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WHO and World Bank warn that poor hospital care is leading to high costs globally

This article was taken from: https://www.telegraph.co.uk/news/2018/07/05/poor-care-makes-patients-leads-high-costs/

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Poor quality health care is making people ill and costing health services around the world trillions of dollars a year.

A report by the World Health Organization and the World Bank says that misuse of drugs, inappropriate treatment and infections picked up in hospitals are harming patients throughout the world, leading to high healthcare costs and lost productivity. The cost of drug errors alone is estimated to be around $42 billion a year.

In high income countries one in 10 patients is adversely affected during treatment, with seven in 100 picking up a hospital acquired infection.

In low-income countries one in 10 patients pick up infections in hospital.

The report also highlighted the lack of regulation which enables patients to get hold of antibiotics without a prescription, fuelling the rise in antimicrobial resistance.

Even where medicine use is properly regulated, drug errors affect about one in 10 prescriptions issued, mostly dose-related errors. The report highlights one study which showed that only 30 to 40 per cent of patients in countries with developing or transitional economies are treated with medicines according to clinical guidelines.

There has been some progress – for example survival rates for cancer and cardiovascular disease have improved in recent years in many parts of the world. But the report estimates that the consequences of poor care – long-term disability, impairment and time off work – cost trillions of dollars a year.

The report found that health workers in seven low and middle-income countries in Africa were only able to make accurate diagnoses one third to three quarters of the time. And clinical guidelines for common conditions – the bedrock of treatment in the developed world – were followed less than 45 per cent of the time on average.

Research in eight countries in the Caribbean and Africa with high death rates found that just 28 per cent of antenatal care, 26 per cent of family planning services and 21 per cent of paediatric services were effective.

The report also found that 15 per cent of hospital expenditure in high-income countries is due to mistakes in care – such as incorrect treatment or surgery on the wrong site – or patients being infected while in hospital.

Patients being harmed by treatment is the 14th leading cause of disease in the world, after conditions such as heart disease, stroke and chronic obstructive pulmonary disease. The burden is much greater in low income countries, with 38 per cent of disease burden caused by harmful treatment, compared to 18 per cent in high-income countries.

The report also looked at waiting times and found that they vary considerably in high and middle income countries. In 2015, the average waiting time for hip replacement was 42 days in the Netherlands, 290 days in Estonia and more than 400 days in Chile and Poland.

There is less evidence on waiting times in low income countries but a study of an outpatient department in Nigeria showed that three quarters of patients waited up to two hours to be registered before they even saw a doctor or other healthcare worker.

The report lays out a number of steps that governments, health systems and citizens should take to improve the quality of health care in their countries. These include having a professional and well-trained workforce, ensuring interventions are based on evidence and supporting patients with chronic diseases.

“Good health is the foundation of a country’s human capital, and no country can afford low-quality or unsafe healthcare,” World Bank Group President Jim Yong Kim said. “Low-quality care disproportionately impacts the poor, which is not only morally reprehensible, it is economically unsustainable for families and entire countries.”