2024 Global Health Care

Sector Outlook
Navigating transformation
Contents

Introduction 3

Transforming health care with artificial intelligence 4

Addressing cost and affordability 12

Responding to the looming global shortfall in health care workers 19

The role of social care 25

A sustainable future 30

Contacts 36

Learn more 38

Endnotes 40
 Introduction

The global health care sector once again faces a year of extending care beyond traditional medical services to
unprecedented transformation and challenges. Providers encompass holistic social care. This shift is attributed
worldwide continue to confront the lingering effects of to the growing recognition of the profound connection
the COVID-19 pandemic, which has led to widespread between the social determinants of health and overall
labor shortages and rising costs. The sector has also been well-being. As a result, providers and policymakers are
buoyed by the broader adoption of technology such as integrating social care into public health systems to
artificial intelligence (AI) that can address some of those address the multifaceted needs of patients.
issues.
As health care costs continue to escalate globally,
At the same time, health inequities persist that could the affordability of care remains a critical concern.
further add to the challenges and costs the sector faces in Governments, payers, and providers are taking measures
2024. Left unaddressed, the cost of health inequities could to control costs while maintaining the quality and
triple to US$1 trillion by 2040—or about US$3,000 a year accessibility of health care. From value-based care models
for each person.1 to innovative pricing structures, these evolving strategies
are designed to help ensure cost-effective health care
The integration of AI and machine learning technologies delivery.
can play a key role in addressing these inequities, if
providers work to earn patients’ trust and ensure that they At the same time, the health care workforce is undergoing
take steps to mitigate bias within the technology. a significant transformation, driven by evolving patient
demographics, technological advancements, and
In 2024, AI is expected to play a pivotal role in streamlining changing care delivery models. Providers worldwide face
administration, diagnosis, treatment, and patient care. deep shortages of clinicians, and are taking innovative
From predictive analytics to automating electronic approaches to improve pay, reduce burnout, and build
health records, AI can further enhance the precision and trust in the health care workplace. As providers work to
efficiency of health care delivery. attract, train, and retain a skilled and more adaptable
talent pool, the role of telehealth, remote monitoring, and
With the growing global awareness of environmental issues the gig economy are all reshaping health care workforce
and resource constraints, sustainability has emerged dynamics.
as a critical aspect of the health care sector. Health care
organizations are adopting sustainable practices to reduce The global health care sector stands at a crossroads
their carbon footprint and ensure responsible use of in 2024, poised for profound changes. The future of
resources. From green hospital designs to sustainable global health care is likely to be shaped by innovation,
supply chain management, this report highlights the sustainability, social care integration, cost management,
impact of sustainability on health care operations, as well and workforce adaptation.
as its potential for cost savings.

The use of remote technologies and telemedicine adopted

during the pandemic are helping to define not just the
delivery of care, but also the nature of it. Providers are

1. Jay Bhatt, “Leaning into health equity can be good for business and society,”
Deloitte Health Forward Blog, August 10, 2023, https://www2.deloitte.com/us/en/blog/health-care-
blog/2023/leaning-into-health-equity-can-be-good-for-business-and-society.html.
2024 Global Health Care Sector Outlook | Navigating transformation

Transforming health care

with artificial intelligence

By the numbers:
US$360 billion—annual potential savings from artificial intelligence (AI) for the US health care system
over the next five years1

Health care generates 19 terabytes of clinical data annually in the US2

The US market for interoperable clinical data is expected to almost double to US$6.2 billion by 2026 from
US$3.4 billion in 20223

US$31.5 billion—the amount of private equity funding invested in health care AI between 2019 and
20224

1,500—the number of health care AI vendors, half of which have been formed in the past seven years5

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 2024 Global Health Care Sector Outlook |
 Navigating transformation

More than three years after the COVID-19 pandemic, has consistently been a leader in AI mergers and
many health care systems globally are still struggling acquisitions.7 The pandemic drove an increased focus
with its lingering effects. The need to reduce costs on telemedicine and online portals for acute and
and improve access to care—while still confronting wellness care. For the sector and patients to continue
a shortage of skilled workers and clinicians—has benefitting from technology, however, providers should
driven some health care systems to adopt emerging sustain investments in technology—much as hospital
technology to fill the gaps.6 systems and operators invested in equipment and
offices in the past.8
Technology offers health care organizations a chance
to personalize patient interactions and treatment, So far, this is happening slowly. Global funding for
taking pressures off clinicians for routine care, and digital health declined by 3% in the second quarter of
enabling them to focus on the procedures that require 2023, to US$3 billion—the lowest in six years.9 Venture
their expertise and training. capital funding, which is often considered a barometer
of technology investment in the industry, fell about
AI and other forms of emerging technology have 30% in 2022, to US$27.5 billion from US$39.3 billion.
the potential to streamline both administrative and However, the investment levels still outpaced pre-
care processes for health care providers. Between pandemic levels, and overall funding levels continue to
2019 and 2022, investors poured US$31.5 billion in accelerate, excluding the boom in 2021 (Figure 1).
equity funding into health care AI, and the industry

Figure 1: 2022 was a strong year for health tech funding

Health tech venture capital funding (US$ billion) Number of deals

1,134

926
852

782

629
585 39.3

27.5
484
19.7

11.2 12.4
6.7 7.5

2016 2017 2018 2019 2020 2021 2022

Note: Data for deals valued at US$2 million and above.

Source: PitchBook Data, Inc.

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2024 Global Health Care Sector Outlook | Navigating transformation

Part of the reason for the slowing pace of investment Relieving clinicians of those administrative tasks can
may be that many providers may hesitate to be early free up time for them to spend with patients.15 In some
adopters of new technology, especially for clinical cases, doctors in the US spend more than two-thirds
applications. Tight margins from declining public of their time on administrative work. With AI-managed
funding, falling outpatient revenue, longer inpatient electronic health records (EHRs) and in-basket
stays, and lower demand for care post-pandemic management, providers can reduce administrative
has crimped some provider margins and reduced demands on physicians, a leading cause of burnout.16
technology investments. The median Kaufman Hall
Year-To-Date Operating Margin Index, which reflects At the same time, AI has the potential to improve
actual margins for 900 US hospitals, was – 0.2% access to care that is designed for patients’ specific
through November 2022.10 As demand for telemedicine needs. Finland, which began a major overhaul of its
and other tech solutions wane, many wonder if the health care system in 2023, is building a digitized
technological advances of the past few years will be system that pledges to deliver services that are both
permanent.11 personalized and cost effective by emphasizing
preventive care that may keep 80% of the population
Yet the potential for financial benefits, improved healthy by 2030. That can allow for additional support
care delivery, and more efficient uses of resources is for the 20% of patients who need disease treatment
fostering newfound enthusiasm for AI. In the US, for or other, more extensive care.17 As part of this effort,
example, wider adoption could generate savings of Finland anticipates that 80% of its citizens will be using
as much as US$360 billion annually—roughly 10% of digital identification by the end of the decade, and each
the country’s health care spending—in the next five citizen will have access to digital medical records and
years. For hospitals, the savings would come largely e-health services.18
from improvements to clinical operations, quality, and
safety; for physicians, from continuity of care; and for
Improving the quality of care
payers, from improved claims and provider relationship
management.12
In addition to streamlining services, AI can help
predict patient outcomes based on their unique
Streamlining administrative tasks health profiles, recommend treatment options to both
patients and providers, and alert clinicians to concerns
AI’s largest and most immediate impact may be its role such as contraindicated medicine or allergies.19
in streamlining administrative processes and reducing
expenses. Hospital CEOs face three core business Meanwhile, generative AI can leverage the various
challenges: margin pressure; recruitment and retention datasets that contribute to medical diagnoses and
of staff; and staff burnout. AI has the potential to ease treatments, including EHRs, sensors, and wearable
documentation burdens, handle pre-op workflows, devices. This technology can play a vital role in early
and simplify insurance claims, for example. Some US detection of illnesses, interpreting radiology results,
hospitals are employing AI to review patient records and identifying patients with the most urgent needs for
and medical policies and address insurance claims treatment.20
denials, potentially saving providers millions of dollars.
More than 60% of denied claims are recoverable, yet Health care providers are partnering with tech
because of errors and limited hospital resources, companies to develop AI tools that can better predict
only 0.2% of in-network claims are appealed, leaving clinical outcomes, enhance radiological imaging, and
millions of dollars a year written off as uncollectible.13 optimize sleep monitoring. NYUTron, a large language
AI can also minimize errors and improve categorization model, predicts multiple clinical outcomes such as
of incoming claims, reducing backlogs and potential 30-day readmission rates, in-hospital mortality rate,
payment concerns.14 comorbidity index, and length of stay. The model

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 2024 Global Health Care Sector Outlook |
 Navigating transformation

reported an accuracy of 79% in predicting patients’ Expanding access to services

length of stay, a 12% improvement over conventional
methods.21 It’s not just providers who can benefit from AI
expanded use in care delivery. AI may broaden access
Meanwhile, Subtle Medical has developed tools to care at a lower cost through retail environments.
for generating better radiological image data and Patients can monitor their overall health and exercise
streamlining radiology workflow. The company’s patterns with smartphones and watches, increasing
proprietary deep learning algorithms enable up to the focus on prevention. Kroger Health with 12%
60% faster PET and MRI scan times, enhancing imaging market share in the US, operates 220 clinics, and
efficiency and improving the patient experience.22 companies such as Walmart, Amazon, Best Buy, and
Dollar General have retail health care footprints
And Zepp Health has developed its Zepp Aura sleep or have tested the waters. Retailers already have
and relaxation platform that connects with its smart customer data, they know how to use to create a high-
wearables. The tool offers personalized sleep coaching, volume low-cost environment, and can provide many
sleep quality analysis, and AI-generated sleep music basic services for less than other providers.27
compositions based on the user’s heart rate to help
improve sleep patterns.23 However, retail clinics in the US are concentrated in
urban and suburban areas, and retailers have been
Another challenge for health systems is managing reluctant to open clinics in rural regions because of
growing volumes of data. The global health care sector less customer traffic. As a result, a retailer may provide
generates 19 terabytes of clinical data annually.24 AI can patients with technological innovation, but those
help it use this information more effectively. By using benefits may be limited to certain geographies.28
centralized clinical data, providers can create a more
comprehensive picture of the patient, while producing AI could further blur the lines between humans and
more consistent results and reducing the cost of care. technology through augmented reality, smart devices,
The market for interoperable clinical data is expected and wearables. Moreover, investment in secure data
to almost double, to US$6.2 billion by 2026 from environments (SDEs) and other measures may reduce
US$3.4 billion in 2022.25 patient concerns about data security. In the future, AI
has the potential to assist in three key areas of health
In the near term, AI can more effectively interpret and care:
respond to queries, improving patient engagement
from initial consultations to post-discharge follow • Intelligent diagnosis: AI-enabled solutions could
ups. In addition, AI’s real-time translation capabilities support clinicians in making precise diagnoses using
can improve accessibility and contribute to health inputs from in-vitro diagnostics, imaging, EHRs,
equity in areas like social services. For example, after patient conversations, biometrics, images, sensors,
Russia’s invasion of Ukraine, Deloitte Czech Republic wearables, and genomics.
developed a cloud-based virtual contact center called • Personalized and adaptive care plans: AI could
IRENA (Immediate Refugee Need Assistance), built on interpret biomarker data from smart devices and
Amazon Connect, that used AI-enabled conversations wearables to generate treatment plans such as sleep
with a virtual agent in any language patients chose.26 analysis, dietary suggestions, and even AI-generated
As refugees fled across Europe in the early days of the music for stress management. Moreover, if a patient
conflict, IRENA handled 10,000 calls daily, with as many faces challenges in adhering to a regimen, generative
as 80% managed automatically. AI-enabled digital avatars could empathetically
interact with patients to understand their barriers
and offer potential solutions or alternatives.

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2024 Global Health Care Sector Outlook | Navigating transformation

• Population health management: AI could analyze The essential elements of trust

large datasets and recognize patterns crucial to
spotting health trends within a population. For Despite the transformative potential of AI in health
example, by reviewing genomic, socioeconomic, care, adoption will likely depend on the trust and
and EHR data, AI could identify risk factors and acceptance of providers, practitioners, and consumers.
predictors of diseases, such as cervical cancer. AI- Health care and technology providers should prioritize
enabled marketing and communications could then responsible and safe use of this technology. To earn
generate tailored audio visual or textual invitations patients’ trust, the technology should be free of bias,
for screening services. Responses, visits, and results inaccuracies, and data breaches (Figure 2).30
could then be stored and used to build more robust
models.29

Figure 2: How to make AI more trusted

Source: Deloitte analysis

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 2024 Global Health Care Sector Outlook |
 Navigating transformation

Currently, AI is more effective at handling Regulatory challenges

administrative tasks than in dealing with predictive
diagnoses or care delivery. When generative AI The regulatory climate around AI in general is changing
encounters gaps in its knowledge, it tends to fill them rapidly. Governments worldwide are working to
with plausible-sounding information that may be establish effective regulation. The EU is leading the
inaccurate. These results are often referred to as an AI charge. The European Commission established a
hallucination or confabulation.31 regulatory framework for AI in 2021, and final rules
could be implemented as early as 2024.34
Improving the knowledge base of generative AI
requires finding quality health care data and the right The UK government in March 2023 published
foundation models—both of which may require large guidelines for regulating generative AI that include
investments to harness the power. These investments data reporting, life cycle accountability, and
can be essential in building public trust.32 industry collaboration with the goal of encouraging
adaptiveness and autonomy.35
The Coalition for Health AI, which includes academic
health systems, organizations, and expert practitioners In Brazil, however, consensus among legal experts,
of AI and data science, has outlined characteristics of academics, industry leaders, and regulators has
trustworthy AI that include: been more difficult, and the country has yet to adopt
a coherent framework for regulating the diverse
• Safety: AI systems should not put human life, health, applications of generative AI. In November 2022, a
property, or the environment at risk. In health care, group of legal, academic and industry experts working
this is fundamentally an extension of the Hippocratic with the country’s National Data Protection Authority
Oath to “do no harm.” AI models can become unsafe published guidelines that focused on the rights of the
for a variety of reasons, including inadequate citizens, risk categorization, and governance measures,
oversight for fairness, accountability, or bias. but the document is being debated at various levels of
• Accountability and transparency: AI should be the Brazilian government.36
auditable; individuals should have access to their
data that is entered into the system and the source of The US, meanwhile, has not adopted comprehensive
the information should be traceable. national regulatory legislation, resulting in a
fragmented framework of state rules. To bring
• Explainable and interpretable: Physicians should greater clarity, the Biden administration issued
understand how the underlying programs compile an executive order aimed at governing the risks
information, and the systems should produce associated with AI.37, 38
outputs with the context in which the information
is requested. In other words, health care AI can’t be The disparity in approaches to regulating and
opaque, that is, without insight into how its results monitoring AI could pose additional challenges to
are produced. health care providers.
• Fair and equitable: AI should not increase a
specific group’s risk for experiencing bias or adverse
outcomes.33

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2024 Global Health Care Sector Outlook | Navigating transformation

Deploying AI responsibly in health care Considerations for providers to build

trust into their AI strategy
AI has the potential to transform health care by
optimizing both administrative functions and care Providers that want to foster trust around their use of
delivery. It will have financial and non-financial benefits AI should:
for the global health system, such as improved care
quality, enhanced patient experience, and greater • Adopt strong governance practices around AI to help
clinician satisfaction. Private providers may gain the ensure the organization can innovate with confidence
greatest benefits from optimization in care, claims, and while reducing the risks that come with complex
provider relationship management. technology.

