The Drive for Universal Health Coverage: Health Care Delivery Science and the Right to High-Value Health Care

The drive for Universal Health Coverage (UHC) gained momentum when the United Nations General Assembly adopted a resolution in December 2012 endorsing UHC and urging governments to provide access to affordable health care. There is also strong support for making universal coverage of health care a priority in the post-2015 development agenda that will succeed the Millennium Development Goals.

But if this movement is to achieve its aims, it is crucial to consider not only financial risk protection and wider access to services, but also to increase the value of health care by embracing innovative ways of improving health outcomes while reducing expenditures. The 2010 World Health Report, which made the case for UHC, estimated that 20-40% of all health care spending is currently wasted. And waste in health care is often associated with harm to patients. The commitment to UHC must go hand in hand with a commensurate commitment to ensure availability, acceptability, affordability, and good quality in health services. Patients and communities have a right to expect nothing less.

Applying the findings of delivery science to improve health care implementation will serve both equity and efficiency, as well as reducing waste (unnecessary or unwanted procedures) and harm to patients and populations. This transformation is not just a matter of boosting supply, but of better understanding and aligning demand and delivery so that patients and populations everywhere can progressively access the care they need, and therefore achieve the highest attainable standard of health to which they have a right. Achieving high-value care for all necessitates engaging people and patients individually and collectively as co-creators of value. It involves structuring health care delivery systems to elicit and respond to patients' needs and informed preferences, and better informing investment and capacity planning through measurement of the needs and wants of those who receive care. It also involves the design and implementation of innovative delivery models that are based on transparency and improving access to health information, as well as on the monitoring of outcomes and performance and effective mechanisms for accountability. These are core principles of both the science of delivery and a rights-based approach to health care.

Salzburg Global's sixth session in our health and health care program builds upon the conceptual and practical outcomes of this series to date, notably the sessions on Innovating for Value in Health Care Delivery and on Realizing the Right To Health. It is designed to engage country teams around the world in cross-border learning, and in sharing experience and understanding of how, as we strive for UHC, we can achieve high-value health care at scale, taking into account the demographic, organizational, and financial challenges on the horizon.

This session will explore how insights derived from health care delivery science, and the practical implementation of models that more fully engage service users, can inform and drive the expansion and improvement of health care systems as we move towards UHC. This requires transparency of information, clear responsibilities and accountability and the measurement of results. We will examine the systems changes needed to support innovative and value-based health care delivery. We will also ask what models, methods and metrics are needed to meaningfully involve patients and communities and to ensure that an accurate assessment of their needs and wants informs what capacity is required as health coverage expands.

Date

Dec 08 - Dec 13, 2013

Session no.

Session 507

Content overview

Program Participant Profile Downloads Faculties Co-Chair

Program

Format:

The session will have a practical focus on implementation, with participants working in country and regional groups to explore how they can apply findings from delivery science to best address prevailing challenges and gaps in their respective countries. There will be a number of expert presentations and interviews, but the emphasis will be on facilitated discussion, case studies, role play, and practitioner-to- practitioner knowledge sharing.

Country team delegations are expected to come to this session with an identified area of work.

Key Questions:

How do we best identify and deliver quality and value in health care? How can we best challenge the overuse, misuse and under-use of care that results in poor quality, waste and sometimes harm to patients?

How can we meaningfully use key principles of a rights-based approach to enhance the value of health care?

How can innovations that maximize value best be identified and assessed in health care delivery? What can we learn from approaches adopted in resource-constrained settings to make health care more efficient and cost-effective? How can collaboration and continuous learning across borders best be encouraged and organized?

What can those involved in reforming and expanding health services learn from the problems of mature health systems?

How can the mapping of practice variations across different districts and providers help reduce waste and stimulate greater responsiveness to the needs and preferences of a given population?

What is the potential of patient engagement to improve quality, restrain unwarranted practice variation, inform capacity planning, and control costs? How might this work in differing income settings, in low-, middle- and high-income countries?

How can we engage patients and communities in the design, implementation and monitoring of service delivery in health care?

Expected results:

A Salzburg Statement which will lay out key principles to help ensure that universal health coverage increases access to high-value care to progressively realize the right to health for all.
Country and regional plans showing how those principles could be applied in specific contexts
Dissemination and discussion of seminar discussions and the Salzburg Statement through media partners
Ongoing networking and collaborations among participants and the institutions they represent

Participant Profile

This Salzburg Global session will bring together 60 highly creative thinkers and doers from around the world, many organized in country team delegations which include politicians and public servants, health policy makers and analysts; health practitioners and providers, both public and private; economists; ethicists; representatives of patient groups and civil society; and the media. This multi-disciplinary approach will be a key feature of the session.