New sustainability index in healthcare

Data gaps, missing target values ​​- in view of the strategic challenge facing the German healthcare system, it is high time for a valid data basis and measurability. A new sustainability index should help.

There is a lot of talk, but when it comes to the Implementation of sustainability good intentions often get lost in the fog of ambiguity. A new sustainability index for the healthcare system now wants to establish clear criteria and measurability. In fact, he largely fails in this claim – because many things have not yet been measured or because there are no target values.

Fix positive developments

The Sustainability Index 2022 was developed by Astra Zeneca and Vandage, a specialist in health economic analyses, with the scientific support of Prof. Wolfgang Greiner from Bielefeld University.
The structure is complex. Ecology, economy and social affairs, supplemented by two health dimensions, one organizational and one epidemiological, as well as the surrounding framework conditions.

These dimensions are divided into 23 categories. The ecological dimension deals, for example, with resource management, environmental health risks and environmental management. The actual evaluation takes place at the next level. Here are 267 relevant indicators that are evaluated using publicly available data.

For example, the indicators “Number of clinics with the BUND seal of approval” and “Dissemination of heat action plans” are used for the “Ecological Management” category. However, the data gaps in this area are serious (38%).

Some significant data gaps

There is even more data desert in the social dimension (50%). As a result, many of the defined indicators cannot be evaluated.

With only 21 indicators (8% of all indicators), the ecological dimension makes up a relatively small part of the overall analysis. The organizational area is the largest with 111 indicators (42% of all indicators), followed by the epidemiological subarea with 71 indicators (27% of all indicators).

The social sub-area comprises just ten indicators. Here, for example, the indicator “unfulfilled need for medical examination or treatment” shows a need for action. Waiting lists, long journeys or financial reasons are given as reasons.

The indicator value was 0.1 percent in 2020 and 2021. This is 0.2 percent lower than in 2019. However, the index warns that this positive development has not been fixed in the form of targets.

Use knowledge politically

In summary, one can say: the core result of this sustainability index is to show a way of evaluating the sustainability of the German healthcare system. The term sustainability describes a moderate and responsible use of resources. It is also clear that this topic is measurable. In this way, the healthcare system can also grow beyond vague declarations of intent. Data on sustainability criteria should be collected across the board and the knowledge gained flow into legislative processes.