世界经济论坛20182019全球健康与医疗未来愿景转变卫生系统英文2019925页

ReflectionPaperGlobalFutureCouncilonHealthandHealthcare2018-2019AVisionfortheFuture:TransformingHealthSystemsSeptember2019WorldEconomicForum91-93routedelaCapiteCH-1223Cologny/GenevaSwitzerlandTel.:[phone]Fax:[phone]Email:[e-mail]©2019WorldEconomicForum.Allrightsreserved.Nopartofthispublicationmaybereproducedortransmittedinanyformorbyanymeans,includingphotocopyingandrecording,orbyanyinformationstorageandretrievalsystem.TheviewsexpressedinthispaperarethoseoftheauthorsanddonotnecessarilyreflectthoseoftheWorldEconomicForumortheOrganisationforEconomicCo-operationandDevelopment(OECD)oritsmembercountries.3AVisionfortheFuture:TransformingHealthSystemsContentsForeword5Executivesummary6Introduction7Methodology9Thehealthjourneyscenarios10Scenario1:Wellnessjourneyinalow-incomecountryorcontext10Scenario2:Womanandchildjourneyinalow-incomecountryorcontext12Scenario3:Diabetespatientjourneyinamiddle-incomecountryorcontext14Scenario4:Cancerpatientjourneyinahigh-incomecountryorcontext16Scenario5:Healthyageingjourneyinahigh-incomecountryorcontext18Recommendations20Conclusion22Acknowledgements23Endnotes244GlobalFutureCouncilonHealthandHealthcare2018-20195AVisionfortheFuture:TransformingHealthSystemsForewordHealthsystemsareundermajorpressureglobally.Populationgrowth,ageing,theemergenceofpersonalizedmedicineandthegrowingpotentialofnewtechnologies,alongwithrapidlyrisingcostsandtheentryofdisruptiveandnon-traditionalcompetitors,willincreasedemandforservicesandaffecttheperformanceandsustainabilityofhealthcaredeliverysystems.By2050,oneinsixpeoplewillbeover65yearsold1andmorepeoplewilllivewithoneormorechronicdiseases.Despitereformsinfundingandpaymentmodelsinsomecountries,thereisampleevidenceofwasteandinefficienciesinhealthsystems.2Globalhealthcarespendingisprojectedtocontinueincreasing.Thesetrendsdemandurgentattentionfromallstakeholdersinthehealthsystem.Suchsystemsmusttransformtodeliverwhatpeopleneedbetter,whileremainingfinanciallyviableinthelongterm.Thispaperarguesthattoday’shealthsystemsneedtobereformed,andthatreformispossible.Itidentifiessomekeyconditionsforreformandbarriersthatneedtobeaddressedtoencouragethistransformation.PreparedbytheWorldEconomicForumGlobalFutureCouncilonHealthandHealthcare2018-2019,thispaperlaysoutfivescenariosdevelopedbytheCouncilofhowindividualswithdifferenthealthneedsnavigatethroughorrelatetothecurrenthealthsystem,andthechallengestheyfaceindoingso.TheCouncilthenconsideredforward-lookingscenariosoutliningwhattheseindividualhealthjourneyscouldlooklikewithimprovementsinhealthsystemdelivery.TheCouncilconsideredquality,accessibility,affordabilityandequityaskeyprinciplesforfuturehealthsystems.Throughthesefuture-orientedscenarios,theCouncilarticulatedhowimprovedandmorecost-effectivejourneysforindividualsinhealthsystemscouldbeachievedacrossdifferentregions.Thesescenariosareachievable;buildingblocksforthemoresustainable,people-centredhealthsystemsmentionedinthemalreadyexist.Nonetheless,realizingsuchscenariosby2030wouldrequiredecisiveaction,suchas:–Reorientinghealthsystemstoincreasethefocusonpreventingdiseaseandpromotinggoodhealthandearlierinterventions–Prioritizinguniversalhealthcoverage,includingbystrengtheninghigh-qualityprimaryandcommunityhealthcare–Ensuringthesmarteruseofinnovationandtechnology-basedsolutionstomakehealthsystemsmoreefficient,effectiveandresponsivetopeople’sneeds–Promotingwell-designedpartnerships–Developingafit-for-purposeinstitutionalarchitectureandgovernanceglobally,nationallyandlocallyThus,aqualityhealthsystemthatmeetstheneedsofindividuals,familiesandwholepopulationsiswithinreach.Achievingthatwillrequireeliminatingunnecessarywaste,encouraginggoodhealthoutcomes,breakingdownsystemsthatoperateinisolationincareserviceprovision,andusingdigitalhealthdataandtechnologiesbetter.Allstakeholderswithinthebroadhealthsystemwillneedtoworktogethertomakeadifferenceforindividualsandpopulations.HelenE.Clark,PrimeMinisterofNewZealand(1999-2008)FrancescaColombo,Head,HealthDivision,OrganisationforEconomicCo-operationandDevelopment(OECD),ParisVanessaCandeias,Head,ShapingtheFutureofHealthandHealthcare,WorldEconomicForum6GlobalFutureCouncilonHealthandHealthcare2018-2019ExecutivesummaryThispaper,“AVisionfortheFuture:TransformingHealthSystems”,addressestheneedforhealthsystemstobereorientedtomeetpopulations’needsinthecontextoftheFourthIndustrialRevolution.Itdiscussespresentandfuturechallengesfacedbyhealthsystems,adoptingasystemsapproachthatplacestheexperiencesofindividuals,familiesandcommunitiesatthecentreofitsanalysis.Thepaperaddressestwosetsofissues:1.Therequirementsforfuturehealthsystemstoachievegoodoutcomesforindividuals,familiesandcommunitiesinasustainableandequitablemanner2.Thewaysthathealthsystemarchitecturecansupportthiseffortatalllevels.Expectedtransformations:Aqualitativescenarioanalysisofindividuals’experiencesidentifiedkeyareaswherechangeswithinhealthsystemscanoccurandcanbeachieved.Theseinclude,amongothers,developingafit-for-purposehealthworkforce,implementingcost-effec