The claim to achieve universal health coverage was heard loudly and its echo reached government leaders who, in an effort to try to mark at least that Sustainable Development Goal as “achieved”, made it a bastion of their policies public health. In the race to build more hospitals and health centers, buy more equipment or hire more staff for that purpose, the key element without which airing the banner of universal health does not count for much has been lost sight of quality.
A matter of life and death
In health, quality care is so important that its absence has repercussions not only on the efficiency of the health system or the perception that citizens have of it, but it can literally cost them their lives. A new report by the Lancet Global Health Commission on high-quality health systems reveals that in low- and middle-income countries—which are the majority in Latin America and the Caribbean—more than 8 million people die from diseases that could be perfectly treatable by health Top Medical Software.
According to the report, 60% of deaths that could have been treated medically are a consequence of poor quality of care. It is worth dwelling on the implications for a moment: the poor quality of health care is currently a greater obstacle to reducing mortality than the lack of access to health services. In other words, even if access to a certain health service is guaranteed, especially in the most vulnerable sectors of the population, progress is nullified if it does not have the capacity to save lives – and improve them.
According to the authors, high-quality health systems have the potential to prevent, each year:
- 1 million neonatal deaths
- 50% of maternal deaths
- 5 million Deaths from cardiovascular diseases
- 900,000 deaths from tuberculosis
Poor-quality care is a huge waste of resources, and can be a problem even in high-income countries like the United States. In 2015 alone, deaths from treatable diseases cost the US economy $6 trillion.
Care from the perspective of patients
Naturally, the consequence of wasteful and inefficient health spending undermines patients’ trust in health systems. According to a new publication by the Inter-American Development Bank, which analyzes the experiences of primary health care in the region from the perspective of the patient, 98% of Brazilians believe that their health system should be reformed. And it’s not just a matter of perception. The low quality of care can result in worse health conditions, aggravation and persistence of symptoms, loss of functionality and even fear of returning to the care center.
There are quality problems in every country – and for every disease. However, the intensity of the problem is variable; it remains much worse in low- and middle-income countries and, within those countries, among the most vulnerable groups, such as those living in poverty or marginalized from health systems for various reasons.
In this countries,
- Women and children receive recommended clinical treatment or follow-up for typical preventive or curative visits only half the time;
- Diagnoses are often wrong for serious illnesses such as myocardial infarction or asphyxia in a newborn;
- Treatment for chronic and mental conditions is often poor or meets minimum standards,
- And care may be too slow in cases that require immediate action.
How to solve it?
Improving the quality of health care will not be easy and will require action from all actors in the system. One place to start, and probably the most important, is to focus interventions on efforts to better train health professionals, in addition to implementing structural reforms that are reflected throughout the system.
The good news is that we have identified the problem and given quality the place it deserves, at least in theory, in its role in achieving true universal health. What remains to be completed is the action. Hopefully this report will serve as a useful, practical and realistic guide for health professionals and decision makers with the desire to offer the best possible care to citizens.