• Prioritize patient data privacy and protection from

Companies that invest in AI early and identify
cyber threats by addressing external, physical,
opportunities for applying it across the value chain are
and digital risks. Once the risks are assessed,
likely to gain a competitive advantage and deliver more
organizations must determine if these risks outweigh
personalized care to patients in the coming year.
the potential benefits.

However, companies must take steps to ensure AI is • Establish responsibility and accountability for AI in
deployed responsibly and that its use and processes the organization, review rules and regulations that
are transparent and auditable. Organizations that don’t might determine legal obligations, and ensure that AI
build this into their AI strategy risk alienating patients systems are auditable.
and other stakeholders. For those who build trust in AI,
• Promote transparency by informing consumers how
the technology can continue to unlock new innovations
AI is using their medical data to make decisions. AI’s
for years to come.
algorithms, attributes, and correlations should be
open to inspection, and its decisions should be fully
For AI to be effective in health care, both medical
explainable.
professionals and patients should have confidence
in the results, understand how those results are
achieved, and have confidence that their confidential
information will be protected.

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 2024 Global Health Care Sector Outlook |
 Navigating transformation

Deloitte AI Dossier
How AI is transforming health care Efficient and accurate diagnoses
AI is rapidly becoming a competitive necessity in the Diagnosis often depends on complex factors,
health care sector. Yet many organizations are still including patient history and genetics. AI can
understanding what AI can mean for them. Deloitte improve them by:
created the AI Dossier to give leaders in different • Analyzing extensive medical data: AI can
industries summaries of key issues and uncover complex patterns and characteristics that
opportunities, and how AI can help achieve them. might be overlooked by humans.

The Dossier identified several key areas where AI can • Offering recommendations: AI technologies such
benefit the sector. as deep neural networks and machine learning can
enhance the analysis of patient data.
Enhancing patient engagement
Personalized health care
Many patients struggle to book appointments,
access medical records, determine which services Precision medicine considers an individual’s genetics,
are available to them, and get answers to simple environment, and lifestyle to provide tailored
logistical questions. AI can improve interactions treatments. AI can deliver more personalized
between patients and providers by: diagnoses, prevention, and treatment by:
• Simplifying complex medical information: • Connecting various datasets: Machine learning
Natural language processing can make medical algorithms link treatment outcomes to diverse
data more understandable to patients, increasing health datasets.
health literacy.
• Analyzing and collecting vast data: AI and
• Streamlining communication among health machine learning enable more effective data
care workers: AI and machine learning can filter collection and analysis.
and share relevant information efficiently.
• Developing personalized treatments and care:
• Accelerating database searches: AI-enabled AI analytics allow health care providers to deliver
databases improve information retrieval and personalized care.
reliability.
• Enhancing chatbots: Chatbots can assist with Optimizing hospital staffing and resources
patient questions, appointment scheduling, and Demand for health care rises and falls in response to
referrals. a complex range of factors, making it difficult for
• Personalizing patient engagement: AI-driven hospitals to optimally allocate their supply of critical
prescriptive analytics can suggest personalized resources such as medical equipment and staff.
actions for patients, increasing focus on care Predictive AI can forecast patient volumes and help
delivery. hospitals adjust staffing and resources accordingly
by:
Automating claims management • Predicting future resource needs: Data mining,
modeling, and AI provide insights for resource
Traditional claims management is costly, slow, and allocation.
error-prone, often relying on manual data input. AI
can assist by: • Analyzing detailed data: AI and machine learning
offer a comprehensive understanding of health
• Automating claims data extraction and input:
status.
Robotic process automation tools extract data
without manual intervention. • Identifying high-impact patterns and trends: AI-
driven analysis reveals hidden trends and potential
• Providing real-time updates and monitoring: AI
risks.
systems offer real-time status updates and claims
monitoring.
• Automating follow-ups and denials: Repetitive
tasks related to claims can be handled instantly by
AI tools.
• Analyzing claims: AI-enabled data analysis
provides real-time insights on filed claims.

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2024 Global Health Care Sector Outlook | Navigating transformation

Addressing cost and

affordability

By the numbers:
3.3 billion—the number of people who live in countries that spend more on debt service than on health
and education1

47%—the percentage of health care providers who say access is worse than it has been during the past
two years2

US$12,500—the amount per capita that the US spends on health care3

80 years—the average life expectancy in Belgium, Denmark, and Finland, driving a growing need for long-
term care4

10.3%—the amount of a recent pay increase for first-year doctors in the UK5

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 2024 Global Health Care Sector Outlook |
 Navigating transformation

The cost of health care continues to define the quality, What’s driving costs?
access, and affordability of health services worldwide.
The effects of the COVID-19 pandemic increased costs Some developed countries such as the US, Canada,
in areas such as staffing, but it also increased a focus and the UK are facing rising health labor costs driven,
on affordability and access. Countries are confronting in part, by worker shortages and reliance on contract
higher costs as inflation increases the price of drugs, staffing firms that often raise prices in the face of
consumables, and other materials. In addition, the surging demand. Pay increases for clinicians has not
pandemic created a backlog of demand that increased kept up with inflation, and productivity remains below
pressure on funding, and, as a result, prioritization pre-pandemic levels, adding to margin pressure among
of care. Providers increasingly are considering more providers. The conflict between margin and labor costs
affordable and efficient models for access, some of is particularly acute in the US, which relies heavily on
which are being delivered through technology and private health care providers.10
other innovations.
In the US, hospital costs per patient increased by
For most countries, the average cost of health care per 22.5% from before the pandemic, and a US hospital
citizen has risen since 2020. The US had the highest association found that the biggest percentage of that
health expenditure per capita, rising 6% to more than increase related to an almost 25% rise in labor costs.
US$12,500 in 2022 from 2020—the equivalent of 17% More than 5 million US medical workers left their jobs
of the country’s gross domestic product (GDP). The during the pandemic, causing industrywide staffing
US spends significantly more of its GDP on health shortages and adding to the pressure on workers who
costs than any other country—for example Belgium, remained in their jobs.11
Denmark, or Finland, which spend about 2% of their
GDP on health care. US health care costs are expected The increased demand has led to higher costs as
to rise another 36%, to more than US$17,000 per providers compete for a smaller number of qualified
capita by 2027.7,8 professionals. Skilled nursing facilities offer an example
of how this affects the cost of care. Full-time employees
While countries such as Italy and Egypt saw per-capita in skilled nursing facilities decreased by 18%, but labor
costs fall as the pandemic subsides, their health costs still increased 30.8%.12
expenditures resumed an upward trajectory beginning
this year. While the cost of care in the US is more pronounced
because of its private health care system, other
Infant mortality can serve as a barometer of a countries also face increases in labor costs. Canada,
country’s overall health. For every 1% increase in health for example, saw physician spending rise by almost
expenditure, infant mortality decreases by 0.2% to 11% and 6.5% in 2021 and 2022, respectively. Physician
1.5%. South Africa, for example, spends US$524 on costs are now the second-largest portion of all health
health per capita, and has an infant mortality of 24 per spending in Canada.13
1,000 births. In contrast, Japan has US$3,951 in health
expenditure per capita and 1.9 infant deaths per 1,000 Among the nurses who faced burnout and left
births. The US is the outlier, with health expenditures Canada’s health care sector in large numbers, many
of more than US$12,500 per capita and infant mortality are coming back through private firms. This is costing
of 5.1 deaths per 1,000 births.9 the public system millions of dollars annually. Toronto’s
University Health Network, for example, spent C$6.74
million on nursing agencies in its 2022 fiscal year, a
significant increase from the C$776,000 it paid in
2021.14

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2024 Global Health Care Sector Outlook | Navigating transformation

In the UK, health care staff costs were £66.2 billion, In the US, the highest inflation in 40 years compounded
or 45.2% of the total National Health Service (NHS) health care prices that historically have increased
budget. NHS recently agreed to a pay increase of more faster than rest of the economy. Health insurance
than 10% for first-year doctors in training.16 premiums rose 28% in 2022 from a year earlier, more
than triple the rate of inflation at the time, raising
Since 2019, NHS has increased its reliance on staffing questions about how many consumers will now be able
companies, which have seen their earnings increase to afford health care.
tenfold. Medacs Healthcare, a leading health care
staffing agency, recorded an 80% increase in sales to A 2022 Deloitte US survey found 28% of consumers,
£160.9 million, between 2019 and 202117,18 or roughly 72 million US adults, feel less prepared to
pay for unexpected medical costs than they did the
While higher labor costs are a major factor in rising previous year (Figure 1).19
health care costs, widespread inflation has also played
a role.

Figure 1: Inflation is the No. 1 reason that nearly one in three people feel less prepared to handle health care
costs in the US
Do you feel less prepared to handle health care costs compared to one year ago? If so, why do you feel less prepared?

(Respondents selected all that applied)

OF THOSE RESPONDENTS

13% I lost my job

33% My household income

decreased

53% I have less money in savings

28% 75%
OF US CONSUMERS Inflation has made all
my expenses go up
feel less prepared than
last year to handle an
unexpected medical
emergency with
out-of-pocket costs of
at least US$500.

Note: N = 2,005.
Source: Deloitte 2022 Pulse Survey of US Consumers.

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 2024 Global Health Care Sector Outlook |
 Navigating transformation

Europe has traditionally seen smaller increases in through social insurance, while the UK, Canada, and
health care costs, but it is not immune to the global Australia use a means-tested system. France employs
trends. The cost of care across the continent was a hybrid approach that combines income-adjusted
expected to rise 8.6% in 2023, compared with 5.6% universal coverage and private insurance.26
in 2021. In Latin America, inflation contributed to an
estimated 18.9% increase in 2023, while health care The US relies on a combination of public and private
costs rose 11.5% in the Middle East and Africa and funding, including out-of-pocket expenses paid by the
10.2% in Asia.20 patient. Most funding, about US$230 billion, comes
from Medicaid and other public insurance sources
In the US, costs are also affected by intermediaries such as the Veterans Health Administration and the
such as insurers, drug distributors, and pharmacy Children’s Health Insurance Program.27
benefit managers. In 2022, the combined revenue from
the nine biggest intermediaries accounted for almost Health care organizations globally are beginning to
45% of US health care costs, compared with 25% in implement innovative technologies such as virtual
2013.21 Government limits on how much revenue wards and AI-enabled diagnostic tools to reduce
insurers can collect from premiums has driven them costs of age-related care. In the US, for example, the
to acquire heath care providers, where the limits don’t Virginia Health System implemented a hospital-at-
apply. While the emerging vertical system can offer cost home program to deliver remote care for patients
benefits, it also raises some concern that companies needing acute care.28 The program saves an average of
may raise prices with impunity or that doctors may US$3,000 per patient visit, or more than US$4 million
be encouraged to provide the cheapest treatments to annually for the average hospital.29
some patients.22
In the UK, the Medway NHS Foundation Trust, which
operates a hospital in Gillingham, uses remote
Paying for long-term and specialized
monitoring technology for an elastomeric pump, a
care device for administering chemotherapy drugs. The
pump allowed patients to receive treatment at home,
While workforce expenses are a major driver of rising saving approximately 496 hospital bed days in the first
health costs, other factors also contribute. The cost 10 months of use, saving almost US$200,000.30
of maintaining care facilities is one factor. Germany is
closing smaller hospitals in rural areas/communities Providers also are investing in technology to accelerate
in favor of clinics that provide basic care. Patients who diagnoses and reduce treatment costs for chronic
need more specialized care would be sent to larger diseases. The China Medical University Hospital in
hospitals that offer a broader range of services.23 Taiwan deployed an intelligent microbial system
into clinical practice in 2022. The AI tool identified a
Aging populations increase demand for long-term disease-causing pathogen in lab samples in as little as
care, and with longer life comes an increase in age- one hour, compared with 72 hours for standard tests.
related diseases such as cancer and Alzheimer’s, The tool reduced antibiotic costs by 25% and patient
all of which contribute to rising health care costs. mortality.31
Belgium, Denmark, and Finland, where the average
life expectancy is about 80 years, face a growing need The Sheba Medical Center in Tel Aviv is using an AI
for long-term care to treat chronic disease.24 They are tool that quickly diagnoses heart-related issues. Using
among the few OECD countries that spent about 2% of a portable ultrasound probe and a computer tablet,
their GDP on long-term care.25 treatment costs between US$2,500 to US$6,000—far
less than the cost of an echocardiography machine and
As the costs of long-term care increase, countries reducing the need for specialty consultation only for
are adopting different funding models to cover the extremely complicated cases.32
expenses. Germany and Japan finance long-term care

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2024 Global Health Care Sector Outlook | Navigating transformation

Access to care is linked to affordability The ADB, through the Rwanda Innovation Fund, for
example, is working with health tech firm Viebeg
While higher costs reduce affordability of care, Technologies to expand access to affordable health
affordability can also reflect the level of investment in care across Central and East Africa. The program allows
health and health systems. As public debt has risen— health care institutions to stock medical supplies using
reaching a record US$92 trillion in 2022—developing AI to oversee shipping to warehousing, distribution,
countries increasingly are spending more to pay and inventory control. Using the platform, health care
interest on their debts than they are on health care and providers can connect directly with manufacturers,
education. The number of countries facing high debt eliminating brokers and middlemen, and generating
levels rose to 59 in 2022 from 22 in 2011, and about savings of as much as 40% for customers.35
3.3 billion people, or roughly half of humanity, now live
in countries where health care investment has taken Even in wealthy countries efforts to improve access to
a back seat to debt service. This holds true for some care have at times fallen short. Forty-seven percent of
developing nations across Africa, Latin America, and providers in a recent Experian survey said they believe
Asia (excluding China).33 access to care is worse than it was in 2020. This may
reflect providers’ frustration that their investments in
In many low-income countries, as few as one in improving information intake, reducing cancellations,
seven individuals received all doses of the COVID-19 boosting patient volumes, and increasing up-front
vaccination. That compares with about three out of collections have so far fallen short of expectations.36
four in high-income countries.34
Recent research by Deloitte US indicates that health
To improve access in developing regions, organizations care inequalities in the US cost the country roughly
are stepping up efforts to improve the availability of US$320 billion annually. If these gaps are not bridged,
medical supplies and treatments in developing regions. that amount may increase to US$1 trillion or more by
204037 (Figure 2).

