Difficult to measure but important impact indicators
Data showing high levels of member and provider satisfaction, improved access
and equity and better financial protection are clear indicators of the significant
positive impact of the UCS. Evidence related to other important impacts such as
quality of care, overcrowding and coverage of specific interventions was more
difficult to gather and interpret systematically. For example, although hospital log
books reflect waiting times for certain elective surgeries, data are not transmitted
to national level for regular monitoring of waiting lists.
Another example was the limited data available to assess variations in
preventable mortality such as stroke and myocardial infarction, which is partly
determined by prompt access to care, effective referral and quality standards
of treatment, and partly influenced by patients’ socioeconomic characteristics.
One study of clinical practice variations17 revealed that widely available
lower-cost medicines are not prescribed optimally for CSMBS patients and that
UCS patients with advanced cancer or leukaemia may not receive the expensive
interventions required to prolong survival. The study also found that prospective
closed-end payment for hospitalization used by the UCS and SSS does not result