Healthcare Systems Future Predictions for Global Care

In this book, we invited 146 authors with expertise in health policy, systems design, management, research, or practice, from each of the countries included, to consider health reforms or systems improvements in their country or region. The resulting case studies, of 52 individual countries and five regional groupings, cover 152 countries or territories, or three-quarters of the world’s nations. Each chapter author was asked to think 5–15 years into the future and make a prediction on how their health system could be strengthened as a result of the successful unfolding of their case study. The types of projects our authors have chosen to explicate into the future are wide-ranging. They vary from e-consultation services in Estonia, achieving universal health coverage in Argentina and Mexico, reforming long-term care in the Netherlands, reassessing care for the aging population and the frail elderly in Australia, streamlining the health system through Lean Thinking in Nigeria, using regulation to improve care in South Africa, developing a new accreditation model in Turkey, through to a critique of physician specialization in Russia and applying IT initiatives to improve care in China, Lebanon, Taiwan, Papua New Guinea, the United Arab Emirates, Venezuela and Wales. Chapter writers recognized that the improvement work they were doing was part of a moving target. There was general agreement that the effective use of limited resources and overcoming hurdles and constraints were crucial to enhancing health systems in order to deliver better care over the medium term. While some initiatives required considerable funding, many were relatively inexpensive. These case studies demonstrate ways in which fruitful application of partnerships and creativity can make considerable gains in strengthening healthcare delivery systems. Features The third book in a series on international health reform Involves 146 contributing authors, five regional editors, a series editor and a highly skilled support team to explore sustainable improvement in health systems in the future Encompasses a time horizon of the next 5–15 years Covers 152 countries or territories, with 52 individual countries and an analysis of five regional groupings comprising 100 countries

Preface Acknowledgments About the Editors About the Contributors Contributors Introduction Jeffrey Braithwaite, Russell Mannion, Yukihiro Matsuyama, Paul G. Shekelle, Stuart Whittaker, Samir Al-Adawi, Kristiana Ludlow, and Wendy James Part I The Americas Paul G. Shekelle 1 Argentina: Achieving Universal Coverage Hugo Arce, Ezequiel García-Elorrio, and Viviana Rodríguez 2 Brazil: Patient Safety: Distance-Learning Contribution Walter Mendes, Ana Luiza Pavão, Victor Grabois, and Margareth Crisóstomo Portela 3 Canada: The Future of Health Systems: Personalization Anne W. Snowdon, Charles Alessi, John Van Aerde, and Karin Schnarr 4 Chile: The Struggle for an Integrated Health Insurance System Oscar Arteaga 5 Guyana: Paradigm Shift: From Institutional Care to Community-Based Mental Health Services William Adu-Krow, Vasha Elizabeth Bachan, Jorge J. Rodríguez Sánchez, Ganesh Tatkan, and Paul Edwards 6 Mexico: Leveraging Conditional Cash Transfers and Universal Health Coverage to Tackle Non-Communicable Diseases Jafet Arrieta, Enrique Valdespino, and Mercedes Aguerrebere 7 Trinidad and Tobago: Nurse Training: A Competency-Based Approach Claudine Richardson-Sheppard vi Contents 8 The United States of America: The U.S. Healthcare System: A Vision for the Future Robert H. Brook and Mary E. Vaiana 9 Venezuela: Learning from Failure and Leveraging Technology: Innovations for Better Care Pedro Delgado, Luis Azpurua, and Tomás J. Sanabria Part II Africa Stuart Whittaker 10 Namibia: Lessons from Patient Involvement in HIV Care: A Paradigm for Patient Activation and Involvement across Health Systems Bruce Agins, Joshua Bardfield, Margaret K. Brown, Daniel Tietz, Apollo Basenero, Christine S. Gordon, Ndapewa Hamunime, and Julie Taleni Neidel 11 Nigeria: Doing More with Less: Lean Thinking in the Health System Emmanuel Aiyenigba 12 South Africa: Regulated Standards: Implementation and Compliance Stuart Whittaker, Lizo Mazwai, Grace Labadarios, and Bafana Msibi 13 Rwanda: Embracing One Health as a Strategy to Emerging Infectious Diseases Prevention and Control Roger Bayingana and Edward Chappy 14 Africa: Equity for All: A Global Health Perspective for the Continent Jacqui Stewart and Shivani Ranchod Part III Europe Russell Mannion 15 Austria: Primary Healthcare Centers: A Silver Bullet? Maria M. Hofmarcher, Susanne Mayer, Nataša Peric, and Thomas E. Dorner 16 Denmark: Patient-Reported Outcomes: Putting the Patient First Liv Dørflinger, Jesper Eriksen, Janne Lehmann Knudsen, and Carsten Engel Contents vii 17 England: Getting Personal? Personal Health Budgets Martin Powell and Russell Mannion 18 Estonia: e-Consultation Services: Cooperation between Family Doctors and Hospital Specialists Ruth Kalda, Kaja Põlluste, and Margus Lember 19 Finland: A