2. TIPS TO FINDING AND CHOSSING A DOCTOR
The process of finding and choosing a phisician to manage your specific illness or condition is, in some respect, analogous to the process of making a decision about whether or not to invest in a particular stock or mutual fund.
It is important to keep in mind that you are not looking for just any general physician but rather for a physician who has expertise in the treatment and management of your specific illness or condition.
3.
4. 4 Overview *Global Trends in Health Care *Defining Succesful Systems *5 International Lessons *Practical Steps for Policy Makers
6. ๏Health Age has Begun
๏6 Billion People / Potential Patients
๏Hospitals - 110’000 in the world
๏Health Care Providers
‣9 Million Physicians
‣13 Million Nurses
‣1 Million Pharmacists
‣1 Million Dentists
The Big Picture
6
7. ๏ US$ 2.9 Trillion
Worldwide Health Care
Expenditure
‣ 21% by consumers out
of pocket
‣ 18% by Private payers
or providers
‣ 61% Spent by Public
Entities
Global Health Care Expenditure
Out of
Pocket
Consumer
s
21%
Private
Payer or
Providers
18%
Public
Entities
61%
7
8. ๏ Medication & Devices
35%
๏ Hospital Care 33%
๏ Prevention & Outpatient
Care 23%
๏ Nursing & Rehabilitation
9%
Health Care Expenditure Breakdown
Medicatio
n &
Devices
35%
Hospital
Care
33%
Preventio
n &
Outpatient
23%
Nursing &
Rehab
9%
McKinsey, March 2004
8
9. Global Trends
๏Chronic Under-Investment in Health
๏Public Sector Health Care limited, Private Sector Growing
๏WHO is leading Global Health Care?
๏Impact of Chronic Diseases
๏Patient Empowerment
๏Role of Communication & Information
9
10. TOTAL HEALTH SPENDING PER CAPITA
Based on data from the WHO 2004 World Health Report, Annex 6
11. COUNTRIES DIFFER
ON HEALTH EXPENDITURE
Health spending per capita (USD Billion)
0 500 1000 1500 2000 2500 3000 3500 4000
Switzerland
Germany
France
Netherlands
Sweden
Ireland
Belgium
Greece
Cyprus
Czech rep
Slovakia
Poland
Lithuania
Bulgaria
Romania
Ukraine
3.4 %
4.2 %
4.7 %
5.8 %
6.1 %
5.7 %
7.4 %
6.1 %
9.5 %
9.1 %
7.3 %
9.2 %
9.1 %
9.7 %
10.9 %
11.2 %
% of GDP spend on
Health (2002)
12. Chronic Diseases: Biggest Burden
๏* 35 Million People died from Chronic Disease in 2005
๏* 17,5 million from Cardiovascular Disease
๏* 7,5 Million from Cancer
๏* 4 Million from Respiratory Disease
๏* 1,1 Million from Diabetes
๏Other:
๏* HIV / AIDS – 2,8 Million deaths and 1,6 Million from TB
๏* 880 000 deaths from Malaria
13. 0 1000 2000 3000 4000 5000 6000 7000 8000
Unsafe health care injections
Vitamin A deficiency
Zinc deficiency
Urban air pollution
Iron deficiency
Indoor smoke from solid fuels
Unsafe water, sanitation, and hygiene
Alcohol
Physical inactivity
High Body Mass Index
Fruit and vegetable intake
Unsafe sex
Underweight
Cholesterol
Tobacco
Blood pressure
High Mortality Developing Countries
Low Mortality Developing Countries
Developed Countries
World Deaths in 2000 attributable to selected leading risk factors
Number of deaths (000s)
Source: WHR 2002
17. 0
100
200
300
400
500
600
700
800
900
2002 1st Half 2002 2nd Half 2003 1st Half 2003 2nd Half 2004
0
200
400
600
800
1000
1200
1400
1600
Articles
Pledges
Global Fund for AIDS, TB & Malaria
and Media Coverage
Number of
articles
Pledges, $ millions
Kraig Klaudt, Massive Effort Campaign
18. Media Coverage and the WHO Global
TB Programme Budget
0
50
100
150
200
250
1985 1987 1989 1991 1993 1995 1997
0
2
4
6
8
10
12
14
16
Articles
Cases*
Funding
Number of articles & Cases notified per 100,000 population
Budget,
$ millions
Kraig Klaudt, Massive Effort Campaign; WHO Global Tuberculosis Report, 2000
Global TB Emergency
declared
20. Lesson 2 : Increase Investment
* Be Aware of False Standards (% of GDP) * Budget for Double Burden of Disease * Legislate Specific Entitlements * Actively Promote More Money for Health, More Health for Money (Mexico, UK)
21. Lesson 3: Patients Matter
๏* Make Services Patient-Centred
๏* Optimize Patient Information & Communication
๏* Ensure Quality Improvement
๏ (Japan)
22.
