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and do no necessarily reflect the views or policies of the Asian Development Bank (ADB),
or its Board of Governors, or the governments they represent. ADB does not guarantee
the accuracy of the data included in this paper/presentation and accepts no
responsibility for any consequence of their use. Terminology used may not necessarily
be consistent with ADB official terms.
April 2018
Outline
• Key 21st Century Challenges which
Hospitals must Face
– Demographic and Epidemiologic Changes
– Increasing Demand for UHC
– The Need to Address Health Security
• Opportunities to Improve Hospitals
KEY 21ST CENTURY CHALLENGES
WHICH HOSPITALS MUST FACE
I. Demographic Changes
• Share of older population (65 years+) is expected to be 26% in 2050 (OECD
average, 25%)
– In 2012, those aged over 65 was 7% in Asian countries
• Greater demand for income security and health care of older people in the
Asia/Pacific region in the coming decades
(OECD/WHO, 2014)
% Population aged over 65 and
80, 2012 and 2050
• Dietary risks were the leading risk factors in most Southeast Asian countries,
high BMI and high fasting plasma glucose ranked high in the Pacific;
Smoking ranked second or third in Cambodia, Indonesia, Laos, Malaysia,
Myanmar, Papua New Guinea, Philippines, Thailand, Timor-Leste, Vietnam
(IHME, 2013)
Shifts in Leading Causes of DALYs in
East Asia and Pacific, 1990-2010
15,818 15,919
16,000 14,455 14,966
14,420
14,000 12,954 12,879
12,000 11,134
10,000 8,861
8,000 7,143
5,485
6,000
4,274
4,000
2,000
-
~34 35~39 40~44 45~49 50~54 55~59 60~64 65~69 70~74 75~79 80~84 85~89 90~94 95~
People-
Health
centered and
Security
Integrated
OPPORTUNITIES TO ADDRESS
THESE CHALLENGES
1. New innovative hospitals whose design
and construction can address these
challenges Design
Planning Space for machines
Infrastructure Data room
for processes IT in patient rooms
More mobile care delive
Construction
Building in cable
connections
Maintenance Operationalization
Cost of ownership Training staff
2. New technology supported health
care to improves efficiencies
$2bn Examples from Australia
17%
Cost of
adverse
events $1.5bn Pathology tests are
of
Cost of non-
collaboration on duplicates ($306m)
Chronic Disease
Management
18%
of errors due to
wrong medical Info
$380m
Cost of
preventable
25%
of Physician’s time
medication errors spent on getting
medical info
* Peter Fleming, CEO NeHTA | Canberra, 12 April 2010
IT in service delivery has economic value
Positive socio-economic value after 7-9 years2)