Real-Life Experiment in Precision Medicine Persephone Doupi 20 France: Horizon 2030: Adopting a Global-Local Approach to Patient Safety Catherine Grenier, René Amalberti, Laetitia May-Michelangeli, and Anne-Marie Armanteras-de-Saxcé 21 Germany: Health Services Research and Future Planning in Pediatric Care Wolfgang Hoffmann, Angelika Beyer, Holger Pfaff, and Neeltje van den Berg 22 Greenland: Everyday Life with Chronic Illness: Developing a Democratic and Culture-Sensitive Healthcare Practice Tine Aagaard and Lise Hounsgaard 23 Italy: The Introduction of New Medical Devices in an Era of Economic Constraints Americo Cicchetti, Valentina Iacopino, Silvia Coretti, and Marcella Marletta 24 Malta: The National Cancer Plan: Strengthening the System Sandra C. Buttigieg, Kenneth Grech, and Natasha Azzopardi-Muscat 25 The Netherlands: Reform of Long-Term Care Madelon Kroneman, Cordula Wagner, and Roland Bal 26 Northern Ireland: Developing a Framework to Support Building Improvement Capacity across a System Gavin Lavery, Cathy McCusker, and Charlotte McArdle 27 Norway: Bridging the Gap: Opportunities for Hospital Clinical Ethics Committees in National Priority Setting Ånen Ringard and Ellen Tveter Deilkås 28 Portugal: Prevention of Antimicrobial Resistance through Antimicrobial Stewardship: A Nationwide Approach José-Artur Paiva, Paulo André Fernandes, and Paulo Sousa viii Contents 29 Russia: The Future of Physicians’ Specialization Vasiliy V. Vlassov and Mark Swaim 30 Scotland: Deliberative Engagement: Giving Citizen Involvement Meaning and Impact Richard Norris, Andrew Thompson, and David R. Steel 31 Spain: How Can Patient Involvement and a Person-Centered Approach Improve Quality in Healthcare? The Patients’ University and Other Lessons from Spain Laura Fernández-Maldonado, Sergi Blancafort Alias, Marta Ballester Santiago, Lilisbeth Perestelo-Pérez, and Antoni Salvà Casanovas 32 Sweden: The Learning Health System John Øvretveit and Camilla Björk 33 Switzerland: Teamwork and Simulation Anthony Staines and Adriana Degiorgi 34 Turkey: Moving Quality in Healthcare Beyond Hospitals: The Turkish Accreditation Model Mustafa Berktas and Ibrahim H. Kayral 35 Wales: Realizing a Data-Driven Healthcare Improvement Agenda: A Manifesto for World-Class Patient Safety Andrew Carson-Stevens, Jamie Hayes, Andrew Evans, and Sir Liam Donaldson 36 Central and Eastern Europe: Strengthening Community-Based Family Care and Improving Health Equities Jeffrey Braithwaite, Wendy James, Kristiana Ludlow, and Russell Mannion 37 Central Asia: From Russia with Love: Health Reform in the Stans of Central Asia Jeffrey Braithwaite, Wendy James, Kristiana Ludlow, and Yukihiro Matsuyama Part IV Eastern Mediterranean Samir Al-Adawi 38 Iran: Hospital Accreditation: Future Directions Ali Mohammad Mosadeghrad 39 Jordan: Improving Quality of Care by Developing a National Human Resources for Health Strategy Reem Al-Ajlouni and Edward Chappy Contents ix 40 Lebanon: m-Health for Healthcare Delivery Reform: Prospects for Lebanese and Refugee Communities Nasser Yassin, Rawya Khodor, and Maysa Baroud 41 Oman: Paradigm Change: Healthy Villages to Meet Tomorrow’s Health Needs Ahmed Al-Mandhari, Huda Alsiyabi, Samia Al Rabhi, Sara S. H. Al-Adawi, and Samir Al-Adawi 42 Pakistan: The Way Forward Syed Shahabuddin and Usman Iqbal 43 Qatar: Hospice Palliative Care Yousuf Al Maslamani, Noora Alkaabi, and Nagah Abdelaziz Selim 44 The United Arab Emirates: Improving Healthcare through a National Unified Medical Record Subashnie Devkaran 45 Yemen: Integrating Public Health and Primary Care: A Strategy for the Health System of the Future Khaled Al-Surimi 46 Middle East and North Africa (MENA): Health Systems in Transition Jeffrey Braithwaite, Wendy James, Kristiana Ludlow, and Subashnie Devkaran Part V South-East Asia and the Western Pacific Jeffrey Braithwaite and Yukihiro Matsuyama 47 Australia: The Silver Tsunami: The Impact of the Aging Population on Healthcare Ken Hillman, Fakhri Athari, Steven Frost, and Jeffrey Braithwaite 48 China: Integrated Stratified Healthcare System Hao Zheng 49 Hong Kong: Integrated Health Services: A Person-Centered Approach Eliza Lai-Yi Wong, Hong Fung, Patsy Yuen-Kwan Chau, and Eng-Kiong Yeoh 50 India: How to Build a First-World Health System on a Third- World Budget Girdhar Gyani x Contents 51 Japan: Toward a Community-Friendly Dementia Strategy Yukihiro Matsuyama 52 Malaysia: The Future Malaysian Antenatal Care System: Building upon the Old Ravindran Jegasothy and Ravichandran Jeganathan 53 Mongolia: Health System Financing Tumurbat Byamba and Tsolmongerel Tsilaajav 54 New Zealand: Strengthening Primary Healthcare Jacqueline Cumming 55 Papua New Guinea: Strengthening the Collection, Analysis, and Use of Health Data through eHealth Solutions Paulinus Lingani Ncube Sikosana 56 Taiwan: "My Data, My Decision": Taiwan’s Health Improvement Journey from Big Data to Open Data Yu-Chuan (Jack) Li, Wui-Chiang Lee, Min-Huei (Marc) Hsu, and Usman Iqbal 57 South-East Asia: Taming Communicable Diseases Jeffrey Braithwaite, Wendy James, Kristiana Ludlow, and Yukihiro Matsuyama Discussion and Conclusion Jeffrey Braithwaite, Russell Mannion, Yukihiro Matsuyama, Paul G. Shekel