23.
24. ๏* Major Driver for Health Progress
๏* New and better Technologies
๏* Improves Personal Health Behaviour
๏* Scientific Foundation for Policy & Practice
๏(Finland, Ireland)
Lesson4: Evidence
25. Lesson 5: International Collaboration
* EU, World Bank, WHO * Framework Convention on Tobacco Control * International Health Regulations (IHR 2005) * Millenium Development Goals (Foundations, Oxford Health Alliance)
26. Knowing is not enough; we must apply.
Willing is not enough; we must do.
– Goethe
27. Practical Steps
1. Understand Specific Issues in Romanian Health Care 2. Specify Objectives 3. Learn from Other Nations & Forge Alliances 4. Determine Feasibility 5. Consultation – Health Professionals & Stakeholders 6. Implement in Fair, Consistent Manner 7. Research, Review and Adjust
28.
29. Time value of information
1/8 second: "instant"
1/4 second: "snappy"
1 second: cognitive drift
10 seconds: capture by other task
33. Clinical User Interface
Health Vertical
Knowledge Driven Health
Investments
Customisation
People & Partners
www.mscui.net
34. Why Communication is important
Caregivers preference their peers over text Communication errors are the most common cause of preventable medical errors Blind calls and paging
Source: J. Westbrook et al, MJA, 5 May 2008
35. What are we trying to resolve
Issue 1: Not knowing who to go to for advice Issue 2: No backup for the person with the info Issue 3: One to One Communication does not make a team. Metcalfe's law states that : The value of a network is proportional to the square of the number of connected users of the system (n2).
Most of Healthcare
44. Patient Safety Rating PSR http://www.leapfroggroup.org/cp?frmbmd=cp_listings&find_by=state&city=&state=AZ&cols=a.b.c. d.e.f.g.h.i.j.oa
4/22/2009
44
THE LEAPFROGGROUP
45. 4/22/2009
45
THE LEAPFROGGROUP
The Leapfrog Group was founded in November 2000 by the Business Roundtable and is supported by its members:
•The Robert Wood Johnson Foundation,
•The Commonwealth Fund,
•The Agency for Healthcare Research and Quality and other sources.
46. Other highlights of the 2008 hospital survey, include: Relatively low percentages of reporting hospitals are fully meeting volume and risk-adjusted mortality standards, or adhering to nationally endorsed process measures for eight high risk procedures, where following nationally endorsed and evidence-based guidelines is known to save lives: 43% for heart bypass surgery 35% for heart angioplasty 32% for high-risk deliveries 23% for pancreatic resection 16% for bariatric surgery 15% for esophagectomy 7% for aortic valve replacement 5% for aortic abdominal aneurysm repair
46
THE LEAPFROGGROUP
48. Patient centered
Team-based/outreach oriented
High tech AND high touch
Doctor of the Future 1
49. Genomic individualization/ functional medicine matrix
Prospective, preventive, behavioral science-based change methods
Self-healing/homeostasis
Doctor of the Future 2
50. Natural treatments: nutrition, botanicals, lifestyle, mind- body, CAM therapies
Integrative
Health system navigator
Doctor of the Future 3
52. Quality and outcomes focused, evidence-based
Empowering patient education through web based resources, health coaching
Community based/Patient advocate/activist
Social/environmental /policy change and self-care strategies
Doctor of the Future 5
