Impact of inadequate health literacy on patient satisfaction, healthcare utilization, and expenditures

Inadequate health literacy (HL) is associated with impaired healthcare choices leading to poor quality-of-care | Geriatric Nursing

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Our primary purpose was to estimate the prevalence of inadequate HL among two populations of AARP®Medicare Supplement insureds: sicker and healthier populations; to identify characteristics of inadequate HL; and to describe the impact on patient satisfaction, preventive services, healthcare utilization, and expenditures. Surveys were mailed to insureds in 10 states. Multivariate regression models were used to identify characteristics and adjust outcomes. Among respondents (N = 7334), 23% and 16% of sicker and healthier insureds, respectively, indicated inadequate HL. Characteristics of inadequate HL included male gender, older age, more comorbidities, and lower education. Inadequate HL was associated with lower patient satisfaction, lower preventive service compliance, higher healthcare utilization and expenditures. Inadequate HL is more common among older adults in poorer health, further compromising their health outcomes; thus they may benefit from expanded educational or additional care coordination interventions.

Full reference: MacLeod, S. et al. (2017) The impact of inadequate health literacy on patient satisfaction, healthcare utilization, and expenditures among older adults. Geriatric Nursing. Volume 38 (Issue 4) pp. 334–341

Competition policy in five European countries

This working paper explores how policies affecting competition have been implemented and promoted in health systems in five countries: France, Germany, the Netherlands, Norway and Portugal | Health Foundation

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  • In conventional markets, customers are attracted to particular suppliers by a more appealing combination of price and quality. But in health care, patients are usually insulated from costs and may find it difficult to judge quality due to information asymmetries and their infrequent use of services.
  • This means that the question – what do we expect or want of competition? – is not so easily answered in health care settings, and lessons from other sectors might not apply.

Key points:

  • Proximity to the health care provider, rather than quality, remains the key driver of patient choice.
  • There is potential tension between stimulating quality competition and controlling expenditure because restrictions on hospital treatments imply that money does not follow the patient, and hospitals may react by making access more difficult or letting their waiting times increase.
  • Information for assessing proposed hospital mergers requires improvement, particularly information on quality.
  • There is limited scope for further expansion in the use of private providers to treat NHS patients given the current focus on controlling expenditure.
  • The economic rationale for controlling entry of providers into general practice is unclear.
  • Selective contracting for patients with chronic and multiple conditions to reduce fragmentation of care raises concerns for competition and regulation. This is because of the long-term nature of the implied contracts and the restricted pool of potential providers willing to bid for these contracts.

Read the working paper here

Health creating economy

The UK Health Forum has published Proposals for a health-creating economy.

This report sets out the Forum’s view that the UK must continue to be an international leader on global non-communicable diseases prevention through engagement at home and abroad with global institutions, governments, the public sector, civil society and commercial operators. This position will in turn lead to savings to the NHS through reduced avoidable demand on services.

NHS efficiency map: updates

The HFMA and NHS Improvement have worked in partnership to update and revise the NHS efficiency map.

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Image source: HFMA

The map is a tool that promotes best practice in identifying, delivering and monitoring cost improvement programmes (CIPs) in the NHS. The map contains links to a range of tools and guidance to help NHS bodies improve their efficiency.

The national focus on improving efficiency and productivity will mean taking local action to deliver savings remains a priority for all NHS organisations. Aimed at NHS finance directors and their teams and other NHS staff with an interest in the delivery of CIPs, the purpose of the NHS efficiency map is to highlight existing resources on eliminating waste, increasing efficiency and at the same time improving quality and safety.

The map is split into three sections: enablers for efficiency, provider efficiency and system efficiency. The map highlights the successes some NHS providers have had in delivering specific efficiency schemes and provides sign-posts to existing tools and reference materials. It also includes updated definitions for different types of efficiency.

The map will be updated as new tools and case studies are produced.

The case studies produced to date are:

Delivering high value health care

The King’s Fund has published the presentations from a conference held on 10 January 2017 on ‘Delivering high value health care’.

The presentations include reducing wasteful spending on healthcare; tackling overuse and underuse of health services; Right Care; improving safety and reducing harm and error; patient safety improvement; and helping patients choose wisely.

Presentations: 

  1. Delivering high value health care

  • Rt Hon Jeremy Hunt MP, Secretary of State for Health, Department of Health

2. International evidence and experience on reducing wasteful spending on health care

Find all the presentations here

Obesity costs the NHS £2.5 billion a year but ageing population is the real ticking time bomb

IEA releases report showing the net cost of obesity to public services is less than £2.5 billion a year

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Image source: IEA

This is the first study to estimate the annual savings that overweight and obese people bring UK taxpayers by dying prematurely (in 2016 prices). Ignoring these savings leads to substantial overestimation of the true burden of elevated body mass index (BMI) to the taxpayer. Our estimate of the present value of pension, healthcare and other benefit payments avoided through early, BMI-caused deaths (net of foregone tax payments) is £3.6 billion per annum. This paper argues the ‘burden-on-the-taxpayer’ narrative, propagated by public health campaigners, is overblown. While claims of a crippling cost are a good way to get media attention, especially during a time of slow motion crisis in the NHS, they irresponsibly incite resentment of a vulnerable group.

Read the full report here

Shaping healthy cities and economies: The role of clinical commissioning

New report shows how clinical commissioning can help realise full potential of local economies | NHSCC

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Image source: NHSCC

NHS Clinical Commissioners have today launched a new report showing the positive contribution that clinical commissioners are making to their local economies. With the recent Autumn Statement making it clear that neither health nor social care will receive additional funding to alleviate pressure on their increasingly overstretched services, the question of how the NHS can drive prosperity in local areas is an increasingly important one.

Read the full overview here

Read the full report here