Figure 2: Modeling the cost of US health inequalities in 2040

Cost of inequities in 2040
US$1 trillion

Cost of inequities today

US$320 billion

Expected changes in population

demographics, cost of care, and
per capita spending

We initially focused on a set of Using the assumptions from these

disease states to establish a disease states and disparities
baseline for the costs potentially research, we extrapolated to all
attributed to inequities and bias other disease states

Note: All values are in US dollars.

Sources: Deloitte analysis.

16
 2024 Global Health Care Sector Outlook |
 Navigating transformation

In Europe, large investments in staffing have led to an Meanwhile, the NHS has developed multiple strategies
increase in headcount, but there is a lag in productivity to promote health equity in the UK, including programs
given higher wages, and increased investment in that foster collaboration among stakeholders and
technology that has yet to pay off.38 data monitoring over a dashboard. It is collaborating
with other programs to improve access for the 20%
Politically, though, governments are reluctant to raise of the population identified as the most deprived,
taxes amid high inflation and recession concerns. according to the National Index of Multiple Deprivation.
In the UK, for example, the NHS has embarked on a The program focuses on clinical areas that include
systemwide savings and efficiency drive that includes maternity, mental illness, chronic respiratory disease,
leveraging technology more aggressively, centralizing early cancer diagnosis, and hypertension and lipid
procurement, back-office functions, and reducing costs management.41
in agency nursing shifts.39
In September 2023, the Pan American Health
Organization (PAHO) signed an agreement to promote
Steps for reducing inequities and
equitable access to medical diagnostic tests in Latin
improving affordability and access America and the Caribbean. The partnership will focus
on expanding timely access of cost-effective medical
Worldwide, providers are working to address inequities
diagnostic tests and promote early diagnosis of
that inhibit access to and affordability of care. Steps
diseases.42
include:

• Collaborating to influence multiagency action, such as The rise of medical tourism

with integrated care systems
Medical tourism has become increasingly popular
• Leveraging their position as an anchor institution in
among businesses and insurance providers as a means
their vicinity or community
of bringing down health care costs. This is particularly
• Conducting quality improvement programs focused true of patients in the US. More than 787,000 people
on health equity were expected to leave the US for health care in 2022
alone. Cost is the overriding factor. Procedures costing
• Promoting targeting of health care delivery to meet
more than US$5,000 grew from 5% of US medical
regional needs and explicitly aim to lessen health
tourism procedures in 2017 to 22% in 2022.43
care inequalities

• Integrating health equity-focused approaches Asia, India, Thailand, and Turkey have emerged as
through advocates across initiatives some of the top medical tourist destinations. While
affordability and the presence of numerous accredited
In the US, the Centers for Medicare and Medicaid
hospitals have contributed to this growth, governments
Services (CMS) recently announced a framework
have also increased efforts to promote the countries as
for enhancing health outcomes for recipients of
medical hubs.44,45
Medicare; Medicaid; CHIP; and the Health Insurance
Marketplaces. The 10-year plan includes collecting Globally, about 11 million people travel to other
standardized data, assessments, and addressing the countries for medical care, and the value of the medical
root causes of health inequities; building workforce tourism market is projected to reach US$43.7 billion by
capacities to reduce health care disparities; providing 2030 and grow at compounded annual growth rate of
culturally tailored services; and increasing forms of around 33% annually between 2023 and 2030. Cross-
accessibility to health care coverage.40 border patients pay approximately between US$3,500
to US$5,000 for a single consultation.46

17
2024 Global Health Care Sector Outlook | Navigating transformation

How providers can transform capabilities and assets and outsourcing others. In
their organizations in a high-cost determining the proper balance, providers should
consider a range of models—fixed-price, everything-
environment
as-a-service, risk-based, capability-focused, and
outcome-based.
The current cost environment requires new strategies
to transform an organization. Traditional cost-cutting • Prioritizing workforce investments: To address
may no longer be enough. Instead, health care the ongoing challenges of recruiting and retaining
organizations should transform themselves by building staff, health care organizations should prioritize
new capabilities, relationships, and competencies. investments in workforce experience and
development. This may include retention bonuses
To help ensure these efforts are successful, they for key talent, developing career paths, training, and
should focus on: reimagining the work, workplace, and workforce.

• Transforming care delivery: Consumers tend to • Adopting a digital strategy: Many health care
have rapidly changing preferences about where they organizations still lag in investments in digitalization.
receive care. Increasingly, they prefer retail clinics and To take full advantage of technology such as AI, they
urgent care centers over a hospital or physician office need a coherent digital strategy rather than simply
visit. Strategic investments in these alternative sites pursuing ad hoc incremental digital initiatives. This
of care can help health care organizations improve includes making investments in digital engagement to
offerings, build trust with their consumers, and address changing consumer needs and establishing
secure better finances. connected platforms for all business units. As part of
this broader strategy, organizations should consider
• Optimizing operating models: Keeping pace
how to integrate AI and other technologies to assist
with rapidly evolving skills and technologies and
workforce, reduce inefficiencies, and improve patient
uncertain supply chains can be challenging. To find
care. As part of this effort, providers must ensure the
the right balance between cost and benefits, some
technology is trustworthy, ethical, and secure.
organizations may look at enhancing certain in-house

18
2024 Global Health Care Sector Outlook | Navigating transformation

Responding to the looming global

shortfall in health care workers

By the numbers:

US$10 million—the projected shortfall of health workers globally by 20301

87%—the percentage of US health care providers that listed staffing shortages as their biggest challenge2

960,000—the number of health and welfare workers Japan needs by 20403

Nine in 10—the number of developed countries in which physicians feel dissatisfied or burnt out4

23% of US health care workers trust their leadership to do what’s right for them5

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 2024 Global Health Care Sector Outlook |
 Navigating transformation

The shortage of health care workers during the A recent survey found that 87% of providers listed
COVID-19 pandemic added a new dimension to the staffing shortages as their biggest challenge.14 And
global public health crisis. Several factors contributed there’s little relief in sight. More than 6.5 million US
to the shortage of professionals, including burnout, health care professionals are expected to leave their
high vacancy rates in health facilities driven by a limited positions by 2026, while only 1.9 million will step in to
talent pipeline, changing demographics, and increased replace them, creating a national health worker deficit
migration rates. of more than 4 million.15

Even with labor-saving technology such as artificial The situation is much the same in Asia. The Japanese
intelligence (AI), demand for health workers globally is health ministry, for example, has forecast a shortfall
expected to surge by 29%, to 84 million in 2030 from of 960,000 health care and welfare employees by
65.1 million in 2020.6 Meeting that demand requires the 2040.16 And in the UK, hospitals and clinics had more
industry to transform care models, redesign jobs, and than 133,000 job vacancies as of September 2022, a
rethink employer-employee interaction. 7.9% increase from the previous year. Almost 12% of
those openings were in nursing.17 More broadly, the
The challenge is profound—and global. The World NHS is understaffed by 154,000 full-time workers, and
Health Organization (WHO) projects a shortfall of 10 if current trends continue, that figure could rise to
million health workers worldwide by 2030, mostly in 571,000 by 2036.18
low and lower-middle income countries.7 About 55
countries currently fall below the number of health The demand for health workers in developed countries
workers that the WHO considers as sufficient. is contributing to larger shortfalls in poorer countries,
as workers migrate, drawn by better wages and
Some of the biggest shortages are for nurses, working conditions. For example, in eight Organization
especially in Southeast Asia and Africa. WHO’s norm for Economic Cooperation and Development (OECD)
is three nurses for every 1,000 people, but India, for countries that already have some of the highest
example, has just 1.7.8 The world will need nine million concentration of health care workers, the number of
more by the end of the decade.9,10 foreign-trained physicians increased to 36% in 2020
from 32% a decade earlier.19
Even in high-income countries, shortages persist. The
UK already had a shortfall of about 50,000 nurses
Burgeoning burnout
before the 2020 pandemic. The British government
has vowed to hire 50,000 new nurses by 2025, but
Clinician burnout is one of the key causes of the
the Health Foundation, a charitable organization
health care sector’s labor shortages. About 49% of US
that invests in health and health care, has said the
physicians said that they have experienced burnout in
government should exceed that goal if the National
the past two years and predicted those rates could rise
Health Services (NHS) is to recover from the current
in 2023.20 Burnout rates are highest among emergency
shortages.11,12
medicine (65%), internal medicine (60%), and pediatrics
(59%).21
Before the pandemic, US hospitals faced a decline in
workers, and the pandemic exacerbated those trends.
It is also a widespread problem among European
During the height of the Omicron COVID-19 subvariant,
physicians, with 22% believing that burnout and
about 30% of US hospitals, or about 1,400 facilities,
staffing issues may worsen.22 In India, 82.7% of doctors
indicated they anticipated critical short-term staffing
reported experiencing work-related stress in 2023.
issues.13
Mental, physical, and emotional attacks on physicians
are at an all-time high, according to the Indian Medical
Association.23

20
2024 Global Health Care Sector Outlook | Navigating transformation

In nine out of 10 developed countries surveyed— Our Deloitte US survey of health care workers
Australia, Canada, France, Germany, the Netherlands, found that only 45% of frontline clinicians trust
New Zealand, Sweden, Switzerland, the United their organization’s leadership to do what’s right for
Kingdom, and the United States—physicians were patients. Even fewer, 23%, trust their leadership to do
dissatisfied with a range of matters, including pay what’s right for workers.26 These two types of trust—to
levels, time spent with patients, time spent on do right by patients and to do right by workers—are
administrative work, and work-life balance. (Switzerland highly correlated and associated with significantly lower
was the only country in which physician satisfaction clinician burnout.
was higher.)24
In October 2023, about 75,000 medical workers at
Kaiser Permanente (KP) initiated a three-day strike
Trust
against one of the largest nonprofit US health care
networks. Workers were demanding higher pay, a
Trust is essential for health organizations, and it
US$25-per-hour minimum wage for all health care
is critical to effective care delivery. Yet Deloitte US
workers, and a reformed bonus structure. In addition
research has found an erosion of trust across the
to pay issues, the union representing the workers says
health care sector, including consumers and health
KP needs 10,000 more workers to fill vacancies.27
workers. Staff shortages have increased because of
burnout since the COVD-19 pandemic, inadequate pay
that has not kept up with inflation, and eroding trust in
executive leadership (Figure 1).25

Figure 1: Clinician burnout rate is highest in the US among those who have lost trust in their organization’s
leadership

Survey question: Do you trust your organization's executive leadership to do what's right for the workers?

The burnout I experience today is ...

2%
7% 2% 4% 5%
25% 17% 31% 14%
16% 34%
11% 11% 24% 55%

Level of Most of Some of

Rarely Never
trust the time the time

27%
41% 36% 39%

No burnout Minimal Modest High Very high

Note: N = 486 (clinicians currently in clinical practice).

Source: Deloitte 2022 Survey of US Frontline Clinicians.

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 2024 Global Health Care Sector Outlook |
 Navigating transformation

In the short term, health care providers have turned • Restore meaning in a clinician’s job and elevate
to contract workers to fill the gaps in the labor force. the humanity of health care. The demands of
The use of contractors in full-time positions more than today’s health care system and the heightened
doubled—rising 138.5%—between 2019 and 2022, and emphasis on the bottom line may be affecting
the median salary paid to staffing companies rose by clinicians’ joy in caring for patients. Giving time and
56.8%. During the same three-year period, the total autonomy back to clinicians allows them to focus on
cost of contract labor increased by almost 258%.28 In a patient relationships.
tight labor market, staffing companies often raise the
• Involve frontline clinicians in leadership roles.
hourly prices they invoice hospitals for services such as
Health care organizations can engage practicing
traveling nurses.29
clinicians on committees or encourage them to join
the leadership ranks. Evidence shows that physician-
To retain and attract the clinical workforce, health
led health care organizations generally do better in
care leaders have a responsibility to rebuild their trust
terms of protecting the core values in medicine than
and restore meaning, value, and purpose in their
non-physician-led organizations (Figure 2).34 Some
industry. Listening to frontline workers, recognizing
organizations appoint clinicians to serve at executive
their clinical autonomy, elevating their voice to
levels to ensure clinicians are engaged and involved
leadership, and building an inclusive culture are some
in decision-making.
ways organizations try to achieve this. Holding leaders
accountable for worker well-being—by weaving well- • Hold leaders accountable for health workers’
being metrics into their compensation and creating well-being. Having supportive leaders who prioritize
leadership positions focused on well-being—can workers’ well-being can be critical in building trust.
further solidify leadership’s commitment to their Some forward-looking organizations have created
workers. leadership positions like chief well-being officers to
lead efforts dedicated to workers’ well-being. While
This isn’t just the right thing to do, it’s also good for such roles are uncommon, clinicians say they can
business. Workers at high-trust companies report boost trust and reduce burnout.
50% higher productivity, 76% more engagement, and
40% less burnout compared to workers at low-trust Figure 2: Clinicians who work for organizations with a
companies.30 leadership role dedicated to employee well-being are
more optimistic
Rebuilding trust is essential as health organizations Survey question: Does your organization have leadership roles
focused on employee or staff wellness?
work to fill vacancies, meet rising demands for labor,
and prevent skilled workers from leaving for staffing Yes
firms that may pay more. Our research has found four 20% 37% 43%
key areas providers should focus on to strengthen
trust within their organizations:31 Not aware

