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Dr. Deon Schoombie delivered the presentation at the 2014 Health Insurance Summit. The 2014 Health Insurance Summit focused on how legislative changes affect the future of health insurance in funding, membership and services. For more information about the event, please visit: http://bit.ly/HISummit14
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The role of self care in a
sustainable healthcare
system
Deon Schoombie
Australian Self Medication Industry
Overview
• Defining self care
• Sustainability of healthcare system – challenges
• UK experience with self care
• Consumer perspectives on self care
• Impact of non-prescription medicines
• An Australian Self Care Alliance
Self care - common themes
• Individuals, children, families, friends, communities &
carers
• Promote health, prevent illness & accidents, cope with
illness & disability
• With and without support of healthcare professionals
• Encompassing all aspects of daily living - hygiene,
nutrition, lifestyle, environmental & socio-economic
factors & cultural beliefs
3
Defining self care
Definitions:
• WHO: 1983,1998 & 2013
Self care is the ability of individuals, families and communities to
promote health, prevent disease and maintain health and to
cope with illness and disability with our without the support of a
healthcare provider.
• UK Dept. of Health paper: Self Care – Real Choice
(2005)
• Health policy perspective (Segall & Goldstein 1989):
Self care is the basic level of healthcare in all societies.
4
Self care – what it isn’t
• Self care doesn’t mean no care
• It doesn’t mean diverting people away from
healthcare services
• It doesn’t mean individuals are left to look after
themselves
• Self care is not what individuals do instead of
going to the doctor, it’s what they do between
visits.
Person-centred care – key themes
• Respect for values, needs & preferences but
also capacity, capabilities & skills
• Partnership & responsibility – collaborating &
sharing
• It requires a supportive environment
Challenges
Australian Health Policy Institute report (2001):
• There is far more that we can do than we can afford to
do.
• There is a problem with rising community expectations
• The ageing population
• Increasing willingness to pay for expansion of medical
care through government spending alone
• All of us need to be better informed about health so our
choices can be more intelligent & demands for
healthcare becomes more restrained than they are.
UK Self Care Policy
• 2000 - Self care on national health agenda
• 2000 – Pharmacists positioned on frontline of
self care strategy
• 2000 – Wanless report:
– Fully engaged patient in all aspects of healthcare
– The patient as partner & resource
– Self care a prime example of effective partnership
– Evolutionary strengthening of patient responsibilities
Consumer perspectives
Eppossi Barometer (2013):
• Understand the concept
• Understand the benefits
• See it as vital part of managing health & disease
• Acknowledge responsibility and willing to take on more
• Minority feels confident to do so
• Health literacy is pivotal
• Don’t view self care as partnership with healthcare
professional
Recommendations
• New policies needed to define the role of healthcare
professionals in self care
• Greater emphasis on shared care
• Government must make self care integral to health policy
• Government should seek improved partnerships with
stakeholders to improve outcomes by sharing data &
resources
• Key role of health insurers & healthcare providers need
to integrate incentives for self care
Impact of self medication
• Current & potential value of non-Rx meds:
– GP visits: $5bn
– Productivity - $7.5bn
• Every $ spent by consumers on 8 OTC
medicines saves $4
The case for self care in Australia
• Translating greater personal responsibility into
practice
• Recognise consumers as a healthcare resource,
not just users
• Making better use of professional healthcare
resources
A new population health strategy
Zollner & Lessof:
• Securing a champion
• Constructing partnerships
• Engaging with private health sector
• Meaningful consultation
• Promoting accountability – monitoring progress &
empowering citizens
An Australian Self Care Alliance
Thank you