Health care services in welfare states are at a turning point: public health will no longer improve at the rate of increasing costs that incur. Yet equal access to services should be provided for everyone, and the health care system should accomplish more with the same or fewer resources.
As health technology progresses, also services specialise and become more fragmented and difficult to understand.
‘Treatment methods are constantly improving, but nobody in the system takes care of the patient as an individual with personal needs and worries. To tackle the problem of constant fragmentation of services is strictly an issue of management,’ team leader of the G3 project group, Aalto University Professor Paul Lillrank says.
According to Lillrank, the “management of effectiveness” of health services is a perspective that has been absent from the current health care reform in Finland from the get-go.
Effectiveness is the meter that describes the relationship between used resources and achieved health effects – bluntly, how much health is gained per euro. In addition to clinical criteria, effectiveness considers the improvement in the patients’ functional capacity and their own experiences regarding care and health.
Tailoring of health services to individual needs has been the focus of the research in the G3 project of HEMA Institute at Aalto University Department of Industrial Engineering and Management. In the project, analysis was made concerning the treatment of occupational accidents, discharging of elderly patients from hospitals and supporting expecting parents in decisions made on the basis of prenatal screening. In all these services, the researchers set to identify whether the patient needs actual clinical treatment or, rather, help and support.
‘Instead of scattering patient care to different units and providers, services should be integrated to meet the needs of each customer individually – in other words, they should be mass personalised. And this is not impossible: we have to find groups of patients with similar solutions to their problems, construct solution into modules and combine them to fit certain types of needs,’ Lillrank describes.
‘In treating occupational accidents, the most important thing is to improve the patients’ health so that they can return to work as quickly as possible, and to avoid surgery when not absolutely necessary. This was accomplished in Pohjola Hospital with the help of so-called care masters: they help patients to organise things with doctors, physiotherapy and the insurance company, so that they receive individual help and care. The model also achieved an average saving of EUR 1000 per patient,’ Lillrank says.
According to the report, the effectiveness of health care should be measured by its impact. In addition to medical criteria, attention should be paid to how quickly a patient’s functional capacity is restored, and how patients assess their treatment themselves. Lillrank thinks that service providers, both public and private, should be able to decide how to produce the services.
‘If public service providers are not able to improve economic efficiency and patient-centred effectiveness, private service providers will eat the public sector alive, regardless of whether current model for the SOTE health care reform by the Finnish Government’s becomes reality or not,’ Lillrank believes.
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