In a data briefing published in the last couple of days in the BMJ, there was an interesting graphic that indicated the public perception of the healthcare system. Although it isn’t particularly easy to find the source of the information in the Health Affairs cited by Appelby (an article with open access), the results are particularly striking for Australia.
While over 60% of the public in the UK believe that only minor changes are needed, around 75% of Australians believe that our health system needs fundamental changes or a complete rebuild. This perception is even more negative than the US, for which the system is widely known to be overly expensive and suffering from huge gaps in access for the disadvantaged.
For quite some time, I’ve been very interested in the disconnect between the research being undertaken and the questions that people (especially patients and doctors) need answered. There is a huge disconnect between the two.
The NEJM has published a short piece on a very well-funded institute, The Patient-Centered Outcomes Research Institute (PCORI), which will use about $500 million each year to provide the evidence that is most important to patients. Their basic aim is to help people make informed healthcare decisions. Even more interesting to me is that the institute plans to “deploy the full arsenal”, which includes not only clinical trials, but also analysis of registries and other databases, as well as data syntheses (read: meta-analysis and review).
A lot can be done with $500 million, to improve some of the major causes of morbidity in the US, which will then have a direct impact on the rest of the world. Let’s hope the opportunity isn’t squandered.
The NY Times reports that four large health insurers have agreed to release claims data to academics on a regular basis. Claims data will allow us (researchers) to look in much greater detail at what is driving excess costs but much more importantly, to find out how quickly physicians are taking up new (and hopefully better) practices, and perhaps even pinpointing where/when/why sub-optimal practices are occurring and take steps to mitigate.
We have been playing with claims data in some recent (Australian-based) work as well as during the Heritage Prize – it’s typically messy but not impossible to work with. Let’s also hope the definition of “academic” does not equate to “US-based academics”.