Poor quality health services are holding back progress on improving health in countries at all income levels, according to a new report by the OECD, World Health Organization and the World Bank, ‘Delivering Quality Health Services – a Global Imperative for Universal Health Coverage’.
The report states that inaccurate diagnosis, medication errors, inappropriate or unnecessary treatment, inadequate or unsafe clinical facilities or practices, or providers who lack adequate training and expertise exist in all countries.
10% hospital infection rate
The situation is worst in low and middle-income countries where 10% of hospital patients can expect to acquire an infection during their stay, as compared to 7% in high-income countries. This is despite hospital-acquired infections being easily avoided through better hygiene and appropriate use of antimicrobials. One in ten patients are harmed during medical treatment in high-income countries.
The report highlights that sickness associated with poor quality health care imposes additional expenditure on families and health systems.
There has been some progress in improving quality, such as in survival rates for cancer and cardiovascular disease. The broader economic and social costs of poor quality care, including long-term disability, impairment and lost productivity, are however estimated to amount to trillions of dollars each year.
Universal health coverage an empty promise
The OECD argues that without quality health services, universal health coverage will remain an empty promise. The economic and social benefits are clear and there needs to see a much stronger focus on investing in and improving quality to create trust in health services and give everyone access to high-quality, people-centred health services.
Good health is the foundation of a country’s human capital, and no country can afford low-quality or unsafe healthcare. Low-quality care disproportionately impacts the poor and is economically unsustainable for families and entire countries.
Other key findings in the report paint a picture of quality issues in healthcare around the world:
- Healthcare workers in seven low and middle-income African countries are only able to make accurate diagnoses one third to three quarters of the time, and clinical guidelines for common conditions are followed less than 45% of the time
- Research in eight high mortality countries in the Caribbean and Africa found that effective, quality maternal and child health services are far less prevalent than suggested by just looking at access to services. Only 28% of antenatal care and 21% sick childcare across these countries qualified as effective
15% of hospital expenditure in high-income countries is due to mistakes in care or patients being infected while in hospitals.
Empower citizens to design new models of care
The three organisations outline the steps governments, health services and their workers, together with citizens and patients, urgently need to take to improve health care quality.
- Governments should lead the way with strong national health care quality policies and strategies
- Health systems should focus on competent care and user experience to ensure confidence in the system
- Citizens should be empowered and informed to actively engage in health care decisions and in designing new models of care to meet the needs of their local communities
- Health care workers should see patients as partners and commit themselves to providing and using data to demonstrate the effectiveness and safety of healthcare