The transformation of the health system is one of Puerto Rico’s most critical needs, as confirmed by a recent study on hospitals based on federal government data. Addressing this need demands a joint effort by the government, the private health sector and entities representing health professionals and patients.
Hospital performance on the island is the worst among 4,000 hospitals certified by the Center for Medicare and Medicaid Services in the United States, according to a study by a consulting firm that uses data from the Center which is provided by hospitals.
It is crucial to resolve this situation. The report, which covers the 2017-2018 period, shows that patients’ lives are more at risk on the island than they would be in a hospital in the United States. In Puerto Rico, patients are more often readmitted to hospitals within a 30-day period after discharge, and the wait in the emergency room is up to three times longer than in the United States.
Besides, in Puerto Rico, there are more patients who die within 30 days after being hospitalized or following heart surgery. And, in the case of mental health care, patients wait an average of up to 16 hours to be treated. These are inhuman situations, bordering on institutional abuse.
How long this poor hospital performance has been affecting the island is unknown and, according to the analysis, it could get worse, putting more lives at risk. However, for years, patients and hospital staff have been reporting similar deficiencies. The tragic outcome of the emergency following Hurricane María confirmed the precariousness of the island’s health care system. It is up to the Department of Health and the Hospital Association to work on the measures to overcome the crisis.
The study suggests that the decline in the number of available health professionals, partly because they have left the island, could also result in hospital deficiencies. The analysis also finds there is abuse of services by patients. Another factor identified is the island’s compensation system based on reimbursements. The analysis states that almost half of the hospitals reported negative margins during the period evaluated.
In any case, it is clear that Puerto Rico’s health care system, both public and private, requires an urgent restructuring that puts patients as a priority. These actions range from public education projects and measures to encourage healthy lifestyles, to the design of a health care system that focuses on disease prevention. These actions also involve creating a financial and operational structure that sees health as a right rather than a commodity.
Ensuring good health and promoting the well-being of all people worldwide is precisely one of the 2030 Global Sustainable Development Goals adopted by all United Nations member states. And one of the agreed global goal targets is to “achieve universal health coverage, including financial risk protection.”
The goal includes access to quality essential health-care services and access to safe, effective, quality and affordable essential medicines and vaccines for all. Although Puerto Rico does not participate in such agreements, these goals provide guidelines for outlining fair and decent policies and actions. Strengthening capacity for early warning, risk reduction, and risk management is another action to achieve the goal. This recently released analysis raises flags about deficiencies that pose a serious risk to Puerto Ricans.
The report anticipates that local hospitals will face further pressure both from patients and from the federal government to improve the quality of their results. This cannot wait. Public health is a cornerstone of Puerto Rico´s long-term, sustainable growth. Hospitals have a mission to protect that.