Saving Plans: 5 Errors and 5 Proposals

Remember the games of the analogue times, precisely the moment when the player put the piece in the wrong place and there came a warning sound and the red light lit up the nose? Now it looks like a naff old thing, but I liked that Robert Kaplan and Derek Haas have chosen the image of one of these games, precisely one that is for operating a patient and that they have chosen it to illustrate their article published in the Harvard Business Review blog, "How not to cut health care costs".

When faced with budget cuts, they say, health managers around the world apply the same recipe: reducing staff costs (both in numbers and in wages), optimize the use of space to save general services, stop investments and rationalize spending. The authors do not maintain that this package of measures is poorly done, but they question whether behind these policies there isn’t a strategic way of thinking that combines resources to achieve the best results in the most efficient manner possible and the efforts of the basic savings pack can become counterproductive for the health of people and also for the economy of organizations.

Therefore, we should appreciate that the article analyzes five errors of the basic savings pack, while proposing five alternatives focused on efficiency and effectiveness.

What can we learn from primary care in Finland?

Josep Vidal Alaball

Finland is a leader in many aspects of the welfare system. It’s well known that they have one of the best educational systems in the world; but what can we learn from their primary care system that can be useful for our area? With this article I want to convey some personal reflections about some peculiarities of the Finnish health system and a comparison with our own model.

Finland is a northern European country with 5.5 million inhabitants and a member of the European Union since 1995. Its health system provides universal coverage and it is noteworthy that health and social services are managed from the same government department.

"Being Mortal" by Atul Gawande: The End Matters

Dr. Atul Gawande is a surgeon, researcher and dilettante but also a writer as he describes himself in his twitter account. Dr. Gawande is also known in the field of clinical safety for his previous book "The Checklist Manifesto". The author of "Being Mortal" masterfully explains that life can also be valuable as we get older, frail and defenceless and that there comes a time when we can no longer fend for ourselves. The end matters, as sports enthusiasts know it so well, when pushing your luck at the last minute can lose the whole game strategy.

In his book, Dr. Gawande reflects on the end of life stage of many people from his experience as a doctor, to the extent that one of the best documented cases is that of his own father. In the video that I have chosen for you, you will see how he and his mother talk about it.

Early Palliative Care: + Life Quality + Life Quantity

More evidence supporting early palliative care:Study Identifies Factors Linked to ED Visits by Cancer Patients http://t.co/jdHwJUIZ99 #hpm”

— Jordi Amblàs (@jordiamblas) 3 de enero de 2015

A meta-analysis (you can access it through the link provided by the tweet from Dr. Jordi Amblàs) of 30 studies in 5 different countries and with a participation of more than one million patients shows that patients who had received palliative care were accessing the emergency wards less in the last month of life, which is very positive, considering that many emergency practitioners confess they are not equipped to properly address this type of patients, and also a trip to an emergency service increases the risk that people in advanced stages of illness are subjected to disproportionate actuations. As for the transcendent matter of the moment of the introduction of palliative care, although there are indications that precocity is positive, this meta-analysis fails to reach conclusions due to the heterogeneity of the selected studies.