Austrália tem um dos melhores sistemas de saúde do mundo, mas os desafios da produtividade e a crescente demanda estão colocando nossos hospitais públicos sob pressão. A experiência global sugere várias respostas que ajudarão os gerentes locais de serviços de saúde a continuar a prestar cuidados de classe mundial.
Public hospitals are critical to our world class health care system
Australia’s health care system was ranked #1 in the world by the Commonwealth Fund in
Public hospitals are facing a dual crisis
Apesar do sucesso do sistema de saúde da Austrália, nossos hospitais públicos estão enfrentando uma crise dupla de diminuição da produtividade e aumento da demanda. Isso está aumentando os custos totais do sistema, enquanto os governos estaduais e territórios estão sob crescente pressão fiscal.
Hospital productivity is declining as costs per patient rise
Productivity has been significantly impacted by rising costs due to labour shortages and supply chain disruptions following COVID-19, and then by inflationary pressures on salaries and
Olhando para o futuro, deve haver outro aumento significativo no preço por unidade de prestação de cuidados hospitalares em 2025-26, com o preço nacional eficiente (NEP)-o valor padrão de financiamento por NWAU-aumentando 12% para US $ 7.258, após um aumento de 7% em
Hospitals are taking on more than their fair share of rising demand
While costs have been growing, Australia's total NWAU has increased by 3.1% per year since 2016-17. This is significantly faster than underlying population growth, reflecting in part the impact of constraints in the primary, specialist, mental health and aged care systems. These constraints are driving more people to hospitals when they could be served by, for example, GPs and specialists. Over the same period, GP visits have only grown at 1.8% per year and declined by approximately 1% per year since the peak in 2020-21. Specialist appointments have shown limited growth and variability, declining slightly at less than 1% per year compared to 2016-17 levels. The lack of growth in primary and community specialist care is a contributing factor to the burden that preventable and non-acute cases place on the public hospital system. For example, in 2021-22, potentially avoidable hospital admissions accounted for 8% of total bed days (2.6 million bed days) – an increase of 3% from 2020-21.
Challenges in the Residential Aged Care (RAC) sector are also contributing to hospital congestion. Since 2016-17, the number of people in RAC facilities has grown by just 1% per year. While home care packages are growing much faster, these are not always suitable for people awaiting hospital discharge. This shortage of RAC places delays the transition of elderly patients from hospitals into aged care, prolonging hospital stays and exacerbating bed block. The scale of this issue is significant – in 2020-21 alone, over 286,000 patient days were occupied by patients waiting for RAC placements.
Relieving the pressure
Health service managers have done well to control costs in this challenging environment so far, but 8% growth in expenditure each year isn’t sustainable for most states and territories. While ongoing reform in primary and aged care is essential to a long-term solution, public hospital system managers also need to unlock savings while continuing to deliver high quality care to a growing number of patients. To support these efforts, we now look at four ways in which health care systems are driving step changes in cost-effectiveness and operational efficiency.
Take a state-wide, AI-powered approach to procurement
Purchased supplies typically comprise ~20% of the total cost base of the public hospital system and these costs have risen at 9% each year for last six years. While local health services are already focused on negotiating better deals, AI can now help whole systems unlock significant savings.
Comparing prices and purchasing patterns across hospitals used to require significant investments in standardising data and integrating enterprise resource planning systems. With AI, it is now possible to bring together data from different systems and unstructured data sets to build powerful spend cubes that reveal price variation and purchasing behaviour. This can support health care systems to realise immediate savings by addressing inconsistencies It can also drive longer term savings by standardising their clinical requirements and combining their purchasing power, enabling more competitive bulk agreements that optimise costs and supplier performance without sacrificing quality. AI can also rapidly accelerate the tendering process, speeding the production of tender documents and the analysis of proposals. This allows systems to re-tender more categories at once, capturing greater savings through increased pressure on suppliers.
Essa abordagem tem o potencial de desbloquear a economia de 10 a 15% da base de custos endereçáveis. Um sistema hospitalar regional de US $ 3 bilhões nos EUA estabilizou rapidamente suas finanças após perdas pós-Covid superior a US $ 1 milhão por dia. Ele simplificou a aquisição racionalizando o Skus, negociando renovações de contratos, introduzindo consumo inteligente e identificando e maximizando sinergias entre hospitais-resultando em US $ 35 milhões em economia de taxa de execução. - com serviços hospitalares em casa. No entanto, esses serviços são principalmente localizados, de subescala e altamente manual em sua entrega e operação. Para impulsionar a economia real, os sistemas de saúde devem adotar modelos de hospitais domésticos altamente escaláveis e ativados digitalmente que podem ser lançados rapidamente em nível estadual ou nacional. Esses modelos podem potencialmente proporcionar economia de custos de até 30 a 50% por dia de cama e custos de capital futuros significativamente mais baixos, reduzindo a necessidade de camas hospitalares mais tradicionais. Em vez de simplesmente mudar os locais de cuidados, essas soluções permitem que os médicos priorizem efetivamente os cuidados, com intervenção precoce impulsionada por alertas oportunos e insights claros. A coleta automatizada de dados e a integração simplificada do paciente reduzem a carga de trabalho administrativa em equipes clínicas, enquanto a integração nas vias de referência existente permite admissões diretas e seguras de práticas comunitárias e departamentos de emergência. Como resultado, os hospitais podem evitar admissões desnecessárias e reduzir a duração da estadia. Por meio de parcerias com operadores de escala como a DOCCLA, o NHS expandiu significativamente o seu custo digitalmente ativado e reduziu o custo operacional de seu modelo de assistência domiciliar. Ao integrar as vias de referência, otimizar a logística dos pacientes e usar sistemas como os processos de monitoramento e escalação de pacientes em tempo real da DOCCLA, o NHS reduziu significativamente as admissões ao alterar 10% da capacidade aguda para enfermarias virtuais e entregar um retorno tríplice sobre o investimento em determinados NHs
Rapidly scale digitally enabled home hospital models
Many health care systems are reducing their reliance on inpatient care – one of the highest-cost components of health care – with home hospital services. However, these services are mostly localised, sub-scale and highly manual in their delivery and operation. To drive real savings, health systems must adopt highly scalable, digitally enabled home hospital models that can be rapidly rolled out at a state-wide or national level. These models can potentially deliver cost savings of up to 30–50% per bed day and significantly lower future capital costs by reducing the need for more traditional hospital beds.
