COMPARING HEALTH CARE SYSTEMS

PRESENTED BY:
SUJATA INGALE ARPANA TIWARI ANUJ SINGH SIDDHARTH KISHAN

PRESENTATION FLOW
Health scenario of India Health care system in UK Health care system in AUSTRALIA Health care system in NEW ZEALAND Health care system in SWEDEN Health care system in CANADA Comparison in health system

Why study different systems?

Understanding the approaches used by other countries may provide important clues to assessing our own system.

Characteristics of Indian Health System

Complex

mixed health system

- Publicly financed government health system - Fee-levying private health sector

Administrative Structure
Central Ministries of Health and Family Welfare

State Ministries of Health and Family Welfare

District Health Teams

Spending on Health

Annually over 150,000 crores or US$34 billion, which is 6% of GDP (Government spending on health Is only 0.9% of GDP) Out of this only 15 % is publicly financed 4% from social insurance, 1% by private insurance remaining 80% is out of pocket spending ( 85% of which goes in private sector) Only 15% of the population is in organised sector and has some sort of social security the rest is left to the mercy of the market

UK HEALTH CARE

Health System Overview

BOTH PUBLIC AND PRIVATE SYSTEM

National Health Service Act 1948based on post-World War II. British NHS: National Health Service, first comprehensive, nationalized healthcare program. Highly centralize management and finance Patients choose their provider Providers can have public & private practices

Organization structure

Economic Factors

Revenues
83% NHS funding from taxes 13% from employer-employee contributions 4% User fees

Expenditures
NHS accounts for 88% of health expenditures Private Insurance (SI) 4% of expenditures ~3/4 of NHS budget goes to workforce salaries 1/10th of NHS budget goes for drugs

Current Issues in the UK

Aging population High cost of advanced technology and its impact on tight budgets Increased incidence of serious and expensive to treat diseases (cancer, HIV/AIDS) On-going problems with long queues and rationing NURSES SHORTAGE

HEALTHCARE SYSTEM OF AUSTRALIA

Health services delivery

Public services - national health programs, community health centres, public hospitals

Private services -Most General practitioner services, dental services, allied health services

Mixed (public and private providers) - Specialist services, physiotherapist, dietician,home nursing programs, rehabilitation, palliative care services

Financing of health care:

Problems faced by australia health system today

ageing population

Workforce shortages

population is projected to grow

Costs have increased

Chronic disease

HEALTH SYSTEM IN NEW ZEALAND

Health System New Zealand

Health System New Zealand

National Government

Ministry of Health (MOH)

Policy, funding, monitoring Crown Funding agreements with DHBs Pharmaceutical Scheme Disability funding/services for under 65 Contracts with DHBs targets

HEALTH SYSTEM IN SWEDEN

HEALTH CARE EXPENDITURE

Healthcare system in Canada

Overview of Canadian healthcare system

Canada

provides universal access to healthcare to 33.2 billion. Healthcare is guided by provisions of Canadian Health Act. The government assures the quality of care through federal

Canadian healthcare system is delivered through a mixture of :Public

hospitals physicians

Mixed
goods and services

Private
goods & services. dental

Healthcare systems in Canada

Financing comes from

Tax revenues from Provincial, territorial & Fed. Govt. Patient out of pocket, Copayments. Private Insurance

70%

15%

12%

Social insurance funds, such as workers compensation & charitable donations.

3%

Systems Challenges
Canada

struggles with administrative efficiency and service quality.

The median wait time in Canada to see a special physician is a little over four weeks with 89.5% waiting less than 90 days. The median wait time for diagnostic services such as MRI and CAT scans is two weeks with 86.4% waiting less than 90 days. The median wait time for surgery is four weeks with 82.2% waiting less than 90 days.

Comparison of health systems with Indian health system

What India can learn from other countries?

From UK national coverage control over private health care sector increase in GDP expenditure on health health manpower(nurses): talent to be preserved use of advanced technology

What can we Learn from New Zealand?

Features to consider

Strong National Drug Program Better engagement of aboriginal people Primary Health Organizations Promotion of public health services Increase R& D investment in Pharmas Promote insurance policy Organize decentralize health body (District Health Boards)

Implications for India

What can we learn from Sweden?

Features to consider
Serving a much older population at less cost Strong Primary Care System using teams National protection program for user fees GP, Hospital, Drug services Very strong community services housing, home help

Implications for India

Major investment in community services Lower compensation levels for health professionals Much higher income tax rates

What we can learn from the Canadian system?

single most important component of the Canadian system is its universality. Universal programs are better able to assure quality for all by extending the service to socially powerful groupings. Canadian experience also shows how quickly things can move once things get started. Canadian model of national health care are useful because they show us concretely that change is possible. single payer system must be placed at both the national as well as the state level.

What can we learn from Australia?

Australia is dedicated to the development of a lifetime
electronic health record for all its citizens. HealthConnect is the major national EHR initiative in Australia, and is made up of territory, state, and federal governments. MediConnect is a related program that provides an electronic medication record to keep track of patient prescriptions and provide stakeholders with drug alerts to avoid errors in prescribing. Although Australia has invested a significant amount of money into the computerization of its healthcare sector, it has run into a number of problems, including those associated with fragmentation, scalability, and inaccessibility.

Comparative Health Systems

NEW ZEA Population Population Over 60(%) % GNP* Per CapHealth Exp*($US) % Public* % Private* 4 MIL 12 % SWEDEN 9 MIL 19 % U.K 60 MIL 16% AUSTRA LIA 21 mil 12 % CANADA 33.2 MIL 12.6 % INDIA 1169 MIL 7.3 %

9.3 % $2,016

8.4 % $2,594

7.7 % $2,031

9.3% $2,699

10.9 % $4,196

6% 40.3

67.5% 32.5%

85.3% 14.7%

83.4% 16.6%

67.5% 32.5%

69.9% 30.1%

26.2% 75.8%

Comparison of health manpower

COUNTR DOCTOR(PER 1000 POPUL) 2.1 BEDS (PER 1000 POP.) 3.8 NURSE(PER 1000 POP.) 9.9 MIDWIVES(PE R 1000 POP.) 0.63

CANADA

NEW ZEALAND
SWEDEN U.K AUSTRALIA INDIA

2.25
3.08 2.8 2.5 0.7

8.0
2.5 2.7 4.4 8.9

8.5
8.21 8.8 10.7 0.8

0.56
0.7 0.5 0.6 0.47

Thank You
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