Jeffrey Braithwaite, BA, MIR (Hons), MBA, DipLR, PhD, FAIM, FCHSM, FFPHRCP (UK), FAcSS (UK), Hon FRACMA, FAHMS is foundation director, Australian Institute of Health Innovation, director, Centre for Healthcare Resilience and Implementation Science, and professor of health systems research, Faculty of Medicine and Health Sciences, Macquarie University, Sydney, Australia. He has appointments at six other universities internationally, is a board member and is President Elect of the International Society for Quality in Health Care (ISQua) and a member of the World Health Organization Global Patient Safety Network. His research examines the changing nature of health systems, attracting funding of more than AU$108 million (US$80.6 million). He is interested in healthcare as a resilient system, and applying complexity science to healthcare problems. In addition to this, he is interested in the Anthropocene and the impact of human activity on human and species’ health, population, and climate. Professor Braithwaite has contributed over 870 publications, presented at or chaired international and national conferences, workshops, symposia, and meetings on more than 900 occasions, including over 80 keynote addresses. His research appears in outlets such as The BMJ, The Lancet, Social Science & Medicine, BMJ Quality & Safety, and the International Journal of Quality in Health Care. He has received 39 different national and international awards for his teaching and research. Further details are available at his Wikipedia entry: http://en.wikipedia.org/wiki/Jeffrey_Braithwaite Russell Mannion, BA (Hons), PG Dip Health Econ, PhD, FRSA, FAcSS, has over 30 years experience in health care research. He is Chair in Health Systems, University of Birmingham, Visiting Professor at the Australian Institute of Health Innovation, Macquarie University, and Visiting Professor in the Faculty of Medicine, University of Oslo. He was previously Director of the Centre for Health and Public Services Management, University of York, and Board Director of the York Health Economics Consortium. He provides expert advice to various health agencies including WHO, OECD, European Health Management Association and UK Department of Health. He has authored or edited 10 books and around 200 peer-reviewed publications, many in leading scientific journals including The BMJ, The Lancet and The Milbank Quarterly. He is associate editor on the editorial board of four international health policy journals and has garnered several international prizes for his research including the Baxter European Book Award. Yukihiro Matsuyama, PhD, is Research Director, the Canon Institute for Global Studies, Affiliate Professor, Chiba University of Commerce and Honorary Professor, the Australian Institute of Health Innovation, Faculty of Medicine and Health Sciences at Macquarie University. His research examines the sustainability of safety-net systems in Japan including healthcare, pension, pandemic crisis and employment through international comparative analyses. He has served on government committees including as a member of the Welfare Committee. He has published many books including Healthcare Economics in the United States (1990), which introduced the theoretical concept of DRG/PPS and Managed Care into Japan for the first time, AIDS War: Warning to Japan (1992), Health Reform in the United States (1994), Break Through of Japan? Economy under Half-Population (2002), Healthcare Reform and Integrated Healthcare Network, as a co-author of: Keiko Kono (2005), Health Reform and Economic Growth (2010) and Depth of Healthcare Reform (2015). Paul G. Shekelle is a staff physician at the West Los Angeles Veterans Affairs Medical Center, and is a professor of medicine at the University of California, Los Angeles (UCLA) School of Medicine. He is widely recognized in the field of guidelines, quality measurement, and evidence-based medicine. In 1996-1997, he spent a year in England as Atlantic Fellow in Public Policy. He is a past chair of the Clinical Guidelines Committee of the American College of Physicians (ACP). Stuart Whittaker, BSc, MBChB, FFCH (CM), MMed, MD, founder and former Chief Executive Officer of the Council for Health Service Accreditation of Southern Africa. He pioneered the concepts of a facilitated accreditation programme and graded recognition to assist disadvantaged hospitals in Southern Africa and other developing countries to comply with professional standards. He has presented at numerous international and national conferences. As a temporary consultant to the World Health Organisation (WHO) he participated in projects to assess the impact of accreditation on national health systems and choosing Quality Approaches in Health Systems. He was appointed by the Minister of Health of South Africa in 2013, and re-appointed in 2017, to serve on the Board of Directors for the Office of Health Standards Compliance (OHSC) in South Africa. He is a Visiting Profe