Cost effective distributed home healthcare
Of
the ten classifications of jobs that experienced the greatest growth after the
recession, three were in-home, outpatient and senior health services. Every
indication suggests that this fact represents a worldly trend. In particular,
assuming that legislators and regulators act to allow, rather than hinder the
advancement of distributed health services, demand for home-based healthcare
for older people is likely to have continuous growth, owing to both the
expected increase in demand for health services resulting from the aging
population and the potential for cost reduction and health care services at
home. A path undertaken by the entrepreneur and innovation towards the
distributed health services has, therefore, the potential to improve quality,
reduce costs and increase access to health services. The widespread diffusion
of distributed healthcare services, in turn, has the potential to increase
economic growth either directly (through transaction increases needed to meet
the growing needs of an aging population) and indirectly (through an Increase
in the actual size of the workforce enabled by the improved health of
populations).
Definition of Distributed Health Services
Not
long ago, of course, most health services were provided at home. The financial
requirements of the medical profession were minimal, so there was little reason
for an office. Since it cost minimum to certify as a physician, the barriers to
entry into medical practice and the relative salary paid to doctors were both
lower than today. The advent of modern medicine in the last century has changed
this aspect. In 1930, home calls accounted for 40 percent of medical
appointments; by 1950, that number had dropped to 10 percent; since 1980 it was
only 1 percent.
At
the same time, the technologies and organizational innovations that enable
healthcare provision at home and at a distance have radically improved in terms
of performance and costs. The term "distributed distribution of health
service delivery" refers to four distinct categories of innovation in
healthcare that together create low cost, equal or greater effective options
for consumers:
1 . Telehealth / Remote
Medicine and Mobile Health (mHealth)
2.
Medical House Calls
/ Primary Care at Home
3.
Big data
4.
Health Care Agency
/ Peer-to-Peer Health Service Delivery
Together,
the four elements listed above combine to create a very real but unrealized
potential for distributed delivery of large-scale health services.
In
general, what fraction of the services currently provided in hospitals can be
offered within the home? We do not know the answer to this question. But we
know it is a much larger fraction than that reflected by current practice.
Enabling Distributed Health Service Delivery
Health
care policy has steadily progressed, focusing first on post-acute care,
gradually incorporating "housekeeping services" as a post-acute care;
providing home health as a substitute for nursing home care, and ultimately
expanding this vision to include a number of individuals above a minimum edge
of demonstrated medical need. The constants of this long range were concerns
about costs and access, all driven by the parallel growth of populations of
people over the age of 65 and people with chronic illnesses and disabilities.
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