Jowett matthew - Innovation in other sectors

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Innovation in other sectors, by Jowett matthew

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Jowett matthew - Innovation in other sectors

  1. 1. MIHealth Forum, Health Management & Clinical Innovation Barcelona, 24 June 2012 Adding value to health systemsthrough service delivery reforms Matthew Jowett Ph.D. Senior Health Financing Specialist & Acting Head, WHO Barcelona Office for Health System Strengthening
  2. 2. Outline The challenge Hospitals: internal coordination Hospitals: external coordination Concluding messages
  3. 3. Increasing diabetes Downward Increasing pressure on cancers public finances HEALTH SYSTEMS OPERATING WITHIN A RAPIDLYTechnological CHANGING Increasing advances ENVIRONMENT COPDs Ageing, dementia & Increasing growing co- CVDs morbidities
  4. 4. Ageing, multiple morbidities and dementia • of 65+ year olds in Australia have 80% three or more chronic conditions • of general and acute hospital beds in 2/3 England used by 65+ year olds many with dementia • is the projected increase in dementia 93% suffers in Western Europe 2010-20506
  5. 5. The challengeHospitals: internal coordinationHospitals: external coordinationConcluding messages
  6. 6. Role of the hospital under question Growing quality and patient safety Rural areas? What is concerns. Specialists desirable / possible? operating in silos. Represents a large Decentralise where fixed cost in the possible, centralise health system where deemed (inflexibility) necessary
  7. 7. The challengeHospitals: internal coordinationHospitals: external coordinationConcluding messages
  8. 8. Unnecessary admissions - diabetes Note: Rates are age-sex standardised to 2005 OECD population. Source: OECD Health Data 2011. OECD
  9. 9. Unnecessary admissions - asthma Note: Rates are age-sex standardised to 2005 OECD population. Source: OECD Health Data 2011. OECD
  10. 10. Unnecessary admissions - COPD Note: Rates are age-sex standardised to 2005 OECD population. Source: OECD Health Data 2011. OECD
  11. 11. PHC - room for improvement • Two countries with free and widely accessible primary care (i.e. full coverage) • Why is there such poor awareness of own blood pressure, low treatment rates, and poor control?Source: Wolf-Maier, et al. 2004. “Hypertension treatment and control in five European countries, Canada, and theUnited States” Hypertension 2004;43;10-17. CREDIT: M. JAKAB
  12. 12. The challengeHospitals: internal coordinationHospitals: external coordinationConcluding messages
  13. 13. Tobacco Unhealthy use diet CORE RISK FACTORS UNDERLYING MAJOR CHRONIC ILLNESSES Harmful Physical use ofinactivity alcohol
  14. 14. Strengthen Multi-population-based professional Unhealthy teams interventions diet FUTURE Harmful Tobacco use of use ACTIONS alcohol Physical Align payment inactivity Family doctors as mechanisms & “navigators” strengthen fiscal throughout instruments patient pathway
  15. 15. Dietary habits in Finland Population aged 15-64 years (1978-2007)% 80 80 Men Women 60 60 40 40 20 20 0 0 Butter on bread Vegetables daily Skimmed or 1 %-milk Source: National Public Health Institute T (KL)/ Health Behaviour among the Finnish Adult Population (AVTK)
  16. 16. “Persistence of a model of primary care which is fragmented andMuch spending on inpatient care often consists of a single doctor represents a significant with limited support is no longer fit misallocation of resources for purpose” (Nigel Edwards, WHO Europe, April 2012) Better coordinated and Improvements in health integrated health and literacy can add significant social care value within health systems

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