Moving treatments from hospitals to patients' homes key to sustainable healthcare

Taking healthcare home is key to delivering sustainable treatment, writes Paul Leeflang.

Doctor | Photo credit: Press Association

By Paul Leeflang

29 Sep 2016

This year, the European Health Forum Gastein will focus on demographic change and its impact on the sustainability of European health systems.

Moving appropriate treatments from hospitals into patients’ homes is a key part of the sustainability puzzle. 

Evidence suggests that where a patient has a condition that can be treated outside of hospital such as home dialysis, home parenteral nutrition or home antibiotic/chemotherapy, home-based care delivers better health outcomes and quality of life for patients at a lower cost. 


However, in many European countries there is little or no funding for home-based care. Despite strong evidence that home peritoneal dialysis (PD) is the most economically efficient form of dialysis, PD use remains low. 

Barriers such as low awareness and lack of patient choice, financial disincentives for clinicians and silobudgeting limit uptake of home PD despite recommendations from government bodies such as NICE (UK) or Cours des Comptes (France). 

Spain and Finland are at the forefront of encouraging home dialysis in an effort to enhance patient empowerment and drive efficiencies. Home-based treatments enable patients to continue full-time employment and to enjoy a better quality of life. They feel empowered and more in control of their disease. 

However, realising these many benefits requires alignment between factors such as a patient’s support network, their condition, and the capacity of health systems to implement homecare.

However, positive change is emerging in some countries; Italy, France, the UK and many Nordic countries are setting out plans to help shift healthcare away from hospitals towards the community. Australia estimates that it could save $3bn (€2bn) by rolling out telehealth accompanied home treatments. 

By working closely with governments, patients, physicians and providers, Baxter has identified key areas that need to be addressed to enable greater use of homecare and to move health systems toward increased sustainability.

First, governments need to be clear on designing policies that incentivise home treatments, including integrating enabling technologies for remote disease management, especially given the major role that these technologies can play in supporting optimised patient care, improving patient-clinician confidence and reducing overall treatment costs. 

Second, political and clinical leadership is needed to spearhead a shift in approach, with the sharing of best-practice guidelines and policies at European level, including for example, the European Semester process. Finally, the social and economic benefits of homecare need to be showcased more effectively to patients and healthcare professionals.

Demographic change and increased pressure on budgets are already changing the nature of healthcare. To respond to these challenges, the model of healthcare delivery will need to change too. We believe homecare can be a key part of this puzzle, and we stand ready to help deliver its benefits to patients and governments.


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