Inquiry may call for body to track private healthcare quality
Patients and medical schemes can shop around but have limited scope to compare the quality of care
The Competition Commission’s healthcare market inquiry is considering recommending that an independent body is established to monitor the quality of private healthcare services.
Patients and medical schemes can shop around for the cheapest doctor or hospital, but have limited scope to compare the quality of care on offer.
The inquiry was established to determine whether there are barriers to effective competition in the private healthcare market, and it is due to release its interim report and recommendations by the end of November.
"It has become apparent to the inquiry ... that the availability of relevant, timely and validated information on provider performance and clinical outcomes of care ... is poor. Information, if publicly available at all, is sporadic, incomplete, not standardised and largely irrelevant for choosing the best value of care," it said in a discussion document released this week.
Patients in many developed countries have access to objective data on the quality of healthcare services, which they can use to help them decide which facilities to use, but there have been limited initiatives like this in SA so far.
Discovery Health ranks private hospitals based on patient satisfaction surveys, but it has yet to publish data on clinical outcomes. Medi-Clinic also publishes the results of its patient satisfaction surveys.
The inquiry said in its document that a standardised set of measures should be developed. It suggested the data should initially be kept out of the public spotlight, but ultimately shared with patients and funders.
While many industry players expressed cautious support for a possible "Outcomes Measurement and Reporting Organisation", Section 27 attorney Umunyana Rugege queried why the inquiry was weighing up a new institution rather than beefing up existing structures such as the Office of Health Standards Compliance.
Afrocentric CEO Antoine van Buuren said he supported publishing information on the quality of services, provided everyone did so. "Let all the companies publish, or we’ll get a backlash from doctors," he said.
Roly Buys, Medi-Clinic head of funder relations, said the inquiry’s proposals were similar to initiatives in the Netherlands and the UK. "What’s quite heartening is there is an understanding that it will take some time."
Roshini Moodley Naidoo, Discovery Health head of strategic risk management, said the private sector was collecting some of the data the document referred to, but it could be better used. "We support the focus on quality outcomes, but there should also be a concomitant focus on efficiencies in any quality performance framework.
"In the process of establishing the proposed model … it is critical that quality initiatives already under way towards achieving value-based care are not set back," she said.