Pubblicato in: Amministrazione, Cina, Devoluzione socialismo

Servizi sanitari. Valutazione mondiale dei benefici/costi. – Bloomberg

Giuseppe Sandro Mela.

2018-10-08.

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Bloomberg è uscito con una ponderoso articolo che compara i servizi sanitari di 56 differenti nazioni, assumendo come criteri uno score di efficienza ed il costo assoluto riportato in Usd.

L’articolo, di grande interesse per i cultori del tema specifico, si presta però ad una considerazione ben più generale ed importante: la valutazione del rapporto beneficio / costo.

Sotto questa ottica importa relativamente poco come siano stati ottenuti gli score di efficienza ed il costo.

«The U.S. had the second-highest per-capita spending on health care at $9,536. Switzerland’s average based on gross domestic product was $9,818. But that $282 supplement helped deliver an extra 4.2 years of life — with the average Swiss lifespan of almost 83»

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«Compared to residents of the Czech Republic — which had an average life expectancy almost at parity with the U.S. — Americans spent more than double on health care relative to GDP, 16.8 percent versus 7.3 percent»

Consideriamo la seguente Tabella estratta da quelle fornite da Bloomberg.

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Gli Stati Uniti spendono 9,536 Usd per ottenere un’efficienza del 29.6, mentre la Svizzera ne spende 9,818 Usd contro un’efficienza del 58.4.

Valutiamo gli estremi.

La Cina spende 426 Usd per una dignitosa efficienza al 54.6. La Svezia ha un’efficienza del 53.2, quasi eguale a quella cinese, ma spende 5,800 Usd. Hong Kong spende 2,222 Usd ed ottiene un’efficienza di 87.3

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Questi dati consentirebbero di trarne alcune considerazioni della massima importanza.

Se sicuramente senza investimenti nulla può essere ottenuto, se altrettanto sicuramente i risultati perseguiti dipendano anche in parte dal volume di risorse rese disponibili, contemporaneamente si dovrebbe constatare come sia più importante la corretta gestione della spesa rispetto a tutte le altre variabili di interesse.

Il caso paramount è la comparazione tra Stati Uniti e Svizzera: con investimenti quasi eguali i primi hanno una efficienza del 29.6 ed i secondi del 58.4, ossia quasi il doppio.

Ragionando su scala così grossolanamente macroscopica, oltre alla struttura organizzativa entra anche in gioco la mentalità nazionale.

Un secondo elemento che emerge è la considerazione di quanto possa costare il miglioramento della efficienza.

Dai dati riportati dovrebbe essere chiaro come maggiori investimenti producano ben poco, se non punto, incremento di efficienza.

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Questi dati sono di una semplicità disarmante, ma nella vita servirebbe anche avere il coraggio e l’acume di guardare e considerare le cose semplici. La troppa complessità troppo spesso racchiude interessi che molti non vorrebbero emergessero alla luce.


Bloomberg. 2018-09-23. These Are the Economies With the Most (and Least) Efficient Health Care

– Americans’ life expectancy of 79 years lags behind 25 nations’

– Bloomberg Health-Efficiency Index tracks medical costs, value

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Want medical care without quickly draining your fortune? Try Singapore or Hong Kong as your healthy havens.

The U.S. will cost you the most for treatment, both in absolute terms and relative to average incomes, while life expectancy of Americans — about 79 years — was exceeded by more than 25 countries and territories, according to an annual Bloomberg analysis in almost 200 economies.

A health-efficiency index was then created to rank those with average lifespans of at least 70 years, GDP per-capita exceeding $5,000 and a minimum population of 5 million.

Americans aren’t getting their medical money’s worth, according to each of the categories.

The U.S. had the second-highest per-capita spending on health care at $9,536. Switzerland’s average based on gross domestic product was $9,818. But that $282 supplement helped deliver an extra 4.2 years of life — with the average Swiss lifespan of almost 83.

READ MORE: U.S. Health system ranked among the least efficient in the world, before and during first year of Obamacare HERE, and HERE and HERE.

Compared to residents of the Czech Republic — which had an average life expectancy almost at parity with the U.S. — Americans spent more than double on health care relative to GDP, 16.8 percent versus 7.3 percent. Health spending is the U.S. is estimated to increase to 18 percent of GDP in the U.S., according to estimates from the Altarum Institute.

The latest reading of the Bloomberg index reflects the second full year of “Obamacare,” the short name for the U.S. Affordable Care Act, which expanded access to health insurance and provided payment subsidies starting on Jan. 1, 2014. The latest health-efficiency gauge used 2015 data, as that’s the most-recent for most economies from the World Health Organization.

That lag time also puts the spotlight on the U.K., which fell out of Europe’s top 10 in the health ranking based on 2015 data. The nation voted in favor of Brexit the following year, with costs and efficiency of the National Health Service a key issue for British voters.

Spain’s health system efficiency ranked third behind Hong Kong and Singapore, followed by that of Italy, which moved up two spots from a year earlier. Italy ranked as the world’s healthiest country in a separate Bloomberg gauge.

Thailand moved up 14 places to No. 27, the biggest annual improvement, as per-capita spending declined 40 percent to only $219, while life expectancy advanced to 75.1 years. Medical tourism industry is among Thailand’s fastest-growing industries.

Chile, highest-ranked from Latin America last year, tumbled 23 positions, out of the top 10 to 31st, well behind Mexico and Costa Rica. The Chilean government spent 28 basis points more on health expenditure relative to annual GDP, while longevity of its citizens fell more than two years.

Israel and the U.A.E. ranked highest among Middle East economies, with both remaining in the top 10 from last year’s survey.

Costa Rica, Ireland, Lebanon and New Zealand were added to the final index this year, having reached the population threshold — all now ranking among the top 25.

Rankings can change substantially year-over-year because of such things as recession, currency fluctuations and volatile spending patterns relative to the slow pace of improvement in life expectancy.

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