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Fragmentation in Asian-Pacific healthcare

Fragmentation in Asian-Pacific healthcare

830 people from 30 countries across the Asia-Pacific region attended the Hospital Management Asia (HMA) conference in Yangon, Myanmar. I was privileged to give a keynote speech on risk-based systems thinking as part of a panel discussion on the characteristics of high performing hospitals. During the conversations that I had with conference participants, two recurring themes were identified: the growing demands arising from ageing populations and the challenge of meeting these in fragmented systems with variable quality.

Number of seniors increasing
The region is currently home to approximately 300 million people aged 65 or above – over half of the world’s total senior population. This number is growing rapidly due to improvements in life expectancy. As a result, Asia’s ageing population is expected to reach 565 million by 2030. Japan is home to the fastest-ageing population in the world, with almost a quarter of its population being over the age of 65 – more than in the US and Europe. While Hong Kong, China, Thailand, the Republic of Korea, and Singapore are also seeing a rise in their elderly populations. As the population ages, so the number of people living longer with chronic illnesses grows – increasing the need for healthcare products and services. This is because people living with chronic diseases require continuous monitoring, treatment, supervision and early intervention to prevent further deterioration.

Fragmented care
At the same time as the region faces such growing demands, it also has to tackle the issue of variable quality and fragmented care. The Asia-Pacific, one of the fastest growing emerging health care markets in the world, has the widest variations in the health care systems across countries. An array of health care delivery systems exists, ranging from fully developed universal health coverage to disjointed healthcare systems with minimal healthcare coverage, limited national guidelines and regulations.

Such fragmentation poses a clear and significant threat to patients – particularly older adults with multiple complex chronic needs that cannot be addressed by single specialists working alone. A holistic, personalized approach to healthcare requires improvements in cohesion, coordination and communication between systems. As Degos and colleagues noted in 2009, lapses in the delivery of quality care “… no longer relate only to episodic errors and failures in procedures at specific times, but also to cumulative failures throughout a patient’s journey within a health system”.

Expectations from healthcare consumers
Consumers of healthcare increasingly expect health services to be modeled on other service sectors. People want to be engaged and consulted by their healthcare providers. Many more are better informed and more likely to challenge health professionals compared to earlier generations. There is a demand for easy 24 hour access. The International Alliance of Patient Organisations’ 2012 review of healthcare indicators reflects that this is driving policy imperatives for greater person-centered and integrated care both nationally and internationally, including within Asia-Pacific.

The conversations at the HMA show that the region faces significant challenges. But all of the delegates that I spoke with were committed to working together to improve and to ensure a seamless patient journey. DNV GL is in a unique position to help healthcare policy makers and providers in the region in overcoming their challenges. Our 150+ year history of risk thinking is focused on improving the safety and reliability of systems – i.e. the ability to see patterns and connections rather than silos. Working together we will go faster and further in ensuring that the needs of ageing populations in Asia-Pacific are met.

Learn more about our work on co-creating person-centred care.

Learn more about our work on developing integrated care standards.


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