12% 44% 45%

• Listen, be transparent, and involve frontline
workers in decision-making. Clinicians want to No
be heard and involved. An inclusive health care
workforce can enrich the discussion by bringing a 11% 33% 56%

diversity of experiences and perspectives, creating Note: N = 486 (clinicians currently in clinical practice).
a sense of belonging, and amplifying voices that
Optimistic Somewhat optimistic
traditionally are not heard.32 Nine in 10 of the
Not optimistic
clinicians we surveyed highlighted how important it is
for health care organizations to involve frontline staff Source: Deloitte 2022 Survey of US Frontline Clinicians.
when developing programs that address workforce
burnout and shortages. But only 54% said it actually
happens, including just 8% who said it happens
regularly.33

22
2024 Global Health Care Sector Outlook | Navigating transformation

Increasing pay HCA Healthcare, the largest US health system, is

developing AI that can convert clinician conversations
To find and retain clinicians among the labor shortages, with patients into medical notes that are then
providers have had to pay them more. The US incorporated into patients’ electronic health records
has witnessed a growth in clinician salaries across (EHRs). The program is designed to mitigate
most specialties. Average pay for physicians rose to documentation demands, one of the leading causes
US$352,000 from US$339,000 in 2022, while average of clinician burnout.40 Similarly, Carbon Health’s
pay for specialists increased to US$382,000 from hands-free charting tool uses OpenAI’s GPT-4 in
US$368,000. Primary care physicians’ average pay rose its proprietary EHR platform to streamline patient
to US$265,000 from US$260,000.35 documentation and generate comprehensive
and accurate medical notes. The tool reduced
Canada, meanwhile, developed a new payment model documentation time from 16 minutes to about four
to promote recruitment of physicians in underserved and increased patient volume by 30%.41
areas. Under a three-year agreement in British
Columbia, for example, a full-time family doctor Using tools such as Nuance’s Dragon Ambient
should now earn about C$385,000 annually, up from eXperience Express, which reduces the time spent on
C$250,000. The new pay scale is designed to enhance documentation, clinicians have reported saving about
recruitment of doctors in the region.36 seven minutes per patient visit, which helps enable as
many as five additional appointments per day. It also
The UK has been locked in disputes over clinician pay could give clinicians more time to spend with each
for most of 2023, with the NHS already offering pay patient or have time for themselves to reduce burnout.
increases. Regardless of how the situation is resolved,
labor costs are likely to rise.37,38
How providers can rebuild their
Increasing clinician pay and rebuilding trust can help workforce
prevent the loss of talent to staffing firms. It may also
reduce providers’ long-term labor expenses as staffing Providers looking to help improve their recruitment
firms tend to increase prices during times of high and retention may need to consider transforming their
demand. care models and redesigning jobs. Some options to
consider include:

Decreasing job demands through • Investing in technology to give time back

technology to workers: For instance, optimizing clinicians’
workflows by removing low-value activities, such as
In addition to building trust and paying clinicians more, reducing the number of EHR clicks, can be a quick
technology can ease some of the biggest contributors win. New work modalities, such as virtual nursing,
to burnout, such as administrative tasks. AI has the which take advantage of remote work possibilities
potential to take over documentation burdens, handle and lessen demands on bedside nurses are longer-
pre-op workflows, and assist with insurance claims, for term investments.
example. Relieving clinicians of those administrative
tasks frees up time for them to spend with patients.39

23
 2024 Global Health Care Sector Outlook |
 Navigating transformation

• Fundamentally rethinking where care is • Expand reliance on advanced practice

delivered: As more care moves out of hospitals and professionals: Government orders during the
into outpatient and other alternative sites of care, be pandemic granted many nurse practitioners
innovative about staff allocation and preparation and expanded roles. Organizations can build on these
design staff development programs accordingly. measures by filling gaps with less traditional care
providers like advanced practice professionals,
• Redesigning work teams: Implement
social workers, pharmacists, and community health
comprehensive interdisciplinary care teams that
workers in lieu of primary care physicians.
take advantage of team members’ strengths, bring
in more assistive clinical workers, and allow each • Leverage experienced clinicians: Design jobs that
person to operate at the top of their license. allow them to use their expertise, reduce physical
demands, give them flexibility in their schedules, and
• Injecting flexibility into jobs: The solutions range
allow remote work when appropriate. Retirement can
from flexible schedules and job-sharing to work
be a gradual transition if workers choose.
models that formalize opportunities to intermix
bedside work with other types of work. • Integrate workforce planning and strategic
planning: Understand how emerging technologies
• Customizing retention strategies: Listening and
and consumerism affect the workforce and the
addressing clinicians’ concerns and needs can help
nature of the jobs clinicians perform. Encourage
boost retention. Some workers may want more
change but do it in a way that supports your
recognition or flexible scheduling, while others want
workforce.42
higher pay for expertise or increased effort.

24
2024 Global Health Care Sector Outlook | Navigating transformation

The role of social care

By the numbers:

£845 million—the UK’s total proposed spending in 2024 and 2025 to improve access to adult social care1

1.3 million—the number of new direct-care workers needed in the US by 2030 to keep up with demand
from older populations and people with disabilities2

C$23 billion—the amount of a Canadian government settlement that will compensate more than
300,000 First Nations children and their families for underfunding of on-reserve child-welfare services3

31.6%—France’s spending on comprehensive social welfare as a share of GDP, making it the leading
spender in social spending among Organization for Economic Co-operation and Development (OECD)
nations 4

21%—the average public social spending in OECD countries in 2022, as a share of GDP5

25
 2024 Global Health Care Sector Outlook |
 Navigating transformation

Location of residence, quality of social support that incorporate various types of care—integrating
networks, and exposure to stress can have powerful health and social care services with the private and
effects on well-being. In fact, it’s estimated that 80% nonprofit sectors to achieve a prevention focused,
of health outcomes depend on behavioral, social, or “whole health” model. It’s a restructuring of complex
environmental drivers of health.6 health care systems to focus on the non-medical
determinants of illness and disease.8
Rather than taking social determinants such as
environment or economic stability into account, the Health care consumers generally support the shift
global health care sector has traditionally focused towards integrated social and health care. A 2023 study
on treating illnesses through medical specialists and examining how people perceive digital government
health centers post hoc. A growing body of evidence services showed that 75% of respondents were
suggests a better approach.7 To address rising health comfortable with government agencies collecting
care costs, health care providers, governments, and personal data to provide integrated and personalized
stakeholders around the globe are shifting to models social care services (see Figure 1).9

Figure 1: I am comfortable with government agencies collecting personal data to ...

Strongly agree Agree Don’t know Disagree Strongly disagree

Track diseases and

28% 49% 5% 14% 5%
predict the prevalence
of endemics and
pandemics

Provide integrated
and personalized 23% 52% 8% 13% 4%
social care services

Prevent crimes in my
neighborhood 24% 46% 7% 17% 5%

Design new services

21% 47% 10% 18% 5%
that are personalized

Offer access to
20% 46% 10% 18% 5%
transportation
options

Recommend jobs
20% 41% 11% 19% 9%
matching my profile

Note: Percentages may not add up to 100 due to rounding off.

Source: 2023 Deloitte Digital Citizen Survey.

26
2024 Global Health Care Sector Outlook | Navigating transformation

To move to a health care system that prioritizes social two years in the National Health Service Corps or
determinants, a number of governments are investing an approved site in a Health Professional Shortage
in the social care workforce and deploying new, holistic Area—a designated location that lacks primary care,
service delivery models to better meet the needs of dental care, or mental health care providers.14
underserved communities.
In Canada, provincial authorities are collaborating with
nonprofit organizations to better support caregivers
Empowering social care workers
at work. One area of focus: eliminating the disparities
between the quality and availability of support across
A number of countries are embarking on partnerships
provinces or territories. For instance, the Canadian
to build a more resilient roster of social care talent—
Centre for Caregiving Excellence is conducting a needs-
and to increase the attractiveness of these careers.
mapping exercise with the Nunavummi Disabilities
Consider that health and social care systems employ
Makinnasuiqtiit Society to address potential gaps in
about 10% of all workers in OECD countries.10 Women
knowledge about the unique needs of caregivers in
account for two-thirds of that workforce—many in
Nunavut. The work includes First Nation-led sharing
low-paid and unpaid roles.11 To acknowledge these
circles in Nunavut communities.15
contributions, Sweden launched its first National
Careers Strategy in 2022 to better support workers in
The UK government is collaborating with the charity
caregiving fields, including informal, unpaid caregivers
Skills for Care, a workforce development organization.
who forgo paid work to support loved ones.12
Their goal is to create a new care workforce pathway
and funding for hundreds of thousands of roles,
The US government has also introduced efforts to
including a new Care Certificate qualification, and is
improve the recruitment, retention, training, and
back by a £250 million investment.16
professional development of direct-care workers.
Among them, grants establishing a national center to
Separately, the UK government has authorized £100
bolster the direct-care workforce through 2027. The
million to help accelerate digitization in the social care
goal is collaboration amongst government, university,
sector so providers can have real-time information on
and nonprofit partners to improve the recruitment,
patients receiving care. The government’s £1.4 billion
retention, training, and professional development of
Market Sustainability and Improvement Fund aims
direct-care workers.13
to allow local authorities to increase the rates paid
to social care providers and reduce waiting times.17
The US is also investing in a new program, the National
These initiatives reflect social care for older people,
Health Service Corps, which offers up to US$50,000 in
vulnerable adults, and children ranked as a Tier One
tax-free student loan repayments for licensed primary
priority—the same rank as crime and policing—in a
care clinicians in eligible disciplines. In exchange for
Deloitte UK survey of 5,800 UK adults on attitudes
loan repayment, participants agree to serve at least
about the public sector (see Figure 2).18

27
 2024 Global Health Care Sector Outlook |
 Navigating transformation

Figure 2: Which of the following issues, if any, do you think should be the top priorities for improvement in the UK
over the next few years or so?

The cost of living 81%

CRISES
NHS waiting lists 66%

Climate change 46%

Crime and policing 44%

Social care for older people, vulnerable adults

44%
and children
TIER ONE PRIORITIES
The availability of housing 40%

Immigration and border security 37%

Provision of care for people's mental health 36%

The country's infrastructure 29%

Protection against COVID-19, and

28%
further pandemics

School and early years education 27%

Our defense and national security 26%

TIER TWO PRIORITIES
Trade with other countries 25%

Inequality between different groups in society 24%

Inequality between different regions 22%

Opportunities for adults to improve their skills 17%

Source: Deloitte UK—The State of the State 2022-23 report

Supporting aging populations at about 2.5% of EU GDP higher than government

expenditures on long-term care.21 The Commission
Across the European Union (EU), as is the case with also reports that improving high-quality care could
other regions, an aging population will likely require ultimately mean improving gender equality, because
millions of long-term care workers in the coming women occupy 90% of the formal care workforce.
decades. About 6 million people work in the sector, but Supporting informal caregivers through training and
some estimates suggest the EU will need another 1.6 financial support are critical parts of the strategy.
million care workers by 2050.19
Governments are also aware that by proactively
The European Care Strategy passed by the European addressing practical needs now, health systems can
Commission in 2022 in part sets targets to meet these avoid more costly interventions in the future. For
needs.20 One of the goals is achieving high-quality, instance, the UK government has earmarked £102
affordable, and accessible care services with better pay million over a two-year period for home adaptations
and conditions for professional caregivers. such as grab rails and ramps, small repairs, and
safety and security checks, to aid people at home and
As the Commission notes, the value of hours of long- ultimately avoid hospital stays.22
term care provided by informal caregivers is estimated

28
2024 Global Health Care Sector Outlook | Navigating transformation

Improving outcomes among • Health Prism is a Deloitte portal that contains more
underserved populations than 165 models to help federal, state, and local
governments identify populations at risk for more
Another focus for governments is ensuring that than twenty disease states and inequities, such as
investments in the social determinants of health are COVID-19, hypertension, cardiovascular disease,
equitably distributed across underserved populations. diabetes, housing insecurity, food insecurity, and
more. It also can identify populations that might
An analysis of results from the Australian Bureau qualify but have not yet applied for benefits.25
of Statistics (ABS) estimates that about one-third • GiveDirectly is a peer-to-peer platform that offers
(34%) of the health gap between Indigenous and cash to extremely low-income households and
non-Indigenous Australians is because of social people affected by humanitarian crises. GiveDirectly
determinants. Among the causes: employment and has delivered over US$500 million to people in eleven
hours worked, the level of schooling completed, countries, “from residents of Houston recovering
housing adequacy, and household income. By from Hurricane Harvey to farmers in Kenya.”26
comparison, just under one-fifth (19%) of the health
gap between Indigenous and non-Indigenous
Questions for stakeholders
populations stems from factors such as alcohol
abuse, high blood pressure, poor nutrition, or physical
Stakeholders that strive to prioritize social care as part
inactivity. The remaining health gap of around 47%
of their commitment to deliver on whole health should:
includes differences in access to care and other
factors.23 • Establish sustainable frameworks for workforce
recruitment and training.
Adapting to digital delivery • Determine how to include a community-based
approach so that people with lived experience with
Delivering social care services to underserved key social issues are involved in the solutions.
populations is a perennial challenge that was
exacerbated during the pandemic. Technology can • Prioritize data governance and data sharing so that
help. A number of examples show how technology can providers can exchange vital information such as risk
support inclusiveness while serving a broad range of factors or family health history.
populations. • Invest in preventive models that focus on social
context and environmental determinants of health.
• Services Australia was created in 2019 to consolidate
and accelerate delivery of federal, social, and health • Support social care workers with technology tools.
services. One result was MyGov, an integrated online
platform that organizes benefits, services, and
programs by genre. MyGov now has 780,000 logins
per day.24

29
2024 Global Health Care Sector Outlook | Navigating transformation

A sustainable future

By the numbers:
Impact to health

US$8.1 trillion—The estimated annual global financial impact of health-related issues caused by poor air
quality1—around 7.7% of global GDP2

US$820 billion—Annual cost of US medical bills stemming from air pollution, which leads to an estimated
107,000 premature deaths annually in the US3

Actions by systems

US$52.5 million—Philanthropic grant to equip 25,000 health care facilities across 12 Indian states with
solar power by 2026 4

10,000—The number of electric vehicle charging points to be installed across Malaysia through a
partnership between KPJ Healthcare, a private health care provider in Malaysia, and with green energy
company Gentar5

261.5 tons—The reduction in carbon dioxide emissions over a six-month period because of energy-
saving measures at an Egyptian cancer treatment center6

30
 2024 Global Health Care Sector Outlook |
 Navigating transformation

Each year, the scientific scenarios on Earth’s changing per year, with disproportionate effects on low-income
climate become clearer. If global warming intensifies areas with poor health infrastructure.10 The World
beyond a 1.5°C threshold, dire consequences become Health Organization (WHO) estimates that 99% of the
more likely: devastating droughts and wildfires, rising disease burden from climate change occurs in these
food and water insecurity, and climate-linked migration, places, 88% of which occurs in children under age
to name a few of the most dramatic effects.7 5. These bleak prospects have triggered alarms for
governments and businesses to take action to build a
There is real momentum underway to counter many more sustainable future.11
of these effects: US emissions have declined on
average by 5% each year since their peak in 20078, The health care sector is susceptible to many of the
and emissions across the European Union (EU) have effects of climate change—for the patients who receive
fallen 34% since 1990.9 Global agreements on methane care, as well as the organizations that deliver it. Climate
and deforestation have progressed in recent years. In change can exaggerate an array of problems like
addition, countries at COP27, the 2022 United Nations economic equity, gender equity, and migrant rights,
Climate Change Conference, created a fund to aid and there’s a common thread in a recently conducted
global adaptation to climate impacts. Deloitte US analysis linking these social issues to
health care (Figure 1). Some estimates suggest that
Still, these impacts are creating health inequities. stronger climate action could eliminate more than 100
Between 2030 and 2050, climate change is expected million premature deaths globally, strengthen health
to cause approximately 250,000 additional deaths outcomes, and maintain a more habitable ecosystem.12

Figure 1: The physical environment is a threat multiplier for overall human health13

Climate change disproportionately affects the health and well-being of historically under-resourced communities
Social determinants of health

Wildfires
Safety Physical
Drivers of health environment Rising sea levels

Extreme heat
Food
Connection
En Severe weather
vi
r
N O L O G IE
EC H
on

T S
Air pollution
l

me
Socia

ntal

Droughts
Education Infrastructure
CULTU
STRU

Eco
n o m ic
RE
CT

ES
UR

Eco
n o m ic

Employment
Economy

Wealth

Source: Deloitte analysis.

