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Healthcare Management Involving the community


The examples of low-cost systems, from the development of health insurance schemes in India to the identification of high performing hospital networks, have leveraged the involvement products


of community delivered and level to ensure the of service are


appropriate for the specific target market and to provide ways of communicating with and being accountable to their communities. Combining these with low-cost insurance products and microfinance as a method for involving the community are promising approaches.


Engaging the patient


Another area where there is more to do is to better engage patients in the system. For providers and payers it will be very important to ensure patients can care for themselves effectively, that they are actively engaged in their treatments and have access to advice and information to make informed and price sensitive decisions.


Managing expectations


The belief that more healthcare means better results and the most high-tech intervention is best is a threat to low-cost, high-quality healthcare. A particular issue, especially in upper income countries, and increasingly for middle class patients in some developing countries, is futile intervention at the end of life.


In low-income countries, there is often an excessive use of IV infusion where oral medication would be cheaper and safer. These choices are often driven by public expectations as well as payment systems. In competitive systems in which doctors bring patients to hospitals there is also the danger of a medical arms race to provide the


best equipment. Policy makers, payers,


providers and other influential people in these systems need to ensure there is proper dialogue with patients, subscribers and the wider public to help them understand that more expensive care is not necessarily better.


Payment mechanisms, regulations and standards may also be required to constrain this – for example, this is an approach that has been used to reduce the use of C-sections.


21 INSIGHT ON Transparency


In designing, wider system transparency around providers’ quality and prices and the coverage and costs associated with insurance is vital. Increasing the availability of information to consumers about prices and providing “Trip Advisor” style patient experience sites will improve accountability and choice in health systems. The availability of smart devices to allow access to these tools is growing exponentially in low-cost markets.


India to the identification of high performing hospital networks, have leveraged the involvement of community to ensure the products delivered and level of service are appropriate for the specific target market and to provide ways of communicating with and being accountable to their communities.


HOSPITAL & HEALTHCARE MANAGEMENT VOL. 3 ISSUE 3 August 2014


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