Centre for Health Policy, Institute of Global Health Innovation, Imperial College London, UK.
Health Aff (Millwood). 2013 Apr;32(4):653-60. doi: 10.1377/hlthaff.2012.1330.
Many factors combine to drive the growth in health spending worldwide, but the introduction of new technologies, drugs, and therapies is probably the most important. However, in contrast to other industries, innovations in health care have not tended to reduce the need for labor. In fact, labor still accounts for the largest proportion of expenditures in many health systems. But labor-saving technologies, workforce innovations, and patient self-care approaches are now emerging and altering health care's labor structure. For example, in Mexico more than one million households pay $5 per month to access a health advice hotline before setting foot in a physician's office. In India assembly line-style eye surgery has dramatically reduced cost without sacrificing quality. Policy makers should focus on such labor-saving innovations; reform reimbursement systems to encourage them; tackle professionals' resistance; and remove regulatory barriers. Bold experiments to redesign health services around patient self-care approaches are also warranted.
许多因素共同推动了全球卫生支出的增长,但新技术、药物和疗法的引入可能是最重要的因素。然而,与其他行业不同的是,医疗保健领域的创新并没有减少对劳动力的需求。事实上,在许多卫生系统中,劳动力仍然占支出的最大比例。但是,节约劳动力的技术、劳动力创新和患者自我护理方法正在出现,并改变着医疗保健的劳动力结构。例如,在墨西哥,有超过 100 万户家庭每月支付 5 美元,在去医生办公室之前就可以获得健康咨询热线。在印度,流水线式的眼科手术大大降低了成本,而没有牺牲质量。政策制定者应关注此类节约劳动力的创新;改革报销制度以鼓励此类创新;解决专业人员的抵制问题;并消除监管障碍。围绕患者自我护理方法重新设计卫生服务的大胆实验也是合理的。