31
2024 Global Health Care Sector Outlook | Navigating transformation

In response to these challenges, health care systems In the US, one hospital has reacted to a string of
around the globe are building more sustainable natural disasters by investing in systems to boost
operations. Some are prioritizing energy efficiency its resilience. In 2001, historic flooding crippled the
within their clinical care systems. Others have largest medical complex in the US. Water damaged
accelerated their decarbonization efforts. There’s a the center’s emergency generator, causing a complete
commitment to improving visibility into supply chains. power outage. The hospital staff invested in a new
on-site, combined heat and power plant to eliminate
And other systems and care providers are improving dependence on the city’s energy grid. The system
the way they share data to eliminate waste and provide was put to the test with hurricanes in 2005, 2008, and
more sustainable, equitable care. This can include a 2017. Despite citywide flooding from Hurricane Harvey
multi-step process to help mitigate climate change: in 2017, all of the system’s hospitals and emergency
rooms remained operational during the emergency.16
• Reducing the sources of greenhouse gases

• Adapting to extreme conditions to lower an Decarbonization investments take

organization’s vulnerability to future risks
shape
• Transforming care delivery so it’s more sustainable14
Keeping these systems running requires resources,
Delivering sustainable care in including heating and cooling, lighting, water, and
transport from the volume of traffic to and from
unpredictable environments
hospitals—producing emissions across these
operations. In fact, health care contributes nearly 5%
Though health care systems and providers treat many
of global greenhouse gas (GHG) emissions, with G20
of the same ailments and conditions irrespective of
countries emitting more than 75% of that total.17 A 2023
geography, the environments in which they do their
report by the independent Indian think tank Observer
work can be significantly different. Low-lying island
Research Foundation reports that some of the main
nations and coastal areas face the threat of rising
contributors to GHG emissions in health care are the
oceans. There can be severe heat crises in regions
US (27%), China (17%), the EU (12%), Japan (5%), and
unaccustomed to dangerously high temperatures.
Russia (4%). Brazil, India, South Korea, Canada, and
Geopolitical conflicts have disrupted supply chains and
Australia contribute about 2% each.18
access to critical medical equipment and goods.

The report equates the climate crisis with a public

One of the ways hospitals are addressing acute energy
health crisis, asserting that the health care sector
insecurities that affect the delivery of care is by building
should decarbonize by reducing direct emissions
resilience into their operations.
produced by health care facilities. Among the
For instance, in Luxor, Egypt, the 150-bed Shefaa Al- recommendations is guidance that countries include
Orman Oncology Hospital, a cancer treatment center, health and health care decarbonization plans in their
faced challenges from high energy consumption that national and sub-national climate policies as stipulated
was driving up operating costs and causing negative in the 2015 Paris Agreement. As of 2023, only 10%
environmental impacts. The hospital took several steps of these national plans refer to the health impacts of
to help increase energy efficiency. Staff used timers to climate change.19
schedule the heating, ventilation, and air conditioning
Some plans, like the UK’s National Health Service
systems, setting a standard temperature of 25°C
(NHS) Carbon Footprint, take a two-part approach: For
(77°F). It also used sensors for external lighting and
emissions the system controls directly, the UK pledges
switched to energy efficient LED lights, reducing its
to be net-zero by 2040, while aiming to reach an 80%
energy consumption by 20% in a six-month period.15
reduction between the years 2028 and 2032.

32
 2024 Global Health Care Sector Outlook |
 Navigating transformation

For emissions NHS can influence outside of its system, processes in a global context are fragmented.
the goal is becoming net-zero by 2045 and reach an Sustainability regulations vary from region to region. In
80% reduction between 2036 and 2039.20 the absence of a comprehensive supplier engagement
program, standardization, or clear mandates, breaking
Investments at the national and operator level are down the barriers between purchasing and clinical care
already addressing the matter. In 2023, the University can be challenging.
Hospital Southampton NHS Foundation Trust (UHS),
an acute hospital trust in the UK, received a US$31.4 The framework to categorize GHG emissions include
million grant from the Public Sector Decarbonization Scope 1, which comprises facility-level emissions from
Scheme; the trust will install an energy-efficient heating service delivery; Scope 2, which includes emissions
system to meet its pledge to become Net Carbon produced while using the energy purchased from
Zero by 2045. The new system replaces 20-year-old external grids; and Scope 3, which covers emissions
infrastructure and provides a more comfortable from the supply chain, including the manufacture,
environment for patients and staff, hospital leaders supply, use and disposal of health care goods and
say.21 services.25

In the US, a health care system is addressing In the UK, the NHS is addressing these challenges
decarbonization by building its own microgrid. In 2023, by launching a comprehensive supplier engagement
Valley Children’s Healthcare, a US pediatric provider, program. This program sets specific targets for supply
launched a new energy resilience and environmental chain partners and emphasizes decarbonization
strategy. The goal is a 50% reduction in greenhouse across multiple scopes—working with suppliers of
gas emissions by 2030, net-zero carbon emissions by consumables and medical devices to reduce excessive
2050, and the establishment of the largest pediatric packaging in the supply chain.26
health care-based renewable energy microgrid in the
country. Valley Children’s anticipates that the system A broader, global effort with climate and sustainability
will be online and operational by 2025, reducing targets for suppliers to reduce emissions across the
reliance on the power grid, and ensuring the complex value chain launched in 2023 through the Sustainable
remains operational even during power outages.22 Markets Initiative Health Systems Task Force. This
Changes are coming in the political arena, too, as the public-private strategic partnership of CEOs and
US state of California will enact new legislation from leaders from global health care organizations, life
2026 to require big corporations to disclose their sciences companies and institutions supports United
carbon footprints and climate-related financial risks.23 Nations efforts to strengthen climate resilience and
lower the emissions of health systems.
And in India, Ambica Constructions and Contractors
and Lifeline Hospitals Group in 2023 announced plans The following are among the targets for the private
to invest US$1.4 billion to develop India’s first 500-bed, sector:
completely carbon-neutral hospital.24
• Switch from 80% to 100% renewable power for their
own operations by 2030
Encouraging sustainable supply chains
• Transition car fleets to zero-emission vehicles by
Another area of focus for health care sector leaders 2030
is creating supply chains that flex with environmental, • Jointly explore green heat solutions by 2025 to boost
social, economic, and technological changes. There adoption of effective and scalable technologies27
are several barriers to adopting sustainable practices
throughout supply chains, however. Procurement

33
2024 Global Health Care Sector Outlook | Navigating transformation

Cutting down on waste across the Here are some other ways health care organizations
value chain can help reduce waste and emissions:

• Supply chain optimization: Incorporate local,

A closely linked issue to supply chains is how health
sustainable, and circular principles in procurement
care systems are managing waste. Consider that
roughly 15% of the total health care waste produced is • Clinical innovation: Support preventative care, and
hazardous and can be infectious, toxic or radioactive; if introduce new processes that help limit the volume
not treated properly it can pose a risk to human health and toxicity of waste
and the environment.28 And the WHO calculates that
• Low-carbon medicines: Substitute high-emission
the average amount of hazardous waste produced per
products with more climate friendly alternatives,
bed per day is 0.5 kg in high-income countries, and 0.2
and incentivize the production of climate-smart
kg in low-income countries.29 But less than one in three
medication
health care facilities globally possess the basic health
care waste management services.30 • Transportation efficiency: Limit transportation-
related emissions via zero-emission fleets, public
Not all of the waste is physical. One anesthetic gas, transport, and hybrid health care strategies33
desflurane, has 20 times the environmental impact of
other less harmful greenhouse gases. Per bottle it has Measuring sustainable outcomes
the same global warming effect as burning 440 kg of
coal. One UK hospital started a campaign with color- Measuring environmental impact and being able to
coded cards to urge staff to use alternative options compare and learn from peers on how to minimize
when possible, resulting in a reduction of 30,000 kg of impact is another way the health care sector can
carbon dioxide per month.31 build more sustainable systems. For instance, in 2023
the Geneva Sustainability Centre of the International
Elsewhere, clinicians are studying ways to use all items Hospital Federation, in collaboration with Deloitte
in procedure packs instead of discarding unused ones. Switzerland, launched the Sustainability Accelerator
There’s opportunity to include discussions of waste in Tool (SAT). The cloud-based platform measures a
the value chain by focusing on high-value materials like hospital’s performance against core indicators, and
electronics. compares those to other health care institutions
worldwide. The dashboard includes benchmarks
Cutting back on the massive amounts of food waste that are specific to the health care sector, providing a
and reducing food insecurity are dual issues that one global reference alongside an organization’s individual
California health care system took on. Food insecurity progress on sustainability. A US hospital association
affects 1 in 5 Californians, with greater levels of signed an agreement with the Geneva Sustainability
hunger affecting Black and Hispanic families. In 2020, Centre to promote the SAT to its network of nearly
Sutter Health began a food donation pilot program, 5,000 hospitals, health systems and health care
collaborating with a logistics company to donate food organizations in the US—helping equip hospital
from 10 hospitals to 40 nonprofit organizations within leaders with information to encourage the sector’s
five miles of each facility, ultimately diverting food transition to sustainability.34
waste from landfills. The program also provided 54,000
meals to community-based organizations.32

34
 2024 Global Health Care Sector Outlook |
 Navigating transformation

A commitment to information sharing can also Questions for providers

influence health outcomes for populations
disproportionately affected by social determinants • Have you thought about the ways environmental
of health. In the US, for instance, the Association for data is impacting health?
Professionals in Infection Control and Epidemiology • Have you looked at the ways social vulnerability and
(APIC) established the APIC Health Equity Fund to environmental data can affect health outcomes?
underwrite the cost of infection prevention tools and
resources for underserved communities.35 • How are you measuring your environmental
footprint?
The ultimate goal is reducing financial strain and • What’s your capacity for adaptation and resilience
increasing access to quality care, thereby encouraging in the event of an emergency? How will it affect your
a sustainable future for patients of all backgrounds. facilities, staffing ratios, or abilities to provide care?

• How well are you sharing data with your peers?

35
2024 Global Health Care Sector Outlook | Navigating transformation

Contacts

Author

Sara Siegel
Deloitte Global Health & Human Services Sector Leader
sarasiegel@deloitte.co.uk

Contacts

Transforming health care with artificial intelligence

Kumar Chebrolu Bill Fera

Principal Principal
Deloitte United States Deloitte United States
kchebrolu@deloitte.com bfera@deloitte.com

Alison Hagan
Principal
Deloitte United States
ahagan@deloitte.com

Addressing cost and affordability

Luke Baxby Minni Sarkka-Hietala

Partner Partner
Deloitte Australia Deloitte Finland
lbaxby@deloitte.com.au Minni.Sarkka-Hietala@deloitte.fi

Liz May Gus Miah

Partner Partner
Deloitte United Kingdom Deloitte United Kingdom
lmay@deloitte.co.uk gmaih@deloitte.co.uk

Viswanathan Nagarajan Ibo Teuber

Director Partner
Deloitte Canada Deloitte Germany
vnagarajan@deloitte.ca iteuber@deloitte.de

Debbie Young
Partner
Deloitte United Kingdom
deyoung@deloitte.co.uk

36
 2024 Global Health Care Sector Outlook |
 Navigating transformation

Responding to the looming global shortfall in health care workers

Amber Kennard Marley Kiewik

Partner Partner
Deloitte United Kingdom Deloitte Netherlands
askennard@deloitte.co.uk MKiewik@deloitte.nl

Maureen Medlock Eileen Radis

Principal Principal
Deloitte United States Deloitte United States
mmedlock@deloitte.com eradis@deloitte.com

The role of social care

Josh Hjartarson
Partner
Deloitte Canada
jhjartarson@deloitte.ca

A sustainable future

Dr. Elizabeth Baca Will Saddington

Managing Director Director
Deloitte United States Deloitte United Kingdom
ebaca@deloitte.com wsaddington@deloitte.co.uk

Acknowledgements

We would like to thank the following individuals for their contributions to this report: Greg Reh, David Rabinowitz, Sarah
Shier, Phoebe Morgan, Liz Hampson, Terry Koch, Tapsi Bansal, Pallavi Shirsat, Dorin Shah, Ketaki Soman, Loren Steffy, and
Cliff Chestnut.

