The Economist (Intelligence Unit) – Creating Healthy Partnerships (2019)

26

THE ROLE OF PATIENT VALUE AND PATIENT-CENTRED
CARE IN HEALTH SYSTEMS

Chapter 4: Health systems that still need work

Doing old jobs better

The relatively modest application of policy levers in pursuit of patient-centricity, in turn, helps explain

the slow evolution of health systems toward supporting this kind of care.

Most countries in this study have some of the best healthcare access in the world, with eight (except

China) finishing in the top 11 out of 60 countries in The Economist Intelligence Unit’s Global Access

to Healthcare Index.^30 Weaknesses around patient-centricity should not obscure the importance of

such ability to receive treatment. Ms Nishimura, for example, stresses the benefits of “Japan’s highly

equitable medical system”.

Moreover, all the study countries have mechanisms to introduce innovative technologies into their care

systems, such as through Health Technology Assessment agencies, with the UK’s National Institute for

Health and Care Excellence an acknowledged global leader. Our scorecard research also found that in

every country, except Brazil and China, getting access to and making appointments with one’s usual

physician was straightforward.

Meanwhile, IT is, if anything, making access to, and use of, health services easier. For example, online

appointment-making or interaction with clinicians are now far from remarkable. For some patients,

even going to see GPs in person may soon be a thing of the past. In 2017 the NHS began trialling

smartphone consultations in London and, in 2018, both the Japanese and French health systems have

introduced payments for clinicians who interact in this way.^31

Access to records: a (small) step in the right direction

The scorecard also shows at least one sign of a noticeable shift toward a more patient-centred

approach. Every country except Brazil and China gives patients the right to access their healthcare

records (see Table 6). This is a significant cultural change, and a necessary one if patients are to play a

truly equal role in decision-making.

Table 6: Patients’ right to access their own health record

Indicator Sub-indicator Brazil China France Germany Italy Japan Spain UK US

Patient involvement

in shared decision-

making

Patients right to access their

own healthcare records

0 0 1 1 1 1 1 1 1

0 = No/Not reported; 1 = Patients have the right to access their own health record.

30. Global Access to Healthcare: Building
    sustainable health systems, 2017.


31. “NHS offers smartphone GP
    appointments,” BBC News, November
    6th 2017; “Telemedicine via smartphone
    apps gaining in popularity in Japan,”
    Japan Times, September 18th 2018;
    French Ministry of Health, Arrêté...
    portant approbation de l’avenant no 6
    à la convention nationale organisant les
    rapports entre les médecins libéraux et
    l’assurance maladie signée le 25 août 2016,
    August 1st 2018.