Dr KK Aggarwal
Every citizen in the
country has a right to receive safe and quality medical treatment. Achieving
universal health coverage is a target (3.8) under the Sustainable Development
Goal (SDG 3). All member states of the UN including India have committed to try
to provide universal health coverage to all their citizens by the year 2030.
Universal health coverage means good quality health care that is Available,
Accessible, Affordable and Accountable.
The Institute of Medicine, USA
(IOM, 1990) has defined quality in health care as “the degree to which
health services for individuals and populations increase the likelihood of
desired health outcomes and are consistent with current professional knowledge”.
The American Medical Association (AMA, 1991) has defined quality as “the
degree to which care services influence the probability of optimal patient outcome”.
When a patient seeks health
care, he/she looks for availability, quality and affordability. Safety, desired
outcome of treatment and respect are becoming more and more important to the
patients today.
It’s not just clinical care
based on best practices alone that decides quality of care. Several other
factors also constitute patients’ perception of quality of care such as
cleanliness, reliability, responsiveness, communication, empathy,
patient-centered with patient as an equal partner is decision making.
But, quality always comes at a
price. Quality treatment is costlier but in the long-term, it is economical as
it is associated with fewer hospital-acquired infections, complications,
adverse drug reactions, re-hospitalization, as well as fewer system failures.
Quality is always preferred
but it may not always be feasible because quality care may increase the cost of
treatment.
So, should we focus on
affordability or should we focus on quality?
Every hospital or health care
establishment must try to improve and maximize quality within the resources
that are available to them and with the best use of those resources. Poor
quality service indicates poor utilization of resources.
Both quality and affordability
need to be balanced, especially in a country like ours, which has one of the
highest out of expenditures on health in the world.
Disclaimer: The views
expressed in this write up are entirely my own
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