Digitally enabled home hospital models combine modern distribution and collection logistics, patient and career support services, scale in device purchasing and management, advanced software for remote patient monitoring, AI-based triage tools, and real-time clinical oversight to safely manage patients at home. Rather than simply shifting care locations, these solutions enable clinicians to prioritise care effectively, with early intervention driven by timely alerts and clear insights. Automated data collection and simplified patient onboarding reduce the administrative workload on clinical teams, while integration into existing referral pathways allows direct, safe admissions from community practices and emergency departments. As a result, hospitals can avoid unnecessary admissions and reduce length of stay.
Despite already having a home-based care model, the UK NHS recognised it needed a more scalable, cost-effective solution to manage patient care outside traditional hospital settings. Through partnerships with scale operators such as Doccla, the NHS has significantly expanded its digitally enabled and lowered the operating cost of its home-care model. By integrating referral pathways, optimising patient logistics, and using systems like Doccla’s real-time patient monitoring and escalation processes, the NHS significantly reduced admissions by shifting 10% of acute capacity to virtual wards and delivered a threefold return on investment in certain NHS
Apoie o envolvimento da linha de frente na melhoria da produtividade
A equipe do hospital pública trabalha duro, mas os hospitais são organizações grandes e isoladas com fluxos de pacientes complexos e variáveis. Nesse contexto, apesar de seus melhores esforços, gargalos e ineficiências geralmente surgem. A maioria dos profissionais de saúde é altamente motivada a enfrentar esses desafios sem a necessidade de metas de cima para baixo e de cima para baixo ou KPIs. Em vez disso, o que os médicos precisam são painéis significativos e em tempo real, que destacam lacunas para os benchmarks de produtividade e insights de fluxo de trabalho. Os médicos já têm acesso a grandes volumes de dados, mas o valor está em comparações concisas e perspicazes. Juntamente com esses painéis, é igualmente importante estabelecer comportamentos de equipe, como abastos curtos e regulares para revisar as idéias; identificar as melhores práticas, questões emergentes e variação clínica desnecessária; Coordenar a ação e revisar o impacto. Ao combinar efetivamente dados perspicazes com esses comportamentos colaborativos, os hospitais podem reduzir os custos de mão-de-obra em 5%. Juntamente com esses dados, criou ambientes de aprendizado colaborativo, onde os médicos poderiam compartilhar as melhores práticas, refinar os processos de cuidados e impulsionar a melhoria contínua. Como resultado, o Santeon reduziu o paciente desnecessário em 50%, as reoperações do câncer de mama em 25% e as reoperações de lumpectomia por
The Santeon Hospital Group in the Netherlands equipped its frontline managers with real-time dashboards and performance benchmarks to drive efficiency and improve outcomes. Alongside this data, it created collaborative learning environments where clinicians could share best practices, refine care processes and drive continuous improvement. As a result, Santeon reduced unnecessary inpatient stays by 50%, breast cancer reoperations by 25% and lumpectomy reoperations by
Build a digital front-end to manage demand more effectively
When patients have fragmented access to care, they often seek treatment in high-cost emergency departments when lower-cost and lower-acuity alternatives are available. Other patients with more acute needs often have to negotiate multiple steps to get to the high-level care they need, adding cost and delaying care. By integrating emergency, urgent and outpatient care access through a unified digital front-end, health systems can resolve issues first time at the lowest appropriate care level, increasing efficiency and reducing spend in targeted clinical streams by 10-20%.
A digital front-end integrates emergency, urgent and outpatient care into a single streamlined platform, directing patients to the most appropriate level of care at their first point of contact. AI-powered assistants handle symptom assessment, reducing unnecessary call centre volume and freeing up clinical staff. While automated appointment scheduling, referrals and check-in processes reduce administrative workload while ensuring patients receive timely and cost-effective care.
US not-for-profit, Intermountain Health needed a more seamless, digital-first approach to direct patients to the most appropriate care level so it launched the "Digital Front Door". The front-end transformed patient navigation and demand management by consolidating telehealth programs into a virtual hospital, introducing an app for appointment scheduling, access to medical records and virtual consultations; and automating administrative workflows. The digital front-end helped Intermountain Health reduce costs per visit by 87%, reduce patient check-in times by 25%, save 30 minutes per day per medical assistant, reduce call centre volume by 30%, increase co-payment collections by 300% and achieve 96% patient
Os hospitais públicos da Austrália enfrentam um desafio significativo de produtividade. Para atender à crescente demanda e minimizar a pressão fiscal, eles precisam encontrar maneiras de melhorar significativamente a produtividade. Embora não exista uma solução única para esse desafio, a experiência global sugere uma série de oportunidades que são melhor abordadas em um nível de todo o sistema. Os gerentes de serviços de saúde já estão trabalhando duro para gerenciar custos; Agora, os departamentos de saúde estaduais e territórios precisam gerar economias em todos os sistemas estaduais de saúde, aproveitando novas ferramentas e tecnologias. Inscreva -se