37
2024 Global Health Care Sector Outlook | Navigating transformation

Learn more

Interested in learning more about transforming health care with artificial intelligence and its impact on global
health care? Check out these Deloitte publications:

Navigating the emergence of Generative AI in health care

The Future of Health in Europe

Digital measurement and digital biomarkers

Digital health integration

Interested in learning more about addressing cost and affordability and its impact on global health care? Check out
these Deloitte publications:

How employers can spark a movement to help us live longer and healthier lives

How CFOs can help transform health care organizations amid an uncertain economic environment

One-stop shop: Where healthcare meets retail

Biomedical innovation

Interested in learning more about responding to the looming global shortfall in health care workers and its impact
on global health care? Check out these Deloitte publications:

Addressing health care’s talent emergency

Employers can spark healthy aging

Time to change: Sustaining the UK’s clinical workforce

38
 2024 Global Health Care Sector Outlook |
 Navigating transformation

Interested in learning more about the role of social care and its impact on global health care? Check out these Deloitte
publications:

Reducing health disparities

The promise of digital mental health in a meta world

Improving access to healthcare in Africa

Integrated health care and the government’s role in funding

Interested in learning more about a sustainable future and its impact on global health care? Check out these Deloitte
publications:

Why climate resilience is key to building the health care organization of the future

Can health care, life sciences firms help heal the earth?

39
2024 Global Health Care Sector Outlook | Navigating transformation

Endnotes

Transforming health care with artificial intelligence

1. Nikhil Sahni, George Stein, Rodney Zemmel, and David M. Cutler, 13. Nitin Mittal, Costi Perricos, Lynne Sterrett, and Deborshi Dutt,
“The Potential Impact of Artificial Intelligence on Healthcare “The Generative AI Dossier,” Deloitte, https://www2.deloitte.com/
Spending,” National Bureau of Economic Research, January 2023, content/dam/Deloitte/us/Documents/consulting/us-ai-institute-
https://www.nber.org/papers/w30857 gen-ai-use-cases.pdf

2. Sundar Krishnan and Narasimha Shashidhar, “eDiscovery 14. Ibid.

Challenges in Healthcare,” International Journal of Information
15. Brian Doty and Jay Bhatt, “Generative AI holds enormous promise
Security Science, Vol.8, No.2, pp.30-43, https://www.researchgate.
for health care,” Deloitte Health Forward Blog, June 27, 2023,
net/publication/335202708_eDiscovery_Challenges_in_Healthcare
https://www2.deloitte.com/us/en/blog/health-care-blog/2023/
3. “Healthcare Interoperability Solutions Market by Type,” Markets generative-ai-holds-enormous-promise-for-health-care.html
and Markets, https://www.marketsandmarkets.com/Market-
16. Nitin Mittal, Costi Perricos, Lynne Sterrett, and Deborshi Dutt,
Reports/healthcare-interoperability-solution-market-17705847.
“The Generative AI Dossier,” Deloitte, https://www2.deloitte.com/
html?utm_source=Prnewswire&utm_medium=referral&utm_
content/dam/Deloitte/us/Documents/consulting/us-ai-institute-
campaign=paidpr
gen-ai-use-cases.pdf
4. “The state of healthcare AI in 5 charts,” CB Insights, August 1,
17. Petri Lehto and Saara Malkamäki, “The Finnish health sector
2023, https://www.cbinsights.com/research/healthcare-artificial-
growth and competitiveness vision 2030,” SITRA, June 8, 2023,
intelligence-ai-market/
https://www.sitra.fi/en/publications/the-finnish-health-sector-
5. Ibid. growth-and-competitiveness-vision-2030/#preface

6. Dhruv Suyamprakasam, “2024 prediction: Tech to change primary 18. Thamidul Hoque and Axel Tuomala, “Finland’s Path To The Digital
care,” Physicians Practice, November 3, 2023, https://www. Decade 2030: Sustainable Growth and Digitalization Plans,”
physicianspractice.com/view/2024-prediction-tech-to-change- Lappeenranta University of Technology, December 2022, https://
primary-care www.researchgate.net/publication/366866856_Finland’s_
Path_To_The_Digital_Decade_2030_Sustainable_Growth_and_
7. “The state of healthcare AI in 5 charts,” CB Insights, August 1, Digitalization_plans
2023, https://www.cbinsights.com/research/healthcare-artificial-
intelligence-ai-market/ 19. Patrick Frank, “Overcoming healthcare’s reluctance to
technological change,” MedCityNews, May 3, 2022, https://
8. Patrick Frank, “Overcoming healthcare’s reluctance to medcitynews.com/2022/05/overcoming-healthcares-reluctance-
technological change,” MedCityNews, May 3, 2022, https:// to-technological-change/
medcitynews.com/2022/05/overcoming-healthcares-reluctance-
to-technological-change/ 20. Brian Doty and Jay Bhatt, “Generative AI holds enormous promise
for health care,” Deloitte Health Forward Blog, June 27, 2023,
9. “State of Digital Health Q2’23 Report,” CB Insights, July 26, 2023, https://www2.deloitte.com/us/en/blog/health-care-blog/2023/
https://www.cbinsights.com/research/report/digital-health- generative-ai-holds-enormous-promise-for-health-care.html
trends-q2-2023/
21. Shania Kennedy, “NYU Large Language Model Forecasts Hospital
10. Seth Joseph, “Under Financial Pressure, How Are Health Systems Readmissions, Length of Stay,” Health IT Analytics, June 9, 2023,
Prioritizing Digital Health Investments?” Forbes.com, January 11, https://healthitanalytics.com/news/nyu-large-language-model-
2023, https://www.forbes.com/sites/sethjoseph/2023/01/11/ forecasts-hospital-readmissions-length-of-stay.
under-financial-pressure-how-are-health-systems-prioritizing-
digital-health-investments/?sh=cc32a0643c20. 22. “Subtle Medical named to the 2023 CB Insights GenAI 50 List of
Most Innovative Generative AI Startups,” Pres release, August 8,
11. Patrick Frank, “Overcoming healthcare’s reluctance to 2023, https://subtlemedical.com/subtle-medical-named-to-the-
technological change,” MedCityNews, May 3, 2022, https:// 2023-cb-insights-genai-50-list-of-most-innovative-Generative-ai-
medcitynews.com/2022/05/overcoming-healthcares-reluctance- startups/.
to-technological-change/
23. “Zepp Health Unveils Generative AI-Powered Features and
12. Nikhil Sahni, George Stein, Rodney Zemmel, and David M. Cutler, Solutions for Enhanced Smart Wearables,” Press release, May
“The Potential Impact of Artificial Intelligence on Healthcare 10, 2023, https://www.prnewswire.com/news-releases/zepp-
Spending,” National Bureau of Economic Research, January 2023, health-unveils-Generative-ai-powered-features-and-solutions-for-
https://www.nber.org/papers/w30857 enhanced-smart-wearables-301821195.html.

40
 2024 Global Health Care Sector Outlook |
 Navigating transformation

24. Sundar Krishnan and Narasimha Shashidhar, “eDiscovery 32. Brian Doty and Jay Bhatt, “Generative AI holds enormous promise
Challenges in Healthcare,” International Journal of Information for health care,” Deloitte Health Forward Blog, June 27, 2023,
Security Science, Vol.8, No.2, pp.30-43, https://www.researchgate. https://www2.deloitte.com/us/en/blog/health-care-blog/2023/
net/publication/335202708_eDiscovery_Challenges_in_Healthcare generative-ai-holds-enormous-promise-for-health-care.html

25. “Healthcare Interoperability Solutions Market by Type,” Markets 33. “Blueprint for Trustworthy AI Implementation Guidance and
and Markets, https://www.marketsandmarkets.com/Market- Assurance for Healthcare,” Coalition for Health AI, April 4, 2023,
Reports/healthcare-interoperability-solution-market-17705847. https://www.coalitionforhealthai.org/papers/blueprint-for-
html?utm_source=Prnewswire&utm_medium=referral&utm_ trustworthy-ai_V1.0.pdf
campaign=paidpr
34. “EU AI Act: first regulation on artificial intelligence,” European
26. “IRENA,” Deloitte, https://www2.deloitte.com/cz/en/pages/ Parliament, August 6, 2023, https://www.europarl.europa.eu/
technology/solutions/irena.html news/en/headlines/society/20230601STO93804/eu-ai-act-first-
regulation-on-artificial-intelligence
27. Nicole Witowski, ”Retailers in healthcare: A catalyst for provider
evolution,” Definitive Healthcare, May 2023, https://www. 35. Charlotte Trueman, “UK data regulator issues warning over
definitivehc.com/sites/default/files/resources/pdfs/Retailers-in- generative AI data protection concerns,” CSOonline, April 4, 2023,
healthcare_A-catalyst-for-provider-evolution.pdf https://www.csoonline.com/article/574941/uk-data-regulator-
issues-warning-over-generative-ai-data-protection-concerns.html.
28. Ibid.
36. Aaron Hurst, “How generative AI regulation is shaping up
29. Debbie So, “From digital triage to digital humans: how generative around the world,” Information Age, July 11, 2023, https://www.
AI will transform the patient experience,” Deloitte, Thoughts from information-age.com/how-Generative-ai-regulation-shaping-up-
the Center Blog, August 9,2023, https://blogs.deloitte.co.uk/ around-world-123503911/
health/2023/09/from-digital-triage-to-digital-humans-how-
generative-ai-will-transform-the-patient-experience.html 37. Blair Levin and Larry Downes, “Who Is Going to Regulate AI?”
Harvard Business Review, May 19, 2023, https://hbr.org/2023/05/
30. Ibid. who-is-going-to-regulate-ai.
31. Hayden Field, “OpenAI is pursuing a new way to fight A.I. 38. “FACT SHEET: President Biden Issues Executive Order on Safe,
‘hallucinations,’” CNBC, May 31, 2023, https://www.cnbc. Secure, and Trustworthy Artificial Intelligence,” The White House,
com/2023/05/31/openai-is-pursuing-a-new-way-to-fight-ai- October 30, 2023, https://www.whitehouse.gov/briefing-room/
hallucinations.html#:~:text=AI%20hallucinations%20occur%20 statements-releases/2023/10/30/fact-sheet-president-biden-
when%20models%20like%20OpenAI%27s%20ChatGPT%20or%20 issues-executive-order-on-safe-secure-and-trustworthy-artificial-
Google,the%20James%20Webb%20Space%20Telescope intelligence/

41
2024 Global Health Care Sector Outlook | Navigating transformation

Addressing cost and affordability

1. “Nations where 3.3 bln live spend more on debt than health, 15. Ryan Patrick Jones, “Ontario Liberal MPP introduces bill to address
schools,” Al Jazeera, July 13, 2023, https://www.aljazeera.com/ ‘price gouging’ by temporary nursing agencies,” CBC, February 23,
news/2023/7/13/nations-where-3-3bn-live-spend-more-on-debt- 2023, https://www.cbc.ca/news/canada/toronto/liberal-bill-temp-
than-health-schools. nursing-agencies-1.6756253.

2. “State of Patient Access: 2023,” Experian Health, https://www. 16. “Key facts and figures about the NHS,” The King’s Fund, May
experian.com/healthcare/resources-insights/thought-leadership/ 4, 2023, https://www.kingsfund.org.uk/audio-video/key-facts-
white-papers-insights/state-of-patient-access-survey-2 figures-nhs.

3. Economist Intelligence Healthcare spending report. 17. Maureen Medlock, Eileen Radis, Ken Abrams, and Jay Bhatt,
“Addressing health care’s talent emergency,” Deloitte Insights,
4. “Life Expectancy of the World Population,” Worldometer, https:// November 15, 2022, https://www2.deloitte.com/uk/en/insights/
www.worldometers.info/demographics/life-expectancy/ industry/health-care/healthcare-workforce-shortage-solutions.
5. “Spending on long-term care,” OCED, November 2020, https:// html.
www.oecd.org/health/health-systems/Spending-on-long-term- 18. Hugh Pym and Caroline Alton, “Record revenue for staff agencies
care-Brief-November-2020.pdf supplying NHS,” BBC News, March 24, 2023, https://www.bbc.com/
6. Gareth Iacobucci, “Doctors strikes: Government agrees to hold news/health-65042658.
talks with consultants,” The BMJ, October 18, 2023, https://www. 19. Asif Dhar, Leslie Korenda, Jay Bhatt, Wendy Gerhardt, “Inflation
bmj.com/content/383/bmj.p2420 signals unrest ahead for health care,” Deloitte Insights, November
7. Economist Intelligence Healthcare spending report. 1, 2022, https://www2.deloitte.com/us/en/insights/industry/
health-care/health-care-affordability-inflation.html.
8. “Who profits most from America’s baffling health-care
system?” The Economist, October 8, 2023, https://www.bmj. 20. “Global healthcare benefit costs projected to jump 10% in 2023,
com/content/383/bmj.p2420 https://www.economist.com/ WTW survey finds,” Press release, WTW, October 13, 2022,
business/2023/10/08/who-profits-most-from-americas-baffling- https://www.wtwco.com/en-us/news/2022/10/global-healthcare-
health-care-system. benefit-costs-projected-to-jump-10-percentage-in-2023-wtw-
survey-finds#:~:text=The%202023%20Global%20Medical%20
9. Economist Intelligence Infant Mortality report. Trends,high%20global%20average%20of%2010%25.

10. Stacey Hughes, “Industry voices-Facing unprecedented challenges, 21. “Who profits most from America’s baffling health-care system?”
American’s hospitals and health systems need help now,” Fierce The Economist, October 8, 2023, https://www.economist.com/
Healthcare, August 26, 2022, https://www.fiercehealthcare.com/ business/2023/10/08/who-profits-most-from-americas-baffling-
hospitals/industry-voices-facing-unprecedented-challenges- health-care-system.
americas-hospitals-and-health-systems.ndustry Voices—Facing
unprecedented s 22. Ibid.

11. Leroy Leo and Bhanvi Satija, “Explainer: Why are Kaiser 23. Oliver Pieper, “Germany’s small hospitals are disappearing,”
Permanente healthcare workers on strike?” Reuters, October Deutsche Welle, December 18, 2022, https://www.dw.com/en/
5, 2023, https://www.reuters.com/business/healthcare- germanys-small-hospitals-are-disappearing/a-64128586.
pharmaceuticals/why-are-kaiser-permanente-healthcare-workers- 24. “Life Expectancy of the World Population,” Worldometer, https://
strike-2023-10-05/. www.worldometers.info/demographics/life-expectancy/
12. Jeff Lagasse, “Hospitals’ labor costs increased 258% over the 25. “Spending on long-term care,” OCED, November 2020, https://
last three years,” Healthcare Finance, March 10, 2023, https:// www.oecd.org/health/health-systems/Spending-on-long-term-
www.healthcarefinancenews.com/news/hospitals-labor-costs- care-Brief-November-2020.pdf
increased-258-over-last-three-years
26. Tariq Siddiqi, “Eight Reasons For Rising Healthcare Costs Globally,”
13. “National health expenditure trends, 2002 — Snapshot,” Canadian William Russell, April 2, 2022, https://www.william-russell.com/
Institute for Health Information, November 3, 2022, https:// blog/reasons-rising-healthcare-costs-globally/ .
www.cihi.ca/en/national-health-expenditure-trends-2022-
snapshot#refiii. 27. Celli Horstman, Evan D. Gumas, Gretchen Jacobson, “U.S. and
Global Approaches to Financing Long-Term Care: Understanding
14. Bethany Lindsay, “Nursing agencies are staffing hospitals the Patchwork,” The Commonwealth Fund, February 16, 2023,
at ‘huge cost’ to health-care system, experts say,” CBC, May https://www.commonwealthfund.org/publications/issue-
12, 2023, https://www.cbc.ca/news/health/cost-nursing- briefs/2023/feb/us-global-financing-long-term-care-patchwork.
agencies-1.6839273.

