As a culture, says my expert, we are in terrible denial about our health

I recently spoke to an AZV consultant, and he made me feel good about AZV. He said we’re lucky we live here and not in Curacao, because as far as health care goes, we’re light years ahead, and that AZV courageously makes investments in public health.

The hospital he explained, has undergone, DRG, diagnostic related grouping, which means that the hospital has categorize all its costs and knows exactly how much is a patient’s hospital stay, and what is the average length of stay, and the therapies received, a process which results in transparency about the hospital activities. All that DRG analysis gives AZV a good idea how much money it needs to cover future procedures and services, and that’s a very good thing.

But typical to Aruba where communication is difficult, the stakeholders are holding on to the insights, and not doing much to affect change, and efficiency. But the materials exist, for when the specialists, board members and management decide to have a dialogue about improvements in health care.

But the hospital was not our subject of conversation.

We were talking about Diabetes, and other chronic life-style diseases. According to my expert 15% of the island’s population suffers from Diabetes, in various stages; 9% of residents have it bad, and are in Secondary Care of specialists and the hospital, with a bleak future ahead of them cluttered with heart disease, kidney dialysis, amputations and strokes.

6% can be saved, if they listen to their house doctors, take their meds religiously, eat well and exercise vigorously. These 6% of residents don’t have to end up in hospital care if they assume responsibility for their own well-being, ASAP.

But the question is, will they? Will they reform their ways, learn new behaviors and save themselves?!

AZV is making great investments in the Diabetes project. Each family physician will from now on employ a Nurse Practitioner whose job will be to monitor the condition of diabetic patients, and help them stabilize their condition so they do not enter that final dreaded stage that requires hospital care.

As a society, says my expert, we are in terrible denial about our health; people here are unhealthy, and it will cost AZV an arm and a leg if nothing is done, so as a preventive measure, the Nurse Practitioners will try to intervene, and save us some money by improving our health.

According to my expert, when referring to Primary Care, he means our family physicians. Then when the family physician runs out of tricks, he refers patients to Secondary Care, the specialists and the hospital, and that is where patients unfortunately stay, until the bitter end.

It doesn’t have to be that way, says my expert, we can REVERSE this trend. Our aim in Secondary Care is to keep patients for a very short period, stabilize them and send them back to the family physician with a new protocol, a new way of life.

If patients cooperate, and follow the instructions, Aruba will keep health care cost down and save lives. So the goal is to keep Secondary Care to the minimum. Stay away from hospitals, you hear me?

Then Primary Care will send patients back to their lives, in the Social Domain, where in a perfect world GOA made lots of investments in bike lanes, outdoor gyms, walking trails, and other health promotions, to remind us that mens sana in corpore sano!

Former MinHealth, Richard Visser, did a lot in the Social Domain to contribute to healthy mind in a healthy body, and the current MinHealth still has to wake up!

If we can save a patient from entering Secondary Care, and dialysis for example, we save Awg 100.000 a year, per person, and the money can then go toward special care for Baby Luna for example or Nicole Natalie Lin. Think about it.


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July 25, 2017
Rona Coster