…how things ought to be
Health systems ought to be seamlessly integrated to meet any person’s health needs wherever they live, whenever they fall ill, and whatever the condition might be.
This view is slowly gaining acceptance, and this view is slowly being conceptualised within medical organisations like the WHO. There is a growing recognition that we ought to redesign our health systems around people/patient, and that our health services ought to deliver “good health” (however, what constitutes “good health” is often not defined).
That there are multiple pathways to good and poor health
That these pathways follow nonlinear patterns and therefore make health outcomes hard to predict
That health results from complex interactions between many different types of determinants
Person-centredness is broader than just the focus on the person, it also requires a focus on his physical and social environments. While some might find the focus on the person, rather than the population, problematic, it ought to be recognised that many of the problems seen in the individual reflect the broader problems in his community.
Equity in healthcare assures access to health (and social) services according to a person’s needs.
As Virchow already emphasised—health professionals have a responsibility to make the health system equitable. Fortunately health professional organisations increasingly recognise this responsibility and advocate for equity measures in their policy agendas.
Equity needs to be distinguished from equality. Equity in healthcare “does not mean that everyone receives the same care. Instead, it means that care aims to achieve optimal outcomes for all groups of patients, even if achieving optimal outcomes means that care differs from person to person, and group to group.”
Achieving sustainability of the health and healthcare system has become an imperative; Nobel laureate economist Robert Fogel predicts that the expenditure on health will reach 20–25% of GDP by the year 2025.
Prevailing tendencies to achieve sustainability by limiting services or redistributing costs for healthcare on those in need of care will ultimately be counter-productive. Sustainability has been defined as the balance between social, environmental and economic concerns. Hence, sustainable solutions must be affordable to individuals and society, acceptable to all constituents and adaptable as needs change over the life trajectory.
Person-centredness and equity have been identified as two key approaches that make health and healthcare systems sustainable.
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