42
 2024 Global Health Care Sector Outlook |
 Navigating transformation

28. Mark Melchionna, “Virginia Health System Creates Hospital-At- 38. “NHS doctors to receive pay raise this month,” Press release,
Home Program,” Remote Monitoring News, January 24, 2023, Department of Health and Social Care, Gov.UK, September 3,
https://mhealthintelligence.com/news/virginia-health-system- 2023, https://www.gov.uk/government/news/nhs-doctors-to-
creates-hospital-at-homeprogram. receive-pay-rise-this-month.

29. “The Value in Hospital Care at Home,” Guidehouse, January 13, 39. “Making the Most of the Money: Efficiency and the Long-Term
2023, https://guidehouse.com/insights/healthcare/2022/blogs/ Plan,” NHS Providers, https://nhsproviders.org/making-the-most-
acute-hospital-care. of-the-money-efficiency-and-the-long-term-plan.

30. Cora Lydon,” Medway virtual ward strategy enables drug 40. CMS Framework for Health Equity 2022-2032, https://www.cms.
administration at home,” Digital Health, May 18, 2023, https:// gov/files/document/cms-framework-health-equity-2022.pdf.
www.digitalhealth.net/2023/05/medway-virtual-ward-strategy-
41. “National Healthcare Inequalities Improvement Programme,”
enables-drug-administration-at-home/.
NHS, https://www.england.nhs.uk/about/equality/equality-hub/
31. Jake Siegel, “Inside Taiwan’s ‘AI hospital of the future,’” Microsoft, national-healthcare-inequalities-improvement-programme/.
February 3, 2023, https://news.microsoft.com/apac/features/
42. “PAHO and FIND sign agreement to improve access to diagnostics
inside-taiwans-ai-hospital-of-the-future/.
in Latin America and the Caribbean,” Pan American Health
32. “Innovative medical developed in Israel uses AI to diagnose Organization, September 20, 2023, https://www.paho.org/en/
cardiac problems,” All Israel News, July 17, 2023, https://allisrael. news/20-9-2023-paho-and-find-sign-agreement-improve-access-
com/innovative-medical-device-developed-in-israel-uses-ai-to- diagnostics-latin-america-and-caribbean.
diagnose-cardiac-problems.
43. Dan Grunebaum, “Medical Travel Soars Past Pre-Pandemic
33. “Nations where 3.3 bln live spend more on debt than health, Numbers,” Healthcare.com, September 6, 2022, https://www.
schools,” Al Jazeera, July 13, 2023, https://www.aljazeera.com/ healthcare.com/medical-travel-soars-past-pre-pandemic-
news/2023/7/13/nations-where-3-3bn-live-spend-more-on-debt- numbers-119300.
than-health-schools.
44. “50+ Medical Tourism Statistics & Facts,” Shortlister, https://www.
34. Andrew Gregory, “Only 14% of promised Covid vaccine doses myshortlister.com/insights/medical-tourism-statistics.
reach poorest nations,” The Guardian, October 21, 2021, https://
45. Shripad Naik, “Over 1.4 mn medical tourists visited India in
www.theguardian.com/society/2021/oct/21/only-14-of-promised-
2022,” Travel World, April 18, 2023, https://travel.economictimes.
covid-vaccine-doses-reach-poorest-nations.
indiatimes.com/news/ministry/over-1-4-mn-medical-tourists-
35. “How Rwanda is using Artificial Intelligence to improve healthcare,” visited-india-in-2022-shripad-naik/99576687.
African Development Bank Group, October 6 2022, https://
46. “Medical Tourism Market Size & Share to Surpass $43.7 Billion by
www.afdb.org/en/success-stories/how-rwanda-using-artificial-
2030,” Yahoo Finance, September 5, 2023, https://finance.yahoo.
intelligence-improve-healthcare-55309.
com/news/medical-tourism-market-size-share-090000836.html.
36. “State of Patient Access: 2023,” Experian Health, https://www.
experian.com/healthcare/resources-insights/thought-leadership/
white-papers-insights/state-of-patient-access-survey-2.

37. Andy Davis, Neal Batra, Asif Dhar, and Jay Bhatt, “US health care
can’t afford health inequities,” Deloitte Insights, June 22, 2023,
https://www2.deloitte.com/us/en/insights/industry/health-care/
economic-cost-of-health-disparities.html.

43
2024 Global Health Care Sector Outlook | Navigating transformation

Responding to the looming global shortfall in health care workers

1. “Health workforce,” World Health Organization, https://www.who. 12. James Buchan, Jane Ball, Nihar Shembavnekar, Anita Charlesworth,
int/health-topics/health-workforce#tab=tab_2 “Building the NHS nursing workforce in England,” The Health
Foundation, December 2020, https://www.health.org.uk/
2. “State of Patient Access: 2023,” Experian Health, https://www. publications/reports/building-the-nhs-nursing-workforce-in-
experian.com/healthcare/resources-insights/thought-leadership/ england.
white-papers-insights/state-of-patient-access-survey-2.
13. “Massive Growth in Expenses and Rising Inflation Fuel Continued
3. “Japan projects shortage of nearly 1m medical workers by 2040,” Financial Challenges for America’s Hospitals and Health Systems,”
Nikkei Asia, July 26, 2022, https://asia.nikkei.com/Politics/Japan- American Hospital Association, April 2022, https://www.aha.
projects-shortage-of-nearly-1m-medical-workers-by-2040. org/system/files/media/file/2022/04/2022-Hospital-Expenses-
4. Evan D. Gumas, Munira Z. Gunja, Arnav Shah, Reginald D. Increase-Report-Final-Final.pdf.
Williams II, “Overworked and Undervalued: Unmasking Primary 14. “State of Patient Access: 2023,” Experian Health, https://www.
Care Physicians’ Dissatisfaction in 10 High-Income Countries,” experian.com/healthcare/resources-insights/thought-leadership/
The Commonwealth Fund, August 16, 2023, https://www. white-papers-insights/state-of-patient-access-survey-2.
commonwealthfund.org/publications/issue-briefs/2023/aug/
overworked-undervalued-primary-care-physicians-10-countries. 15. Rob Preston, “The Shortage of US Healthcare Workers in 2023,”
Oracle, January 2023, https://www.oracle.com/human-capital-
5. Maureen Medlock, Eileen Radis, Ken Abrams, and Jay Bhatt, management/healthcare-workforce-shortage/.
“Addressing health care’s talent emergency,” Deloitte Insights,
November 15, 2022, https://www2.deloitte.com/uk/en/insights/ 16. “Japan projects shortage of nearly 1m medical workers by 2040,”
industry/health-care/healthcare-workforce-shortage-solutions. Nikkei Asia, July 26, 2022, https://asia.nikkei.com/Politics/Japan-
html. projects-shortage-of-nearly-1m-medical-workers-by-2040.

6. Mathieu Boniol, Teena Kunjumen, Tapas Sadasivan Nair, Amani 17. Eren Waitzman, “Staff shortages in the NHS and social care
Siyam, James Campbell, and Khassoum Diallo, “The global health sectors,” House of Lords Library, UK Parliament, https://
workforce stock and distribution in 2020 and 2030: a threat to lordslibrary.parliament.uk/staff-shortages-in-the-nhs-and-social-
equity and ‘universal’ health coverage?” BMJ Global Health, June 17, care-sectors/.
2022, https://gh.bmj.com/content/bmjgh/7/6/e009316.full.pdf.
18. Denis Campbell, “NHS staff shortages in England could exceed
7. “Health workforce,” World Health Organization, https://www.who. 570,000 by 2036, leaked document warns,” The Guardian, March
int/health-topics/health-workforce#tab=tab_2. 26, 2023, https://www.theguardian.com/society/2023/mar/26/
nhs-england-staff-shortages-could-exceed-570000-by-2036-
8. “India’s shortage of doctors, nurses may hamper COVID19 study-finds.
response,” IndiaSpend, March 27, 2020, https://www.indiaspend.
com/indias-shortage-of-doctors-nurses-may-hamper-covid19- 19. Megha Kaveri, “WHO Raises Alarm Over Increased Healthcare
response/. Worker Migration to Rich Countries Post Pandemic,” Health Policy
Watch, March 14,2023, https://healthpolicy-watch.news/eight-
9. “Global Per Diem Nurse Staffing Market Size and Share country-healthcare-workers-migration/.
Analysis - Growth Trends and Forecasts (2023 - 2030),”
Research and Markets, October 2023, https://www. 20. “The 8th Annual Apollo Global Healthcare Predictions,”
researchandmarkets.com/report/temporary-medical- Apollo Intelligence, https://apollointelligence.net/wp-content/
staffing?utm_source=BW&utm_medium=PressRelease&utm_ uploads/2023/02/2023-Apollo-Healthcare-Predictions-
code=9sqn2j&utm_campaign=1872685+-+Increasing+Dem Report2.16.23.pdf.
and+for+Healthcare+Facilities+and+Lack+of+Skilled+Health
21. “Medscape Physician Burnout & Depression Report,” American
care+Staff+Drive+Global+Per+Diem+Nurse+Staffing+Market
Medication Institute, July-August 2023, https://issuu.com/
+to+Reach+%2413.58+Billion+by+2030&utm_exec=jamu273prd.
americanmeditation/docs/26_6_julyaugust_2023/s/27174991.
10. “Healthcare Staffing Market Size, Share & Trends Analysis
22. The 8th Annual Apollo Global Healthcare Predictions,” Apollo
Report By Service Type (Travel Nurse, Per Diem Nurse, Locum
Intelligence, https://apollointelligence.net/wp-content/
Tenens, Allied Healthcare), By End-use, By Region And Segment
uploads/2023/02/2023-Apollo-Healthcare-Predictions-
Forecasts, 2023-2030,” Grand View Research, https://www.
Report2.16.23.pdf.
grandviewresearch.com/industry-analysis/healthcare-staffing-
market 23. D Ram Nakipuria, “IMA Survey: Majority Of Indian Doctors Are
Stressed Out Of Medical Profession,” Docplexus, https://www.
11. “Why Is There a Shortage of Healthcare Workers in the UK?” Cairn
docplexus.com/posts/ima-survey-majority-of-indian-doctors-are-
Technology Ltd., March 14, 2023, https://cairntechnology.com/
stressed-out-of-medical-profession.
why-shortage-healthcare-uk/.

44
 2024 Global Health Care Sector Outlook |
 Navigating transformation

24. Evan D. Gumas, Munira Z. Gunja, Arnav Shah, Reginald D. 34. Michael C Tasi 1 , Aakash Keswani, Kevin J Bozic, “Does physician
Williams II, “Overworked and Undervalued: Unmasking Primary leadership affect hospital quality, operational efficiency, and
Care Physicians’ Dissatisfaction in 10 High-Income Countries,” financial performance?,” Health Care Management Review, July/
The Commonwealth Fund, August 16, 2023, https://www. September 2019, https://pubmed.ncbi.nlm.nih.gov/28700509.
commonwealthfund.org/publications/issue-briefs/2023/aug/
35. Kari Redfield, “Physician salary report 2023: Physician income
overworked-undervalued-primary-care-physicians-10-countries.
continues to rise,” Weatherby Healthcare, July 25, 2023, https://
25. Leslie Read, Heather Nelson, and Leslie Korenda, “Rebuilding trust weatherbyhealthcare.com/blog/annual-physician-salary-
in health care,” Deloitte Insights, August 5, 2021, https://www2. report#:~:text=The%20average%20physician%20income%20
deloitte.com/us/en/insights/industry/health-care/trust-in-health- was,compared%20to%20%24260%2C000%20in%202022
care-system.html.
36. Bridgette Watson, “B.C. launching new payment model for family
26. Maureen Medlock, Eileen Radis, Ken Abrams, and Jay Bhatt, doctors in 2023,” CBC News, October 31, 2022, https://www.
“Addressing health care’s talent emergency,” Deloitte Insights, cbc.ca/news/canada/british-columbia/bc-doctor-supports-
November 15, 2022, https://www2.deloitte.com/uk/en/insights/ announcement-1.6635200#:~:text=Family%20physicians%20
industry/health-care/healthcare-workforce-shortage-solutions. will%20be%20getting,Doctors%20of%20B.C.%20last%20week. “
html.
37. “NHS Doctors in England Awarded Marginal Pay Increase,” IMG
27. Leslie Read, Heather Nelson, and Leslie Korenda, “Rebuilding trust Connect, September 25 2023, https://www.imgconnect.co.uk/
in health care,” Deloitte Insights, August 5, 2021, https://www2. news/2023/08/nhs-doctors-in-england-awarded-marginal-pay-
deloitte.com/us/en/insights/industry/health-care/trust-in-health- increase/384.
care-system.html.
38. Ben Ireland,””Junior doctors and consultants to strike on the
28. Jeff Lagasse, “Hospitals’ labor costs increased 258% over the same days this autumn,” British Medical Association, August 31,
last three years,” Healthcare Finance, March 10, 2023, https:// https://www.bma.org.uk/news-and-opinion/junior-doctors-and-
www.healthcarefinancenews.com/news/hospitals-labor-costs- consultants-to-strike-on-same-days-this-autumn
increased-258-over-last-three-years
39. Brian Doty and Jay Bhatt, “Generative AI holds enormous promise
29. “Massive Growth in Expenses and Rising Inflation Fuel Continued for health care,” Deloitte Health Forward Blog, June 27, 2023,
Financial Challenges for America’s Hospitals and Health Systems,” https://www2.deloitte.com/us/en/blog/health-care-blog/2023/
American Hospital Association, April 2022, https://www.aha. generative-ai-holds-enormous-promise-for-health-care.html
org/system/files/media/file/2022/04/2022-Hospital-Expenses-
40. Shania Kennedy, “HCA Healthcare Launches AI-Enabled Ambient
Increase-Report-Final-Final.pdf
Documentation Partnership,” Health IT Analytics, April 20, 2023,
30. Paul J. Zak, “The Neuroscience of Trust,” Harvard Business Review, https://healthitanalytics.com/news/hca-healthcare-launches-ai-
January-February 2017, https://hbr.org/2017/01/the-neuroscience- enabled-ambient-documentation-partnership
of-trust.
41. Maria Deutscher, “Carbon Health launches medical charting tool
31. Maureen Medlock, Eileen Radis, Ken Abrams, and Jay Bhatt, powered by GPT-4,” Silicon Angle, June 5, 2023, https://siliconangle.
“Addressing health care’s talent emergency,” Deloitte Insights, com/2023/06/05/carbon-health-launches-medical-charting-tool-
November 15, 2022, https://www2.deloitte.com/uk/en/insights/ powered-gpt-4/.
industry/health-care/healthcare-workforce-shortage-solutions.
42. “6 considerations for building a sustainable healthcare
html.
workforce,” Deloitte, February 17, 2023, https://action.deloitte.
32. Paul Atkins, Kimberly R. Enard, Kim Griffin-Hunter, and Diane com/insight/3167/6-considerations-for-building-a-sustainable-
Howard, “Amplifying Black voices,” Deloitte Insights, July 22, 2021, healthcare-workforce.
https://www2.deloitte.com/us/en/insights/industry/health-care/
diversity-in-healthcare-workforce.html.

