An aging population and significant increases in chronic lifestyle-related diseases place Sweden in the position of needing to transition from a reactive healthcare system to mindset dominated by proactive measures. To this end, RISE contributes methods, knowledge, analysis and data via its Social and Health Impact Centre (SHIC)
An aging population and sharp increases in lifestyle-related diseases such as type 2 diabetes and cardiovascular disease is a potentially disastrous combination. In addition to the human cost of more people becoming sick, this development is also a cost driver for the healthcare sector.
“The cost curve increases exponentially, while the tax-revenue curve remains flat,” says Krim Talia, RISE business area manager for Life Science.
It is not difficult to draw the conclusion that future needs cannot be financed with increased taxation; rather, one solution is to reduce demand for healthcare.
"The term lifestyle-related diseases in itself suggests that this development can be reversed through changing lifestyles," says Krim Talia.
Difficult to find funding
Preventative healthcare is not a hard sell to the public; the problem lies in obtaining the money to fund the work. Transferring resources from caring for the sick is politically and ethically untenable, even if it will pay dividends in the long term.
"At RISE, however, we do in fact have the knowledge and resources to study and design solutions that don’t place a burden on the public sector. One example of this is social impact bonds, which are currently being used to reduce sick leave among municipal employees in Örnsköldsvik and Botkyrka,” says Krim Talia.
The idea has its origins in the Peterborough Social Impact Bond to reduce reoffending among prisoners at Peterborough Prison in the United Kingdom. As it was possible to accurately work out the cost of a prison sentence, the social savings for each prisoner who did not reoffend on release could also be calculated.
“The public authority expressed a willingness to pay a certain amount of money to a private-sector service provider based on results; however, if results were not achieved there would be no money. This method indemnifies the public sector against risk. Helping the public sector to improve procurement and only pay for results is an exciting model that we believe should work equally well in the healthcare sector,” said Krim Talia.
Tech development helps
Technology developments also create opportunities to work preventatively. The costs of monitoring health, diagnostics and various types of health tests has decreased and will continue to do so.
"Health data will become much cheaper and more accessible. The downside is that costs per therapy will increase for some patients. Individual analysis will lead to many smaller patient groups undergoing shorter treatment series,” says Krim Talia.
On the other hand, cheaper tests may also lead to the earlier detection of diseases that can then treated at an earlier stage.
"It will make a tremendous difference if we are able to detect lifestyle-related diseases such as diabetes in good time. By changing diet and exercise habits, prediabetics can actually avoid contracting type 2 diabetes,” says Krim Talia.
Digitalisation in the form of online doctors has already had an impact on primary healthcare, which has been forced to adopt the technology.
"If the divide between public-sector healthcare and attractive private-sector offers becomes too great, it will be difficult to maintain tax morality. Public-sector healthcare must remain relevant,” says Krim Talia.
Social plans for healthy lifestyles are required
ealthcare has a role to play in the transition from a reactive approach in which we cure those who are already sick, to a more proactive approach; however, it is much more important that we mobilise other stakeholders.
"The major target areas for reaching people and convincing them to change their lifestyles are in churches, gyms, workplaces, supermarkets and many other places throughout society. That said, we also require a social plan that encourages people to live healthier lives,” says Krim Talia.