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Health bill

Over $700 million spent between 2012-13

A recent National Health Accounts (NHA) study has shown that Barbados’ total health spend for fiscal year 2012-13 stood at BDS$732.4 million.

Chief Health Planner in the Ministry of Health Samuel Deane revealed the findings during a dissemination workshop this morning at the Savannah Hotel, Hastings, Christ Church.

The study showed that overall health spending was strongly supported by Government, which financed more than half of this recurrent expenditure. However, 39 per cent of spending on health was by households, many of which paid for health care with no financial risk protection.

It was also found that 44 per cent of health spending was on secondary care compared to six per cent for tertiary treatment.

The NHA study further revealed that nearly 60 per cent of HIV spending was for care and treatment.

It also found that prevention spending for HIV was higher than for other diseases, with curative care accounting for 58 per cent of HIV spend, compared to 18 per cent on surveillance management, 22 per cent on prevention strategies and two per cent on the purchase of condoms and drugs at private pharmacies.

Deane however cautioned that current spending data by disease and health conditions was limited.

In fact, he pointed out that based on the findings 53 per cent of health spending was not classified to any particular disease. Of the 47 per cent of spending that was determined to be “disease-specific”,

HIV/AIDS accounted for three per cent of the total, hypertension two per cent, cancer 13 per cent, cardiovascular disease three per cent, diabetes three per cent, mental disorder six per cent, other non-communicable diseases or NCDs five per cent, reproductive health eight per cent, asthma two per cent and injuries two per cent.

As for lessons learnt, the Chief Health Officer said the study, which was carried out by the University of the West Indies, provided new insight into how the country’s health resources were being spent.

However, he said there was need for more investigations to be conducted out.

Also welcoming the research, the Deputy Permanent Secretary in the Ministry of Health Cheryl Alleyne said the study provided a more comprehensive estimate of expenditure in the health sector and allowed the Ministry to measure and to analyze the flow of financial resources among all sectoral actors, including the private sector.

She said the information could be used by policymakers to examine viable alternatives for financing national health services and designing innovative revenue-generating models for programmes and services.

“Of course we have to maintain a socially-minded balance in any intiative to ensure that the most vulnerable in our society are always provided for and continue to enjoy the health and well-being that every individual in our country has a right to enjoy,” she said, in delivering the feature address on behalf of Minister of Health John Boyce.

“However, there are some systematic changes that we can employ immediately to improve efficiencies, and to bring greater accountability and to the management and utilization of resources,” she said, while identifying the procurement system as one such area.

Alleyne also suggested the standardization of patient care through the use of care maps and clinical protocols for the management of patients with specific health related conditions.

“This would also include specific guidelines for lengths-of-stay in the hospital, a source of major expenditure within the system.”

However, the health official made it clear that “such guidelines would not be instituted at the expense of quality care, but would be based on evidence from documented research on the management and care of disease and medical disorders”.

Alleyne added that duplication of health services was another factor that may be addressed with the view to rationalizing existing services and optimizing expertise and technologies.

The Ministry also needs to reorganize its priorities to place greater emphasis on policy development, strategic planning and regulation, she said.

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