Waste

… “wasteful”:

i) services and processes that are either harmful or do not deliver benefits; and

ii) costs that could be avoided by substituting cheaper alternatives with identical or better benefits. Linking actors – patients, clinicians, managers and regulators – to key drivers of waste – errors and suboptimal decisions, poor organisation and co-ordination, incentives misaligned with health care system goals, and intentional deception – helps to identify three main categories of wasteful spending:

• Wasteful clinical care covers avoidable instances when patients do not receive the right care. This includes duplicate services, preventable clinical adverse events – for instance, wrong-site surgery and many infections acquired during treatment – and low-value care – for instance, medically unnecessary caesarean sections or imaging.
• Operational waste occurs when care could be provided using fewer resources within the system while maintaining the benefits. Examples include situations where pharmaceuticals or medical devices are discarded unused or where lower prices could be obtained for the inputs purchased (for instance, by using generic drugs instead of originators). In other instances, costly inputs are used instead of less expensive ones, with no additional benefit to the patient. In practical terms, this is often the case when patients seek care in emergency departments, end up in the hospital due to preventable exacerbation of chronic disease symptoms that could have been treated at the primary care level, or cannot be released from a hospital in the absence of adequate follow-on care.
• Governance-related waste pertains to resources that do not directly contribute to patient care. This category comprises unneeded administrative procedures, as well as fraud, abuse and corruption, all of which divert resources from the pursuit of health care systems’ goals.

Source: Organisation for Economic Cooperation and Development (2017) Tackling Wasteful Spending on Health. OECD Publishing, Paris. pp. 11-12. http://dx.doi.org/10.1787/9789264266414-en

Improving the outcomes that matter to an individual for a given amount of resources (money, leadership, time, assets, and carbon) used not only by the health system but also by the individual and their family, recognising that the experience of care is a critical element.

Source: Oxford Centre for Triple Value Healthcare