Doctors study the biology of diseases and whether a disease a patient has could be eliminated or controlled. In the 21st Century, what’s been added to this equation is the role of cost and healthcare expenditure in the medical decision-making process. This is in view of finite resources. A country’s GDP also plays a vital role in the cost matrix.
This reality of finite resources and a country’s GDP forces the question of how much can be afforded in treatment to a patient. Does providing those services to a patient take away from other patients? Is treatment to be based purely upon the means a patient has, or do governments invest in healthcare treatment on the basis of cost effectiveness so that a larger group of patients experiencing the same disease is benefitted?
Governments need to decide if they will provide free healthcare at the point of service or rely on private healthcare providers. NGO’s, bilateral and multilateral agencies need to decide how they will spend their resources and how they can make the most of the money spent in healthcare. This implies a need to calculate the cost per DALY (disability adjusted life year) averted for each medical intervention. Here is where health economists play a paramount role.
For example, if the cost for treating disease A in a particular country is $40 USD per DALY averted while the cost for treating Disease B in the same country is approximately $8,000 per DALY averted, governments and NGO’s know that they could buy 200 times more DALY averted by investing in treatment for Disease A particularly since the disease is prevalent in the country.
If cost effectiveness is the central issue in healthcare, would this invariably exclude those with terminal diseases seeing that it’s probably not cost effective to treat a person facing impending death? These are some of the considerations that governments, NGOs, bilateral and multilateral agencies have to mull over. Here is where the work of health economists becomes important.
Health economic studies focus on providing information to decision makers for efficient use of available resources for maximizing health benefits. Economic evaluation is one part of health economics, and it is a means for comparing the costs and the consequences of different interventions.
According to Dr. Michael S. Saag, in an article in the Infectious Disease News section of Healio.Com, the time has come for doctors to shift from a purely physician point of view to one that emphasizes health economics when it comes to treatment.
He states that doctors would need to see beyond the one patient sitting across from them and take into consideration the many patients who may be affected by the same health condition. This would invariably mean that doctors must now consider the fundamental role of the cost of treatment in medical decision-making process.
Many doctors in the public healthcare sector in Malaysia are aware of the cost of treating patients with limited resources available to them. A doctor once mentioned to Disruptive Doctors (DD) that when a hospital he once worked at ran out of keyhole pods needed for appendix and gall bladder surgeries using the laparoscopy keyhole technique, he was instructed to perform open surgery. This cost him valuable time while making the patients more susceptible to infection and taking a longer time to recuperate.
While the problem mentioned above is clearly a question of budget, health economics can help governments realize which interventions are cost and time effective. Further, when it comes to health economists, it makes sense that doctors not economists would be the most suitable for the role. Here some reasons why.
To find out the reasons why doctors make the best health economists look out for Part II of our article which will be published on coming days.
