Tertiary care refers to specialized medical attention that is provided by highly skilled and trained professionals for complex, serious, or uncommon health conditions. It includes services such as intensive care, specialized surgeries, and specialized treatments for chronic diseases. In the current healthcare landscape, tertiary care plays a crucial role in addressing the diverse healthcare needs of individuals and communities. However, it also faces numerous challenges and limitations that can impact its effectiveness and accessibility. In this article, we will explore the challenges and limitations of tertiary care in the current healthcare landscape, along with practical examples.
One of the primary challenges of tertiary care is its high cost. The advanced technology, specialized equipment, and highly trained professionals required for tertiary care services come at a significant expense. This can make it unaffordable for many individuals, especially in low and middle-income countries. As a result, many people are unable to access the specialized treatment they need, resulting in poorer health outcomes. For example, a 2019 study found that in India, only 18% of people who needed specialized care were able to access it due to financial barriers. This highlights the stark reality that cost can be a significant limitation for tertiary care in many parts of the world.
Another challenge facing tertiary care is the shortage of skilled professionals. Tertiary care often requires a team of specialized doctors, surgeons, nurses, and other healthcare professionals to work together. However, the supply of these professionals is limited, and the demand for their services is increasing. This shortage can lead to longer waiting times and overcrowding in tertiary care facilities. An example of this is the shortage of nephrologists, who are responsible for providing tertiary care for kidney diseases. According to a 2020 report, there is only one nephrologist per 100,000 people in India, where over 100,000 people require dialysis every year.
The growing burden of non-communicable diseases (NCDs) is also a significant challenge for tertiary care in the current healthcare landscape. NCDs such as heart disease, cancer, and diabetes require complex and long-term management, which falls under the domain of tertiary care. The increase in NCDs has put added pressure on tertiary care facilities and resources, which are already stretched thin. For instance, a 2020 report found that in India, NCDs account for 63% of all deaths and over 55% of the total healthcare expenditure, putting a strain on tertiary care services.
Moreover, the COVID-19 pandemic has highlighted the limitations of tertiary care in the face of a health crisis. Tertiary care facilities were overwhelmed with COVID-19 patients, leading to a shortage of beds, medical supplies, and skilled professionals. This has revealed the need for a more robust and coordinated healthcare system that can handle such emergencies effectively. It has also brought attention to the lack of preparedness and investment in public health infrastructure, which is crucial for the prevention and management of diseases.
Another limitation of tertiary care is its urban-centric nature. Tertiary care facilities are primarily located in urban areas, making it difficult for people in rural and remote areas to access specialized medical services. This further exacerbates health inequities and disparities in access to healthcare. For example, a 2020 study found that in India, rural areas have only 12% of the total tertiary hospitals, which cater to only 30% of the population. This creates a significant gap in healthcare access and quality between urban and rural areas.
In conclusion, tertiary care faces several challenges and limitations in the current healthcare landscape. The high cost, shortage of skilled professionals, increasing burden of NCDs, and lack of preparedness for emergencies are some of the significant challenges that need to be tackled to improve the effectiveness and accessibility of tertiary care. Moreover, addressing the urban-rural divide in access to specialized services is crucial for achieving equitable healthcare for all. Policymakers and healthcare providers must work together to overcome these challenges and ensure that tertiary care is available and accessible to those who need it the most.