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Healthcare Management
I
n August 2017, parents watched helplessly as more than 60 babies, diagnosed with encephalitis from mosquito bites,
died due to lack of oxygen at a hospital in Gorakhpur, UP, because suppliers’ bills of INR 68 lakhs had not been paid.
Such news is made even more tragic when India, in stark contrast, claims to be the lowest cost provider of the highest
quality care in the world.
Post such an event, questions get raised and the usual causes get flogged in public: corrupt administrators, low
government spend, poor sanitation, incompetent or absent doctors, inadequate supplies, etc. After an appropriate period of
ennui, the nation moves on until the next tragedy that is inevitable and imminent.
Gross negligence and such obvious causes, though difficult to digest, are easy to understand. Our real quest, the Holy
Grail, should be to eliminate any and all errors that prevent us from delivering the best modern science has to offer and
delivering the same to all. Anticipating and correcting or preventing the errors created in healthcare delivery systems is a
larger systemic challenge. The healthcare system is characterized by several major factors that are enlisted below.
Many agencies have recommended that the government spend of 1.1% of
GDP be increased immediately to at least 2.5% and eventually to 3% of GDP.
Each year over 55 million people go bankrupt due to healthcare expenditure,
most of which is due to the cost of medicines. Before we get the increased
spend we need to be prudent and pragmatic in how we spend rather than how
much.
Affordability
If we take a systemic view of healthcare and improved it from first principles
with a strong foundation on education, sanitation, primary and preventive
care, we could stretch the healthcare spend to reach millions more and lift the
nation to a higher global standard that each citizen truly deserves. In order to
reduce the complexity, narrow the variability, increase the availability,
improve the know-how and complete the gaps in information at the point of
care, we need to invest more in digital health tools than increasing beds or
doctors. Ayushman Bharat is a welcome program designed to fix the twin
challenges of affordability and access to 10 crore families across India.
Information is at a premium when the time is of essence. But it is often the
least available when most needed. Latest lab results, adherence to current
medication, a detailed symptomatic history, past medical conditions, genetic
profiles, latest best practice evidence. Most of the time the healthcare provider
is working with less than the full picture.
Incomplete
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