India placed at bottom fifth, with a score of 36 percent, among the countries on the transparency index...
New Delhi, 13 April, 2017: Health system transparency varies greatly from country-to-country, according to a study from KPMG International titled – “Through the looking glass; A practical path to improving healthcare through transparency.” A total of 32 countries were compared. The study mapped 27 indicators across six dimensions of transparency to provide an individual score for each country. Four Nordic nations – Denmark, Finland, Sweden and Norway – stood at the top of the transparency rankings, with Australia, Netherlands, New Zealand, UK, Portugal and Singapore among the second tier, and China and India propping up the index. KPMG rated nations’ healthcare systems on the availability of data across six dimensions of transparency, including quality care, financial performance and governance.
India achieved an overall transparency score of 36 percent, placing it in the bottom fifth tier among countries on the index. However, an analysis of the results shows that India achieved its highest transparency scores for ‘Governance’ (44 percent), ‘Personal Healthcare Data’ (43 percent), and ‘Finance’ (42 percent). Scores ranged from 29 to 31 percent across the other three dimensions within the transparency index, signalling opportunities to improve in these areas (‘Quality of Healthcare’, ‘Communication of Healthcare Data’ and ‘Patient Experience’).
India is still woefully short in terms of healthcare infrastructure. The overall shortage of healthcare infrastructure (buildings and human resources) is aggravated by the inequitable distribution among urban and rural areas. Over 70 percent of the infrastructure (beds and outpatient clinics) and 80 percent of medical professionals are based in urban areas, which are home to a mere 30-35 percent of Indian population.
Speaking about the India specific report card findings, Nilaya Varma, Partner and COO, Infrastructure, Government and Healthcare (IGH), KPMG in India said, “India’s health system is unique and continues to grapple with the dual burden of high disease prevalence and large out of pocket payment for healthcare. With dominance of the private sector in healthcare delivery, institutionalization of transparency measures continues to be a challenge.”
He further added, “The government will need to take the lead in making India’s health system more transparent. Steps like developing basic framework to report specific parameters, linking performance with incentives and developing a central repository with information publicly available, needs to be taken.”
India is making gradual progress towards a more transparent health system. To progress even further, India should consider mandating public reporting of health outcomes, tariffs and pricing, and patient satisfaction. We need to ensure few things. Firstly, the government should develop a basic framework to report on select transparency parameters such as surgical complications etc. Secondly, the government could work to improve reporting by public hospitals against the set indicators. Thirdly, a centralized repository of health data for the general population needs to be developed. Finally, efforts to develop learnings through various initiatives on electronic health/medical records or digitalization of records should be continued.
The Global scenario on Transparency in Healthcare facilities
Countries like Japan, Greece and South Africa comparatively fared better than India on the transparency index with scores of 46 percent, 43 percent and 37 percent respectively.
The global study also highlights big variations across several dimensions of transparency. ‘Governance’ and ‘Finance’ indicators scored the highest across six dimensions, while data on ‘Quality of Healthcare’ was the lowest – suggesting this is the area where health systems are most cautious to release data.
Even the high performers lack consistency across all forms of transparency, with much room for improvement. “These findings show that health systems are struggling to make the most of transparency,” said Mark Britnell, Chairman of KPMG’s Global Health Practice and a partner with KPMG in the UK. “Our global index reveals a patchwork of efforts that often lack strategic coherence.”
Imagining a brighter future for healthcare transparency
Transparency may not have delivered on its promise, but that doesn’t mean it’s going away. As the report emphasizes, the trend towards greater transparency is inevitable, given the explosion in the amount of healthcare data and rising consumer expectations of patients and the public.
To successfully apply transparency, Governments’ and organisations should adopt a consistent strategy, take the lead from innovative providers, measure what matters to patients, have fewer measures and more meaningful data, provide personalized price transparency, adopting give and take approach to safeguarding patient data and promoting independent narratives to improving understanding.
About the paper
Through the looking glass: A practical path to improving healthcare through transparency is a global study that examines how health systems are approaching transparency, and what they can do to maximize the benefits from this powerful, positive change agent. The study also explores what makes a health system transparent, and imagines an optimum future for transparency – and how to achieve this. The study is the result of 25 interviews with a variety of global healthcare experts, 16 global case studies from countries like Australia, Denmark, Germany, the Netherlands, UK and US, an extensive literature review, plus a transparency scorecard completed by leaders of KPMG’s health practices in 32 countries, which informs an index of performance across six key dimensions of transparency.
About KPMG International
KPMG is a global network of professional services firms providing Audit, Tax and Advisory services. We operate in 152 countries and have 189,000 people working in member firms around the world. The independent member firms of the KPMG network are affiliated with KPMG International Cooperative ("KPMG International"), a Swiss entity. Each KPMG firm is a legally distinct and separate entity and describes itself as such.
About KPMG in India
KPMG in India, a professional services firm, is the Indian member firm of KPMG International and was established in September 1993. KPMG has offices across India in Chandigarh, Gurugram, Noida, Ahmedabad, Vadodara, Mumbai, Pune, Bengaluru, Kochi, Chennai, Hyderabad and Kolkata. We strive to provide rapid, performance-based, industry-focused and technology-enabled services, which reflects a shared knowledge of global and local industries and our experience of the Indian business environment.
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