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The role of self care in a
sustainable healthcare
system
Deon Schoombie
Australian Self Medication Industry
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Overview
• Defining self care
• Challenges in creating a sustainable healthcare
system
• UK experience with self care
• Consumer perspectives on self care
• Impact of non-prescription medicines
• An Australian Self Care Alliance
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Common themes
• Individuals, children, families, friends, communities &
carers
• Promoting health, preventing illness & accidents,
managing illness & disability
• With or without support of healthcare professionals
• Encompassing all aspects of daily life - hygiene,
nutrition, lifestyle, environmental & socio-economic
factors & cultural beliefs
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Definitions of self care
• WHO: 1983,1998 & 2013
Self care is the ability of individuals, families and
communities to promote health, prevent disease and
maintain health and to cope with illness and disability
with or without the support of a healthcare provider.
• Segall & Goldstein (1989):
Self care is the basic level of healthcare in all
societies.
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Self care – what it isn’t
• Self care doesn’t mean no care
• It doesn’t mean diverting people away from
healthcare services
• It doesn’t mean individuals are left to look after
themselves
• Self care is not what individuals do instead of
going to the doctor, it’s what they do between
visits.
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Person-centred care
• Respect for values, needs & preferences but
also acknowledging capacity, capabilities & skills
• Partnership & responsibility - sharing &
collaborating
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Challenges
Australian Health Policy Institute report (2001):
• There is far more that we can do than we can afford to
do.
• There is a problem with rising community expectations
• The ageing population
• Increasing willingness to pay for expansion of medical
care through government spending alone
• All of us need to be better informed about health so our
choices can be more intelligent & demands for
healthcare becomes more restrained than they are.
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UK Self Care Policy
• 2000 - Self care on national health agenda
• 2000 – Pharmacists positioned on frontline of
self care strategy
• 2000 – Wanless report:
– Fully engaged patient in all aspects of healthcare
– The patient as partner & resource
– Self care a prime example of effective partnership
– Evolutionary strengthening of patient responsibilities
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Consumer perspectives
Eppossi Barometer (2013):
• Consumers understand the concept & benefits
• They see it as vital part of managing health & disease
• They acknowledge responsibility & are willing to take on
more
• Minority feels confident to do so
• Health literacy is pivotal
• Consumers don’t view self care as a partnership with a
healthcare professional
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Recommendations
• New policies needed to define role of healthcare
professionals in self care
• Greater emphasis on shared care
• Government must make self care integral to health policy
• Government should seek improved partnerships with
stakeholders to improve outcomes by sharing data &
resources
• Key role of health insurers & healthcare providers need
to integrate incentives for self care
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Impact of self medication
Current impact:
• 1 in 9 consumers use NMPs regularly – 80% adults &
40% children
• Savings of $10.4bn
• For every $1 spent $4 saved
Potential future impact through “switch”:
• $2.1bn in savings
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A new population health strategy
What will it take?
• Securing a champion
• Constructing partnerships
• Engaging with private health sector
• Meaningful consultation
• Promoting accountability – monitoring progress
& empowering citizens
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The case for self care in Australia
• Translating greater personal responsibility into
practice
• Recognise consumers as a healthcare resource,
not just users
• Making better use of professional healthcare
resources
• A partnership approach is vital
• Starting a systematic debate - Australian Self
Care Alliance