OECD-report outlines rescue plan for welfare systems

The health care systems in the industrialized world suffers from the financial crisis and reduced economic growth. Innovation and development is the answer to the problems, according to a recent OECD-report which outlines a rescue plan for the welfare systems, were the increasing number of elderly and chronically ill is causing further pressure.

- Should the current level of services in the health care systems be maintained the funding issue must first be solved, but the key to success is knowledge-based development, says Professor of Health Policy and Management Johan Calltorp at the Nordic School of Public Health.

The OECD-report Health Sector Innovation and Partnership: Policy Responses to the New Economic Context deals with the health systems funding and structural problems caused by among other things an aging population combined with reduced growth. The subject of Public Health is a central source of knowledge for health care. Professor Calltorp is one of the authors of the report.

- Health care is society's most complex knowledge-based organization and it must be reflected within the organization and how it is run, says Johan Calltorp.
In today's global economic climate, the well-developed countries' health systems are put under dual structural and organizational pressure. The aftermath of the 2008 global financial crisis and the transfer of economic growth to Asia and the Pacific region are affecting the western economies. The health care systems are nowadays undergoing repeated structural reforms and improvements in efficiency and quality, ever since globalization took off in the 1990s. And this process is increasing with the funding problems facing the health care machinery.

- The discussion that must follow is the question of priorities. And that will include what the patient can expect to be treated in the public health system and what will be the individual's own responsibility to take care of, says Johan Calltorp. Due to the result of the report his opinion is that the challenges of the systems are predictable and manageable. The answer is innovation, initiative and entrepreneurial forces.

- One way to deal with future rationing, which means that care provision is limited, is to develop new tools that can provide a more effective health care, based on urgency. The report was first presented at the 50th Anniversary of OECD. It demonstrates innovation projects that give effect on mortality, illness scenarios and quality of life. Technology evaluation, Performance measurement, Quality and Patient safety movement are significant areas for development.

- The challenge of the health care systems must be addressed by linking costs and quality, says Calltorp and emphasizes the importance of setting an agenda for assessment and evaluation. This will ensure that the political and administrative decisions will be based on established knowledge and research.

- Increasing competition on the healthcare market has in many countries - for example Sweden - led to a variety of providers, which in itself may create innovations in the organization such as integration, networking, expanded health care offerings and focus on chronic disease but also integration in local health services and between primary health care providers and hospitals, explains Calltorp. The report takes as a prime example those independent, non-profiting, health care organizations in the U.S. that now is ranked among the nation's very best. Those are characterized by having a knowledge-based management and governance. The success factors are also strong IT-systems and ability to be linking goals and actual outcome but also evaluation and feedback.

- It's all about integration and interaction between actors, targets and performance measurements. But the situation is extremely complex and there is a resistance towards changing that must be forced through international exchange of knowledge, concludes Calltorp.