Economist intelligence unit cost of living survey 2009 pdf

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Occasionally, we group together content from various sources relating to the same topic. At all times there is a clear division between our editorial staff and sponsors, and sponsors are never allowed to influence what our editorial teams write. Sponsors are solely responsible for their content, and their views do not necessarily reflect those of The Economist. The burden of cardiovascular disease CVD across Asia-Pacific varies by country, but is nonetheless substantial.

Collectively CVD is the leading or second-leading cause of death across the region and the prevalence continues to rise. Further, shifting demographics in the region—with both an increase in younger people experiencing CVD and ageing populations with multiple comorbidities—are putting health systems under increasing pressure. Progress in tackling the problems associated with CVD has focussed in the primary prevention space, and age-standardised incidence of CVDs are beginning to fall.

However, undermining this progress, there is still an unacceptably high recurrence rate of heart attack and stroke with associated economic and human cost. As more patients now survive an initial heart attack or stroke, the secondary event burden is likely to increase.

This demands urgent attention but also represents an eminently realisable opportunity to improve care and outcomes in this group. While CVD policies do exist, some are more comprehensive than others. All of the study economies have some form of CVD policy, either as a standalone document or as part of a non communicable disease strategy.

Few policies make explicit provision for secondary prevention, with only South Korea and Australia demonstrating this the latter is yet to be implemented. The extent to which plans are followed and the process for timely updates both remain unclear. The success of translating policy on modifiable risk factors into legislation and action, along with measuring impact, is yet to be defined.

Lifestyle modification is a building block for CVD prevention that must be continually prioritised. All economies have policies on achieving healthy diet,have a harmful alcoholic consumption policy, and a physical activity policy. Improvements are required for tobacco control. Estimating the impact and effectiveness of these policies is not clear cut. Tobacco use is declining across the region, however obesity is on the rise.

While short-term lifestyle modification is achievable, especially in engaged patients who have recently experienced a cardiovascular event, long-term change remains challenging. Government audits are lacking. The existence of government audits and the availability of this audit data in the public domain is needed to assess the implementation of policies which aim to improve service delivery of CVD using outcomes data.

Only two economies in this study, Australia and South Korea, report any form of audit, and government audits against quality standards are severely lacking.

There is an overall lack of information on how CVD implementation plans are measured. Primary care systems, a key componentfor integrated care, are evolving.

Integrated primary care is a relatively new concept in many economies, and uptake of services remains slow. In Asia particularly, this is further complicated by provision of care split between private and public health systems.

Primary care services can be a key contributor to managing non-communicable diseases and must be strengthened in order to realise true integration of care for secondary prevention of CVD.

Rehabilitation services exist but coverage is limited, and they struggle to recruit and retain patients. Most economies in this study have rehabilitation programmes in place, but the coverage and accessibility of these vary.

Referral to rehabilitation services is inconsistent, especially outside of large population centres, and the ability to share patient information is hindered without electronic health records.

Individual economy-level responses must be based on the local situation and priorities, and it is up to each to develop a strategy that meets the needs.

However, policymakers looking to tackle this issue may well consider some of the key priorities identified in this research:. Integrated, coordinated patient-centred care is a necessary goal: While policy does seem to recognise the importance of high-quality integrated care, the lack of examples in the region reflects the challenges of achieving this goal. Building on data, the use of electronic health records, and implementing individualised care plans are the first steps towards addressing structural barriers within health systems.

The interface between primary and specialist care is a priority area to address for most economies. Patient empowerment is essential for success: Lack of patient participation in rehabilitation programmes and adherence to medication are two of the biggest issues that must be addressed in secondary prevention of CVD. Evidence-based patient education and empowerment initiatives appear to be lacking across the region and therefore should be prioritised.

The use of technology may offer opportunities in this area. Maximising data and measuring progress: Improving and expanding registry data coverage is vital to understand the true picture and inform policy. Integration of data through electronic health records is currently lacking, but may contribute towards this goal. Strengthening monitoring of secondary prevention goals in non-communcable disease or CVD plans, and auditing service delivery based on establishing quality standards and patient outcomes should be considered a high priority for study economies to refine their healthcare offerings and ensure patient needs are met.

This research project follows on from the Economist Intelligence Unit report The cost of silence: Cardiovascular disease in Asia. We would like to thank the following listed alphabetically for contributing their time and insight:. This report was sponsored by Amgen. The Economist Intelligence Unit takes sole responsibility for the contents of the scorecard and the report findings do not necessarily reflect the views of the sponsor.