As one of the baby boomers and firmly fingered with responsibility for both the healthcare funding and pensions crises, it is with a very personal interest that I look at emerging trends in care of the chronically sick and ageing. Age unfortunately means collecting co-morbidities, hopefully minor ones, and dealing with them in a way that minimises dilution of quality of life. Undoubtedly staying away from hospitals could be described as a key determinant of well-being and an interesting study by the Rand Corporation in the USA has started to peel away some of the layers of economic understanding of the benefits of investing in care at home. So it is not just good for the patient to stay at home but it is increasingly obvious that it is good for the budget as well.
Sponsored by Philips and reported yesterday by Reuters, the study strongly advocates investing in home monitoring of patients with a variety of chronic conditions including diabetes and heart disease. The report’s release coincided with an appeal to US Health and Human Services Secretary Kathleen Sebelius and Centers for Medicare and Medicaid Services Administrator Donald Berwick to pay for a large-scale study of home monitoring equipment among people in the Medicare insurance program for the elderly. Not restricted to the US, the report is drawn from more than 100 interviews with researchers, providers, regulators and others in China, France, Germany, Singapore and the United Kingdom.
Suggesting a need for much better health economic and outcomes research on the use of home monitoring technologies the report does cite some examples of the benefits of such models of care. A 2008 US Veterans Administration study of 17,025 home telehealth patients showed the devices cut the average number of days hospitalised by 25 percent and produced a 19 percent reduction in hospital admissions. This translates into real money as well as real well-being for patients demonstrating that better and cheaper are not mutually exclusive.
Given the prominence of the Active and Healthy Ageing Innovation programme launched by the EU in the past few weeks as part of the Europe 2020 agenda, it is clear that there is a need for more research on better models of care for the chronically sick to gain a better understanding of the investment and infrastructure needs to make this both possible and deliverable. With most healthcare systems structured to reinforce inertia, the evidence base needs to be developed quickly along with a real understanding of how to drive organisational change management. I would echo the need to mirror the call for work in the USA with similar studies in Europe.
– John Wilkinson, Chief Executive, Eucomed