In Ontario and across Canada, it’s a time of transformation for home health care. Our population is aging. Chronic disease is on the rise. And now, more than ever, patients are expressing a preference for living at home. But these changes aren’t just nation-wide.
In an increasingly global world, health care leaders have the opportunity to share data and innovation. Nurses and frontline workers can learn from one another, wherever they’re located. In the digital age, cultures change quickly. Often, population health and care delivery is dramatically affected. Mexico is an interesting example.
The Mexican health care system is unique, but the same can’t be said of some of the biggest challenges it’s facing.
As just one example, chronic diseases are on the rise. They pose a growing threat to the country, in large part because they often lead to costly hospital readmissions. Efficient home health care will be critical to solving this problem.
In this post, we’ll look at some of the similarities and differences between Mexican and Canadian care delivery. We’ll explore how innovation and information sharing can improve at-home care in both countries – and across the globe.
Chronic Disease: Two Nations and a Major Health Care Challenge
Between 1950 and 2000, Mexican life expectancy grew from 36 to 74 years. By 2050, predictions set it at 80 years. That’s a pretty dramatic shift, to say the least.
A 2012 study (published in Rand Health Quarterly) identifies some of the major reasons for this change. They include improved quality of life and better health care.
There’s no doubt about it – this is a positive change. But it’s also creating new challenges. As the Mexican population ages, chronic diseases are becoming far more common. As of 2015, ischemic heart disease and diabetes were the number one and two causes of death, respectively.
This statistic speaks to the massive shift that’s occurring in the Mexican population. And it also raises plenty of questions. How will Mexican health leaders deal with the burden of chronic disease? Is the country’s system set up for the task?
To answer this question, we need to look at the health care system improvements that have led to better health. Since 2012, Mexico has had universal health care for its citizens. This care, provided by a government program known as Seguro Popular, includes screening and treatment for chronic diseases like diabetes.
A short time after Seguro Popular was introduced, several key health indicators had already risen.
That said, some studies – including this one, published in Gaceta Sanitaria – point to ongoing issues. It seems that many people covered by Seguro Popular are still burdened by out of pocket health care expenses.
It’s worth noting that Canada is also far from perfectly prepared to deal with the rise of chronic diseases. The country’s health care systems just weren’t designed for it. Luckily, measures to improve home health care – like Ontario’s Health Links – are set to make a real difference.
In the years ahead, both countries will face challenges associated with a major uptick in chronic conditions.
The Need for Home Health Care: an International Comparison
In countries like Mexico and Canada, demographics are changing. And the health care needs of citizens are changing along with them.
Health care leaders need to find new ways to treat chronic conditions like diabetes and heart disease. Studies show that patients would prefer to receive care at home. They value their independence.
And here’s another critical factor: cost. Acute care beds are expensive – something both countries need to be aware of.
The OECD notes that while health care spending has grown in Mexico in recent years, economic development has remained low. And in Canada, organizations like the Fraser Institute indicate that current health care spending patterns aren’t sustainable.
Home health care is a clear solution. It’s an option that’s far less expensive than acute care – and it’s the preference of most patients.
Here it’s important to consider some of the unique home care challenges Mexico is facing. To name one: women, who have long acted as full-time, unpaid caregivers, are moving increasingly into the workforce. This is something that began happening in Canada decades ago. Needless to say, the Mexican health care system faces a huge hurdle with regards to ensuring that it’s sickest citizens receive care.
But despite such differences, many of the major challenges are the same. In a recent study, nurses for Mexican hemodialysis patients reported some of their biggest home care coordination challenges. And they’ll look awfully familiar to any home care coordinator in Canada.
Heavy workloads and insufficient human resources. Struggles associated with lifelong patient education. Limitations that make it harder for care teams – including professionals and family caregivers – to work together.
Reducing Hospital Readmissions, Improving Patient Care
When it comes to chronic conditions, one of the most serious consequences is hospital readmissions. As any health care expert knows, leaders who wish to cut costs should look closely at preventable readmissions.
In a 2012 study, Canada’s CIHI found that one in 12 patient discharged from the hospital returns within 30 days. It makes sense to be concerned that future Mexican statistics will also reveal high rates of unplanned readmissions.
Consider how much is expected of family members and informal caregivers in Mexico. The study that surveyed nurses for hemodialysis patients (linked above) makes a clear connection between care received in the home and overall patient health.
For example, nurses say that patients frequently return to the hospital “in poor hygienic condition”. Often, they’re showing signs of infection. This is frequently true of patients who live with family caregivers. Without the right support, complications can easily occur.
Of course, these complications can wind up sending patients back to the hospital for costly (and, in many cases, preventable) treatment.
Coordination and communication between care team members – including family members – is key. This means that better home health care is the way forward. Carried out correctly, it’s more efficient and less costly than other models. It’s also in keeping with patient preferences.
But given current strains on the health care systems in Canada and Mexico, can the goal of improved care at home be achieved?
In Mexico, the developing home health care system has a long way to go. This is also true of Canada. But here in Ontario, leaders have already fought half of the battle.
From policymakers to nurses, health professionals know the importance of investing in home care. Initiatives such as Health Links are fast tracking the improvement of care coordination. And advanced telemedicine systems are bringing patient circles of care together.
Bringing it all Together
Canada – and Ontario in particular – is on its way to reducing some of the biggest threats associated with chronic disease. But leaders in our corner of the world still have a lot to learn from outside of our borders.
Mexico is a nation that has embraced and brought about massive positive health care change – all in relatively short period of time. By sharing data and analyses of what works and what doesn’t, these countries can learn from one another.
Let’s end with an illustration of the power of innovation: CASALUD. Established in 2008, the program aims to improve the prevention and treatment of chronic diseases in Mexican primary care.
Mobile technology plays a major role in the program. And Brookings reports that the fresh approach has paid off, leading to improved diabetes screening rates and clinical infrastructure.
Through cross-border information sharing and a willingness to explore innovation, health leaders can tackle many health challenges on the horizon.
Feature image courtesy of Rosmarie Voegtli