strain on the existing hospital system. Many such facilities have lower overheads, saving both the patients and the system money, and they’re quicker to set up, which lets them better respond to shifting needs. They add to the geographic distribution of hospital locations and help bring care closer to more patients.

Care coordination and disease management programs: Implementing care coordination models for individuals with chronic conditions promotes better health management, reducing emergency room visits and costly hospitalisations. Such programs both control costs for care providers and improve patient outcomes, and they share the common objective of extending care beyond hospital walls.

In the past, it was more difficult to capture information about patient behaviour and analyse data about illnesses to deliver truly personalised care, but technology and communication advancements have changed that. Treating patients at the appropriate level of care benefits providers, patients and payors alike. Providers can better ensure that patients receive timely and tailored care better suited to their individual needs. Providers can get closer to the patient, especially in areas where distances are daunting and circumstances where the patient is home-bound, which allow for vigilant monitoring of chronic conditions and more personalised recommendations.

Revolutionary change can seem to unfold both very slowly and very quickly. Then you wake up one day and shops and malls no longer occupy the centre of retail, and streaming services have upended how entertainment is delivered to us. Health care, too, is not immune to the vast changes wrought by technology and communications.

Because treating and caring for patients is such a localised endeavour, it can be hard to see the innovations already taking place, but change is happening all around us. The people next to you glued to their phones may well be scheduling prescription refills or reviewing their lab-work results. All signs point to a health care future that’s more consumer-centric, customised, local and personalised, and in emerging markets the time to make care delivery holistic and accessible is now.

For emerging markets, the issues of affordability and accessibility are growing concerns. The above highlights how opportunity lies in non-silo thinking and developing, for example, micro private health systems that can help patients access care in the right location. Not everything needs to happen in a hospital. Building an integrated system around the hospitals presents the opportunity to create stickiness with the patient and effectively help them through the right care process, which can improve care outcomes and also help in terms of value for money.

Charles Dalton and Raju Narayan are global sector specialists for Health at the International Finance Corporation (IFC), the private sector arm of World Bank Group.

We would welcome your thoughts on this story. Email your views to Lee Murray or call 0207 183 3779.