Learning from Developing Countries

When it comes to saving money in health care, the developing world which financies health care largely through out-of-pocket health expenditures, often finds good ways to save money. That’s because developing countries accept decremental cost-effectiveness;   they tolerate small sacrifices in quality for big cost savings.  For residents of the developing world, the alternative (as I saw in Laos) l  was no access to health care at all.

Jaclyn Schiff wrote a good piece for the Kaiser Health Network on Friday reviewing a number of decrementally cost-effective interventions developed outside of the US which are promising in terms of increasing access while decreasing cost.  The interventions include:

ð  Inexpensive EKG machines developed in China and commercialized in the US by General Electri
ð  Prevention and Access to Care and Treatment (PACT) in Boston, using community health workers to improve medication adherence among HIV patients, and decrease the annual cost of care.  This approach was developed in South Afric
ð  Holding premature babies in a sling – to increase maternal contact in the US (but initially developed in Colombia to address a shortage of incubator
ð  Oral rehydration for diarrhea, developed in Bangladesh
ð  Open architecture medical record systems used in Africa

These innovations aren’t going to by themselves shave enough from our health care expenses to solve our health care cost crisis.  But it’s promising to see innovation that increases value coming from developing countries – which have a lot to teach us.