Bermuda has one of the highest per capita health expenditures globally, but our population health outcomes do not reflect this.
This from Health Minister Kim Wilson, who told MPs that the use, or “super-use” of the hospital’s Emergency Department points up a very clear example of that.
Speaking on the way forward for Bermuda’s healthcare system and the ‘Next Steps for Universal Coverage’, she said when it comes to chronic disease management, we must achieve better outcomes.
“We must ensure the availability of essential health services residents can be confident they can afford when they need them.
“We must strive to be efficient and effective in the delivery of these services, and eliminate waste and duplication where it occurs in the health system,” she added.
In a Ministerial Statement delivered in the House of Assembly on October 7, Ms Wilson also referred to “an eye-opening” study of “superusers” of the Emergency Department.
“Dr Dean Okereke of the Bermuda Hospitals Board is the project lead on an eye-opening study of “superusers” of the hospital’s Emergency Department,” said the Minister.
“Superusers are individuals, often with complex care needs, who make disproportionate use of health resources.
“Of the 778 Emergency Department visits in a year made by the top 50 most frequently attending ‘superusers’, there were 101 admissions resulting in 1,002 inpatient bed days.
“While 10 percent of attendances at Emergency are for scheduled visits such as IV medications and blood transfusions, 60 percent of patients present with the same issue nearly every time, and chronic conditions are a recurring theme,” she added.
“I know I need not remind this House that Emergency Department treatment is one of the most expensive ways to receive regular medical care but if you are uninsured or underinsured, it can be viewed as the viable option.”
Moving forward, she said: “A revamp of our healthcare system is necessary to help these individuals access care more appropriately, to ensure we, as a community, make best use of our vital hospital resources.”
While noting that the Government “took the first steps” towards implementing universal health coverage for all residents last year, the Minister said the overall process will take several years.
“As I have said before, Bermuda is very fortunate in that we have a health system that is well-developed and well-supported by dedicated professionals. However, the overall lack of affordability and sustainability of our health system is alarming for this Government.”
The Minister also noted that the Ministry “brought together a core group of stakeholders from across our health system to serve as the UHC Steering Committee” last year and “developed a high-level roadmap for strengthening Bermuda’s healthcare and delivering on UHC”.
While noting that “there are many different systems used worldwide”, she said: “It bears repeating that the approach taken here, on our island, must be Bermuda-centric.
“We know the goal of achieving universal health coverage will be accomplished in stages over several years,” she added.
“During this time, this Government will work with our many stakeholders to ensure our decisions and actions are based on, and framed by, a patient-focused approach that puts patient experiences and outcomes at the centre of the work on universal health coverage.”