Healthcare funders rely heavily on data to inform their decisions. They have access to statistics on patient admissions, daily hospital bed occupancy, and even the number of steps taken by patients. These metrics are meticulously measured, reported, reimbursed, and integrated into health budgets.
However, what often goes unnoticed are the hospitalizations that don’t occur because patients receive effective palliative care at home.
Emergency visits that are prevented through early symptom management, as well as the support offered to families before a crisis arises, are difficult to quantify. There remains a significant blind spot regarding the value generated from coordinated care that enhances patients’ quality of life while alleviating the burdens on overtaxed healthcare systems.
This represents a critical gap in the financing of medical care.
Health systems generally prioritize funding for services that can be easily seen, counted, and measured. When the outcomes of palliative care are not well understood, the considerable benefits of this type of care often remain hidden.
Consequently, intangibles associated with palliative care frequently lack adequate funding.
The Complexities of Funding Palliative Care
The need for palliative care is escalating across Africa, driven by a growing population grappling with cancer, non-communicable diseases, chronic HIV-related illnesses, and conditions related to aging. Continuous symptom management, psychosocial support, family interventions, and long-term coordinated care are increasingly essential.
Simultaneously, healthcare systems face mounting pressures: overcrowded hospitals, rising costs, and an aging population. Funders and policymakers are challenged to improve health outcomes while navigating limited resources.
In this context, all medical services are compelled to demonstrate their inherent value. Unfortunately, palliative care is often assessed using systems that focus more on activities rather than tangible outcomes.
Current reimbursement models tend to incentivize hospitalizations, procedures, and other easily quantifiable metrics such as theater time and bed occupancy. In contrast, palliative care fosters a unique value proposition by enhancing early symptom management, supporting seriously ill patients and their families, and enabling care closer to home.
While these outcomes are crucial, they are also more challenging to measure than standard medical activities. Consequently, healthcare systems acknowledge the costs associated with palliative care but often overlook the potential savings generated by reducing avoidable hospitalizations and unnecessary acute care interventions.
The Growing Importance of Data
The discourse surrounding the future of palliative care funding increasingly centers on data analytics.
As healthcare systems push towards value-based care, investments in digital health, and reform of health financing, the necessity to demonstrate measurable outcomes is more critical than ever.
For a healthcare system to transition effectively toward value-based care, bundled payments, and outcomes-driven reimbursement models, reliable evidence demonstrating value is essential.
It’s challenging to allocate funds for results that are difficult to measure.
Historically, many important outcomes related to palliative care have gone largely unrecognized within health data systems.
Key questions remain: How can we consistently measure improvements in symptom management? How can we quantify the benefits of providing care at a patient’s preferred site? How can we illustrate reductions in hospital utilization due to early interventions? How can we assess improvements in patients’ overall quality of life?
These inquiries are vital as they directly influence policy, reimbursement structures, and health benefit designs.
The Transformative Role of Digital Health
This is where digital health solutions come into play.
In discussions about healthcare innovation, attention often gravitates toward artificial intelligence, robotics, electronic medical records, and advanced diagnostics. While these technologies will undoubtedly redefine healthcare, one of the most promising avenues lies beyond traditional hospital environments. Connected care technology has the potential to illuminate previously unmeasured outcomes.
Technologies such as remote patient monitoring, wearable devices, telehealth services, and integrated health records enable the generation of objective evidence for outcomes that have been hard to quantify historically.
Remote monitoring platforms can detect health deterioration before it escalates into a medical emergency. Telehealth services allow for patient and family support without the need for travel. Wearable technology offers real-time insights into individual health statuses, while integrated records help care teams track symptoms, interventions, and outcomes across different care settings.
Crucially, these technologies enhance care delivery and provide the evidence necessary to demonstrate the positive impacts of interventions that have traditionally been difficult to measure.
Timely support facilitated by early detection through remote monitoring may reduce emergency hospitalizations. Improved symptom management might lessen the need for urgent care interventions. Such results are both clinically significant and economically vital. Digital health technologies are beginning to create opportunities for large-scale measurement of healthcare outcomes.
Data Must Support Human Needs
The ultimate goal of enhanced data collection is not to reduce healthcare to mere metrics and dashboards. In palliative care, data should always serve a human purpose. It is essential to understand whether patients feel comfortable, whether their symptoms are effectively managed, whether families receive adequate support, and whether care is delivered in the most appropriate settings.
These human-centered results must be integrated into health planning to ensure they are not neglected in decision-making processes regarding funding and resources.
Collaborative efforts among technology companies, healthcare providers, academic institutions, funders, and policymakers are required to address this challenge collectively.
Together, they can develop a comprehensive data system that encompasses the entire patient journey, rather than focusing solely on the most costly interventions.
Bringing Palliative Care into Focus
Palliative care should not be viewed as an optional enhancement to the healthcare system; it is increasingly recognized as an essential facet of comprehensive healthcare.
In 2014, the World Health Assembly passed resolution WHA67.19, urging Member States to strengthen palliative care and ensure its integration into national health systems across all levels. The resolution acknowledged that palliative care must coexist with prevention, treatment, and rehabilitation as part of a holistic approach to managing serious illness.
This principle is further encapsulated in the World Health Organization’s definition of universal health coverage, which asserts that all individuals—without facing financial hardship—should have access to quality health services throughout their care continuum, including health promotion, disease prevention, treatment, rehabilitation, and palliative care.
The policy directive is clear, yet challenges remain in its implementation.
Fully incorporating palliative care into health systems and benefit designs requires making its value evident within the funding frameworks that dictate healthcare delivery. Relying solely on sporadic funding models and philanthropic contributions is insufficient.
Integration hinges on evidence, which mandates effective measurement—and increasingly, such measurement depends on data.
Discussions surrounding digital health, medical financing, and palliative care must now be interconnected.
Despite accumulating evidence suggesting that outcomes-based models offer superior value for patients, providers, and funders, many healthcare systems continue to reward activities rather than the outcomes themselves.
Envisioning the Future of Healthcare
The trajectory of healthcare in Africa will not solely hinge on cutting-edge technology or advanced infrastructures but on the ability to utilize technology to illuminate meaningful, measurable, and fundable outcomes.
If a healthcare system aims to prioritize results over mere activity, it must first be capable of detecting and quantifying those outcomes. Ultimately, healthcare systems cannot allocate funding for what they cannot measure.
—Written by Motlalentoa Motsoane, Chief Executive Officer, Association of Palliative Care Centers (APCC)
