The twenty first century presents many challenges and pressures that health care systems in their current form are not able to address. Demographic and epidemiological transition in the developing world has created new challenges for health care systems. Population health needs, patterns and outcomes are also changing due to better prevention and control of communicable diseases. Consequently, life expectancy is increasing and shifting the burden of disease.
Now, chronic conditions or non-communicable diseases account for the foremost burden of disease in the Asia-Pacific region. The increasing prevalence of chronic diseases and the complexity and continuing nature of these conditions creates a greater need for people to have regular contact with the health care system. However, communicable diseases still pose a threat to health care systems. Chronic (such as tuberculosis, HIV/AIDS, malaria) and new and re-emerging communicable diseases (such as SARS, avian bird flu, polio) are further putting pressure on health care systems to be adaptable, accessible, culturally appropriate, and capable of meeting the expectations of patients and their families.
Community demands and expectations of health care systems are changing. Improved access to health-related information, increased level of education and income, and advances in consumer-facing technologies have provided people with more opportunities and choices. People now demand quality and expect health care systems to deliver care in ways that suit their requirements for information, psychosocial support, and participation in decision-making.
New evidence about the importance of psycho-social factors in health care, including self-efficacy and self-management, suggest new approaches are needed in patient care. In order to ensure continuity of care, models of care need to focus on the empowerment of people seeking health care and the establishment of positive ongoing relationships between health practitioners and patients.
However, current medical education mainly covers body systems and disease conditions, and hardly touches on the social and cultural context, psycho-social factors, ethics and communication, and the relational aspect of the clinical experience. Health systems are biomedical-oriented and technology-driven whiles services are often fragmented due to clinical specialization, ineffective teamwork, and vertical program approaches. Health care organizations and health systems are not adequately prepared or designed to provide care that meets the needs and preferences of patients.
Developed and developing countries in South-East Asia and the Western Pacific are increasingly receptive to integrating new perspectives on patient care with developments and reforms in health systems. With the increasing availability of information, there is growing community awareness of and demand for better quality of health care. Many health systems in the Asia Pacific have reached a level of maturity where they can examine the quality of care from the patient’s perspective.
New approaches are needed in health care, starting with placing people at the centre of health care systems. Enhancing patients’ experience of care requires attention to both health care system design and the focus and process of patient care.