For older people and frail people, the long-term benefit of medicines reduces and the potential for harm from adverse effects increases. When the benefit–risk balance changes in this way, medicine review and optimisation are important to simplify the therapeutic regimen, reduce inappropriate medicines and minimise risks. In this article, pharmacist prescriber Linda Bryant uses two case studies to illustrate important considerations during medicine reviews
Acute demand driving deficits
Acute demand driving deficits
Pressuring District Health Boards to reduce their deficits will exacerbate the critical shortfall being experienced in public hospitals dealing with significant increased acute demand, says Ian Powell, Executive Director of the Association of Salaried Medical Specialists (ASMS).
“Health Minister David Clark acknowledges DHBs are under pressure but says he expects them to get closer to break-even financial positions,” Mr Powell says.
“This is unrealistic in a climate of increasing acute demand and constrained funding increases.”
“Hospital specialist members are reporting significant increased acute demand in excess of both population growth and funding increases. This acute demand surge is due to a number of factors such as the aging of the population, the effects of sustained poverty and reduced assess to earlier preventative treatment such as non-urgent surgery.”
“Hospital staff remain strongly committed to providing safe patient care but the immense pressure they are under is unsustainable,” Mr Powell says.
This week the New Zealand Herald reported the overall DHB deficit in the year to March was $264 million.
A pre-Budget analysis conducted by ASMS and the Council of Trade Unions concluded that Vote Health total operational spending needed to increase by more than $1.3 billion just to maintain current service levels.
The Budget increase to DHBs fell short by about $300 million. ASMS’ media release on the Budget can be read here: https://www.asms.org.nz/news/asms-news/2019/05/30/health-budget-barely-maintains-the-status-quo/
The pre-Budget analysis can be read here: http://www.union.org.nz/wp-content/uploads/2019/05/How-much-funding-is-needed-to-avoid-the-condition-of-the-Health-System-worsening-2019.pdf
“Dr Clark needs to step up and show leadership at this critical time and accept that DHBs cannot continue to squeeze services to breaking point,” Mr Powell says.