Report: Health economists could boost healthcare efficiency

Research from Flinders University has revealed that greater input from health economists could provide better solutions to healthcare problems such as emergency department (ED) ramping. The research found that allowing health economists to play a key role in decision-making would improve the efficiency of local hospitals and health networks, while also garnering better results from Australia’s healthcare services expenditure.

Professor Jonathan Karnon, from Flinders University’s College of Medicine and Public Health, said health economists — “who are located at hospital sites rather than sitting in ivory towers” — are better able to play a direct part in decision-making processes, resulting in better health outcomes.

“It takes a healthy population to build a thriving economy and governments have long been challenged by how best to provide care for people and deliver more sustainable health systems and solutions. Economic evaluation aims to provide decision-makers with information on the relative costs and benefits of alternative spending options, but hospitals are so complex that it has proven difficult to provide decision-makers with timely and relevant information,” Karnon said.

Led by Karnon, health economists from Flinders University were embedded in the South Adelaide Local Health Network (SALHN) for two years; in doing so, researchers found that embedding academic health economists into hospitals and allowing them to work directly with clinicians to analyse and interpret data could improve budget decisions. Karnon explained that in Australia, local health services with allocated budgets manage public hospital services for defined geographical areas. While the health economists were embedded in SALHN, they undertook local-level economic evaluations to add value to local decision-making around the development of new interventions. The health economists also implemented new interventions and prioritised clinical areas with the greatest capacity for improvement.

“Our general approach involved the use of local health systems data and published data and engagement with local clinicians to interpret this information in the local context. Using this approach, we evaluated a range of different intervention options to inform decisions on how best to reduce the number of patients experiencing complications during an admission to hospital. We also evaluated significant new programs that have been developed to tackle major issues such as the ED ramping in South Australia,” Karnon said.

The research findings provide a basis for engagement around a sustainable approach to the use of health economics across local health services in Australia. The researchers are currently developing training programs and resources to promote the uptake of economic evaluation in hospitals and local health services. “We want to see education and economist-in-residence programs whereby researchers actively engage with the health service to ultimately impact on patients through the best possible evidence informing health services decisions,” Karnon said.

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