Low Health Transparency | An Opportunity to transform – Public reporting of Health outcomes, tariffs and pricing and patient satisfaction needed in India: KPMG Global study

· India placed at bottom fifth, with a score of 36 percent, among the countries on the transparency index

· Less than one-third of Indian population use public sector health services

· Nordic countries lead the way in health transparency, but many industrialized countries lag

· Transparency in finance and governance most common; fewer instances of transparency in care quality

New Delhi, May 03, 2017: Health system transparency varies greatly from country-to-country, according to a study from KPMG International titled – “Through the looking glass; A practical path to improving healthcare through transparency.” A total of 32 countries were compared. The study mapped 27 indicators across six dimensions of transparency to provide an individual score for each country. Four Nordic nations – Denmark, Finland, Sweden and Norway – stood at the top of the transparency rankings, with Australia, Netherlands, New Zealand, UK, Portugal and Singapore among the second tier, and China and India propping up the index. KPMG rated nations’ healthcare systems on the availability of data across six dimensions of transparency, including quality care, financial performance and governance.

India achieved an overall transparency score of 36 percent, placing it in the bottom fifth tier among countries on the index. However, an analysis of the results shows that India achieved its highest transparency scores for ‘Governance’ (44 percent), ‘Personal Healthcare Data’ (43 percent), and ‘Finance’ (42 percent). Scores ranged from 29 to 31 percent across the other three dimensions within the transparency index, signalling opportunities to improve in these areas (‘Quality of Healthcare’, ‘Communication of Healthcare Data’ and ‘Patient Experience’).

India is still woefully short in terms of healthcare infrastructure. The overall shortage of healthcare infrastructure (buildings and human resources) is aggravated by the inequitable distribution among urban and rural areas. Over 70 percent of the infrastructure (beds and outpatient clinics) and 80 percent of medical professionals are based in urban areas, which are home to a mere 30-35 percent of Indian population.

India is makinggradual progress towards a more transparent health system. To progress even further, India should consider mandating public reporting of health outcomes, tariffs and pricing, and patient satisfaction. We need to ensure few things. Firstly, the government should develop a basic framework to report on select transparency parameters such as surgical complications etc. Secondly, the government could work to improve reporting by public hospitals against the set indicators. Thirdly, a centralized repository of health data for the general population needs to be developed. Finally, efforts to develop learnings through various initiatives on electronic health/medical records or digitalization of records should be continued.

The Global scenario on Transparency in Healthcare facilities

Countries like Japan, Greece and South Africa comparatively fared better than India on the transparency index with scores of 46 percent, 43 percent and 37 percent respectively.

The global study also highlights big variations across several dimensions of transparency. ‘Governance’ and ‘Finance’ indicators scored the highest across six dimensions, while data on ‘Quality of Healthcare’ was the lowest – suggesting this is the area where health systems are most cautious to release data.

Even the high performers lack consistency across all forms of transparency, with much room for improvement. “These findings show that health systems are struggling to make the most of transparency,” said Mark Britnell, Chairman of KPMG’s Global Health Practice and a partner with KPMG in the UK. “Our global index reveals a patchwork of efforts that often lack strategic coherence.”

Imagining a brighter future for healthcare transparency