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How to make our healthcare systems better

How to make our healthcare systems better

Growing life expectancy, while worthy of celebration, also means a rising number of people are living with chronic conditions such as cardiovascular diseases. Access to optimal medical treatments often depends on a person’s financial resources, and with healthcare costs skyrocketing and coverage declining, the patient gets squeezed in the middle.

The healthcare system is not working optimally for everyone regardless of who pays. The goal of universal health coverage is to address the health needs of patients, like those with cardiovascular disease, while ensuring minimum standards of care and financial protection.

Traditionally the bulk of costs for healthcare come from national health budgets; however, out-of-pocket expenses for patients are often necessary at the time of care.

Sadly, more than half of the global population cannot access essential healthcare, and 100 million people go into poverty each year because of out-of-pocket spending on health services.

Cardiovascular mortality is on the rise

In 2015, there were an estimated 422.7 million cases of cardiovascular disease, and nearly 18 million such deaths globally. Ischemic heart disease was the leading cause of lost CVD health lost globally, as well as in each world region, followed by stroke.

Cardiovascular diseases remain a major cause of health loss in all regions of the world. Socio-demographic changes during the past 25 years have been associated with dramatic declines in CVD in regions with a high socio-demographic index (SDI) but only a gradual decrease or no change in most regions.

Geographic location, wealth and education — collectively called social determinants of health — increasingly determine cardiovascular mortality. These factors also influence modifiable risk factors like diet, physical activity and smoking.

Patient-centered cardiovascular care

When we talked with U.S. patients, they tell us they appreciate life-saving and life-improving treatments, but they have rising concerns about whether they can afford the cost of that care.

They also consistently tell us they want to be engaged in their care, understand what their doctor recommends and develop a partnership that goes beyond the examination room.

Beyond affordability, patients report that care is disparate, too complex to manage, unfocused and incongruent with their goals and priorities.

Globally there is a growing recognition that healthcare leaders should prioritize patient-reported outcomes and patient-reported experiences, as well as health-outcome metrics to assess quality whenever possible.

As people live longer, the need is urgent to improve innovation, treatment and payment systems so they incentivize and support the delivery of value in healthcare. Without the patient voice represented throughout this process, we cannot reach true value.

“Growing life expectancy, while worthy of celebration, also means a rising number of people are living with chronic conditions such as cardiovascular diseases.”

Invest in upstream care

According to the World Economic Forum, global healthcare has advanced tremendously in knowledge and innovation, yet many informed observers doubt that society is getting the full value of the annual $6.5 trillion spent worldwide on healthcare. It is estimated that 30 percent to 50 percent of this spend is wasted.

That’s because one-third of all healthcare spending is on services and treatments that account for only 10 percent to 20 percent of improved patient outcomes.

The Astana Declaration reaffirms the need to move care upstream by focusing on prevention and primary care. It calls for enhancing capacity and infrastructure of public health functions and developing continuous, comprehensive, coordinated, community-oriented and people-centered primary care.

Outcome-based care will go global, triggering the adoption of risk-sharing solutions by payers with involvement by governments, providers, clinicians, researchers and patients.

“More than half of the global population cannot access essential healthcare, and 100 million people go into poverty each year because of out-of-pocket spending on health services.”

A clear path forward

By pursuing the following strategies, stakeholders across the healthcare ecosystem — from healthcare leaders to ministries of health — can improve the quality of care:

  • Partner with regulators on sustainable clinical trial models to support and encourage investment in cardiovascular innovation.
  • Create an evidence-based strategy that inspires investment in solutions that support a consumer-centric system of value, affordability and innovation.
  • Engage patients and their caregivers and ensure understanding of their desires and goals.
  • Create unique payment model solutions that focus on upstream prevention rather than downstream treatment.
  • Invest in technology such as virtual health and telehealth and expand services while helping hospitals curb costs.

The World Economic Forum Global Coalition for Value in Healthcare has joined forces with the American Heart Association and Duke-Margolis Center for Health Policy as part of the Value in Healthcare Initiative to tackle this challenge.

Our efforts are convening many diverse stakeholders including patients, clinicians, researchers, public health officials, product developers, employers and others. All share the sense of urgency for change and are willing to act now to develop solutions for the people who are counting on us most.

Republished with permission, this article first appeared on World Economic Forum.

Top Image: Abby Anaday/Unsplash

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