Economic Transformation Strategy

CHAPTER 2 / BROAD STRATEGY FOR DEVELOPMENT As per the global experience, ageing and the rise of NCDs increase the needs for expensive, long-term care and chronic care. Coupled with the spread of expensive health technologies, they can lead to escalations in health care costs. These challenges may lead to unsustainable healthcare spending. Service utilisation is already high in Sey- chelles: on average, a person visits health facilities six times a year, and in most cases (four of the six visits) is seen by a doctor. This number is higher than Nordic countries (3.8 visits per person). Also, quality of health services is critical to the "value for money" agenda in health spending. Successful manage- ment of NCDs in primary healthcare (PHC) settings can prevent hospitalisation and complications such as lower extremity amputation in diabetics. Such indicators are therefore used to assess the quality of PHC. Compared to OECD countries, Seychelles has very high avoidable hospital admission rates for common conditions such as asthma, hypertension and diabetes. The country's diabetes amputation rate is also much higher than the OECD average. For three common cancers (breast, cervical and colorectal), Seychelles has much lower survival rates compared to OECD countries, pointing to the need to improve the quality of care in Seychelles, especially in PHC. Table Quality of care: Seychelles vs. OECD in selected healthcare measures Indicator OECD Seychelles Lowest Average Highest Asthma: hospital admission rate 10 44 109 96 Hypertension" hospital admission rate 9 83 397 262 COPD: hospital admission rate 23 198 395 84 Chronic heart failure: hospital admission rate 74 244 548 230 Diabetes: hospital admission rate 44 150 338 938 Diabetes: lower extremity amputation rates 2.4 6.4 15.9 99 Cervical cancer 45 66 81 36 Breast cancer 74 85 89 44 Colorectal cancer 50 62 71 48 49 49

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