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Healthcare Management


Trying to make the hospital low-cost will only get us so far. The best results are likely to come from thinking in terms of a low-cost system of care. Payers and governments can work with providers to assemble the components of this. In addition to all the components we have discussed low-cost systems will also need some or all of the following:


A primary population


care system with a registered


While there will be demand in many populations for direct access to specialists for some conditions, the evidence is very clear: primary care is still the most cost effective model and gatekeeping, where culturally acceptable, is vital to keep costs under control. Family doctors or other primary care providers need to be able to offer a wide range of health and wellbeing services, diagnostics, and preventative care.


Moreover, grouping GPs into larger group practices has important benefits in terms of cost-sharing, knowledge sharing and improvements in clinical outcomes. A patient register needs to be used to identify high-risk patients and ensure they have care plans that anticipate, rather than


19 INSIGHT ON


merely respond to the need for care. Where family doctors are in short supply, it is possible to consider dividing some of their tasks between different providers but the key is to ensure there is someone with responsibility for patients over time able to coordinate different services and deliver anticipatory care.


Ambulatory and homecare services


Homecare may have similar direct costs to hospital care unless some of the burden of caring is transferred to family and other carers. However it has much lower overheads, so expanding capacity by increasing these services rather than adding additional buildings can help to contain costs. These


approaches allow improved management of


chronic disease, end of life care, and post hospital care which can help to increase hospital productivity.


HOSPITAL & HEALTHCARE MANAGEMENT VOL. 3 ISSUE 3 August 2014


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