33. Howard Drenth, Hemnabh Varia, and Shaun Rangappa, “Evolving

the team-based care model,” Deloitte Insights, September 8, 2022,
https://www2.deloitte.com/us/en/insights/industry/health-care/
team-based-care.html.

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2024 Global Health Care Sector Outlook | Navigating transformation

The role of social care

1. “Next steps to put people at the heart of care,” Department of 13. “Strengthening the direct care workforce,” Administration for
Health & Social Care, April 4, 2023, https://assets.publishing. Community Living, September 7, 2023, https://acl.gov/programs/
service.gov.uk/government/uploads/system/uploads/attachment_ direct-care-workforce
data/file/1148559/next-steps-to-put-people-at-the-heart-of-
14. “National Health Service Corps Loan Repayment Program,” US
care_a-plan-for-adult-social-care-system-reform-2023-to-2024-
Department of Health and Human Services, February 2023,
and-2024-to-2025.pdf
https://nhsc.hrsa.gov/sites/default/files/nhsc/loan-repayment/
2. “Strengthening the direct care workforce,” Administration for lrp-application-guidance.pdf
Community Living, September 7, 2023, https://acl.gov/programs/
15. “Giving care,” Canadian Centre for Caregiving Excellence, https://
direct-care-workforce
canadiancaregiving.org/wp-content/uploads/2022/11/CCCE_
3. Darren Major and Olivia Stefanovich, ”Judge approves historic Giving-Care.pdf
$23B First Nations child welfare compensation agreement,”
16. “Government sets out next steps to support social care,” Gov.uk,
CBC News, October 23, 2023, https://www.cbc.ca/news/
April 4, 2023, https://www.gov.uk/government/news/government-
politics/judge-approves-23-billion-first-nations-child-welfare-
sets-out-next-steps-to-support-social-care
agreement-1.7006351
17. ibid
4. “Social spending,” OECD, Accessed October 8, 2023, https://data.
oecd.org/socialexp/social-spending.htm 18. “The State of the State 2022-23,” Deloitte, https://www2.deloitte.
com/content/dam/Deloitte/uk/Documents/sots-22/deloitte-uk-
5. ibid
state-of-the-state-2022-23.pdf
6. Kulleni Gebreyes, Jessica Perez, David Rabinowitz, and Dr.
19. Fanny Gauret, “How is Europe addressing challenges in long-term
Elizabeth Baca, “Activating health equity,” Deloitte, April 12, 2021,
care?” Euronews, February 23, 2023, https://www.euronews.com/
https://www2.deloitte.com/us/en/insights/industry/health-care/
next/2023/02/22/how-is-europe-addressing-challenges-in-long-
developing-an-agenda-of-equity-in-health.html
term-care
7. “Social drivers of sustainable development,” United Nations
20. “A European Care Strategy for caregivers and care receivers,”
Research Institute for Social Development, February 2014, https://
European Commission, https://ec.europa.eu/commission/
sustainabledevelopment.un.org/content/documents/1213unrisd.
presscorner/detail/en/ip_22_5169
pdf
21. “Communication from the commission to the European
8. William D. Eggers, Beth McGrath, and Jason Salzetti, “The nine
Parliament, the Council, the European Economic and
trends reshaping government in 2023,” Deloitte, https://www2.
Social Committee and the Committee of the regions on the
deloitte.com/us/en/insights/industry/public-sector/government-
European Care Strategy,” European Commission, September
trends.html
7 2022, https://eur-lex.europa.eu/legal-content/EN/
9. William D. Eggers, Jean Gil Barroca, David Noone, Pankaj Kishnani, TXT/?uri=CELEX%3A52022DC0440
and Mahesh Kelkar, “The digital citizen,” https://www2.deloitte.
22. “Government sets out next steps to support social care,” Gov.uk,
com/content/dam/insights/articles/in176014_cgi_digital-citizen-
April 4, 2023, https://www.gov.uk/government/news/government-
survey/DI_Digital-citizen-global.pdf
sets-out-next-steps-to-support-social-care
10. “Health at a glance 2021: OECD indicators,” OECD iLibrary, https://
23. “Determinants of health for Indigenous Australians,” Australian
www.oecd-ilibrary.org/sites/8218c4fe-en/index.html?itemId=/
Institute of Health and Welfare, July 7, 2022, https://www.aihw.gov.
content/component/8218c4fe-en
au/reports/australias-health/social-determinants-and-indigenous-
11. “Value gender and equity in the global health workforce,” World health
Health Organization, https://www.who.int/activities/value-gender-
24. Services Australia, Annual Report 2022-23, https://www.
and-equity-in-the-global-health-workforce#:~:text=The%20
servicesaustralia.gov.au/sites/default/files/2023-10/annual-
health%20and%20social%20sector,the%20world%2C%20
report-2022-23.pdf
particularly%20of%20women.
25. Health Prism, Deloitte, https://www2.deloitte.com/us/en/pages/
12. “Sweden’s first national carers strategy,” Euro Carers, April
public-sector/solutions/predict-better-act-faster-solution.html
28, 2022, https://eurocarers.org/swedens-first-national-
carers-strategy/#:~:text=The%20Swedish%20government%20 26. Zach Winn, ”Fighting poverty with direct cash payments,” MIT
recently%20launched,more%20equal%20across%20the%20 News Office, August 16, 2022, https://news.mit.edu/2022/
country. givedirectly-cash-charity-0816

46
2024 Global Health Care Sector Outlook | Navigating transformation

A sustainable future

1. “The global health cost of PM2.5 air pollution: A case for action 11. “Act now: Future Scenarios and the case for equitable climate
beyond 2021,” World Bank Group eLibrary, April 22, 2022, https:// action,” Deloitte, https://www2.deloitte.com/us/en/pages/about-
elibrary.worldbank.org/doi/abs/10.1596/978-1-4648-1816-5. deloitte/articles/monitor-institute-climate-scenarios.html.

2. Pallavi Rao, Visualizing the $105 trillion world economy in 12. ibid.
one chart,” Visual Capitalist, August 9, 2023, https://www.
13. Dr. Elizabeth Baca, Neal Batra, Michael Joseph Johnson, and Jay
visualcapitalist.com/visualizing-the-105-trillion-world-economy-in-
Sekhon, “ Why climate resilience is key to building the health care
one-chart/#:~:text=By%20the%20end%20of%202023,2023%20
organization of the future,” Deloitte Insights, April 4, 2022, https://
World%20Economic%20Outlook%20report.
www2.deloitte.com/us/en/insights/industry/health-care/climate-
3. “Air pollution costs each American $2,500 a year in healthcare change-and-health.html
– study,” World Economic Forum, June 1, 2023, https://www.
14. “The journey of transformation begins with a single step,” Deloitte,
weforum.org/agenda/2021/06/air-pollution-cost-america-
https://www.deloitte.com/content/dam/assets-shared/docs/gx-
healthcare-study.
deloitte-overview.pdf.
4. “IKEA awards $52 million to bolster Indian health care with solar
15. “New case study: Shefaa Al-Orman Oncology Hospital energy
power,” Candid, April 11, 2023, https://philanthropynewsdigest.
reduction program,” Global Green and Healthy Hospitals, August
org/news/ikea-awards-52-million-to-bolster-indian-health-care-
16, 2023, https://greenhospitals.org/news/new-case-study-
with-solar-power.
shefaa-al-orman-oncology-hospital-energy-reduction-program.
5. Joanne Rose, “KPJ and Gentari partner for sustainable healthcare
16. “Safe haven in the storm,” Health Care Without Harm, January
solutions,” Solar Quarter, July 11, 2023, https://solarquarter.
2018, https://noharm-uscanada.org/sites/default/files/
com/2023/07/11/kpj-healthcare-and-gentari-partner-for-
documents-files/5146/Safe%20Haven.pdf.
sustainable-healthcare-solutions/.
17. “Decarbonising the Healthcare Sector: A Roadmap for G20
6. “New case study: Shefaa Al-Orman Oncology Hospital energy
Countries,” Observer Research Foundation, June 28, 2023, https://
reduction program,” Global Green and Healthy Hospitals, August
www.orfonline.org/research/decarbonising-the-healthcare-
16, 2023, https://greenhospitals.org/news/new-case-study-
sector/.
shefaa-al-orman-oncology-hospital-energy-reduction-program.
18. ibid
7. Aimée-Noël Mbiyozo, “East Africa and the Horn light the way
for climate migrants,” Institute for Security Studies, September 19. ibid
27, 2022, https://issafrica.org/iss-today/east-africa-and-the-
horn-light-the-way-for-climate-migrants#:~:text=Climate%20 20. “Our green plan: 2020 to 2025,” University Hospital Southampton,
change%20is%20a%20crucial,sub%2DSaharan%20Africa%20 https://www.uhs.nhs.uk/Media/UHS-website-2019/Docs/uhs-
by%202050. green-plan-2022-2025-1.pdf.

8. “U.S. energy-related carbon dioxide emissions,” US Energy 21. “UHS to reduce carbon emissions with new energy-efficient
Information Administration, December 14, 2022, https://www.eia. heating system thanks to £29.4m grant,” University Hospital
gov/environment/emissions/carbon/. Southampton, March 22, 2023, https://www.uhs.nhs.uk/whats-
new/press-releases/uhs-to-reduce-carbon-emissions-with-new-
9. “Is Europe reducing its greenhouse gas emissions?” European energy-efficient-heating-system-thanks-to-29.4m-grant.
Environment Agency, June 22, 2022, https://www.eea.
europa.eu/themes/climate/eu-greenhouse-gas-inventory/ 22. “Valley Children’s commitment to energy resilience
is-europe-reducing-its-greenhouse#:~:text=The%20EU%20 and environmental stewardship,” Valley Children’s
has%20a%20set,were%2034%20%25%20below%201990%20 Healthcare, https://www.valleychildrens.org/about-us/
levels.&text=Emissions%20have%20decreased%20in%20 sustainability#:~:text=Valley%20Children’s%20Healthcare%2C%20
almost,industry%20and%20the%20residential%20sector. the%20leading,improved%20air%20quality%20in%20the.

10. “Climate Change,” World Health Organization, October 12, 2023, 23. Jordan Wolman, “Newsom signs first-in-the-nation corporate
https://www.who.int/news-room/fact-sheets/detail/climate- climate disclosure bills,” Politico, October 7, 2023, https://www.
change-and-health#:~:text=Research%20shows%20that%20 politico.com/news/2023/10/07/newsom-california-climate-
3.6%20billion,diarrhoea%20and%20heat%20stress%20alone. disclosure-00120474.

47
 2024 Global Health Care Sector Outlook |
 Navigating transformation

24. “India launches first carbon neutral hospital in Bengaluru with 30. Anastasios Sepetis, Paraskevi N. Zaza, Fotios Rizos, and Pantelis G.
investment of Rs 1,200 Cr,” BioSpectrum India, January 28, Bagos, “Identifying and Predicting Healthcare Waste Management
2023, https://www.biospectrumindia.com/news/98/22547/ Costs for an Optimal Sustainable Management System: Evidence
india-launches-first-carbon-neutral-hospital-in-bengaluru-with- from the Greek Public Sector,” Int J Environ Res Public Health,
investment-of-rs-1200-cr.html. August 2022, https://www.ncbi.nlm.nih.gov/pmc/articles/
PMC9408452/#:~:text=In%202022%2C%20the%20WHO%20
25. “Decarbonising the Healthcare Sector: A Roadmap for G20 %5B54,basic%20services%20to%20handle%20HCW.
Countries,” Observer Research Foundation, June 28, 2023, https://
www.orfonline.org/research/decarbonising-the-healthcare- 31. “Putting anaesthetic-generated emissions to bed,” NHS England,
sector/. https://www.england.nhs.uk/greenernhs/whats-already-
happening/putting-anaesthetic-generated-emissions-to-bed/.
26. “Delivering a net zero National Health Service,” National Health
Service, October 2020, https://www.england.nhs.uk/greenernhs/ 32. “Hunger data and research,” California Association of Food Banks,
wp-content/uploads/sites/51/2020/10/delivering-a-net-zero- https://www.cafoodbanks.org/hunger-data/.
national-health-service.pdf.
33. “Accelerating Health Equity and Business Resilience through
27. “Accelerating the delivery of net zero health systems,” Sustainable Decarbonization,” Commonwealth Fund, the Black Directors
Markets Initiative, November 2022, https://a.storyblok.com/ Health Equity Agenda, and Deloitte Consulting LLP, https://
f/109506/x/96fc198cb8/smi-hstf-executive-summary.pdf. bdhea.org/wp-content/uploads/2022/06/Playbook-Update-
Handout-6.2022.pdf
28. Edyta Janik-Karpinska, Rachele Brancaleoni, Marcin Niemcewicz,
Wiktor Wojtas, Maurizio Foco, Marcin Podogrocki, and Michal 34. “Geneva Sustainability Centre launches Sustainability Accelerator
Bijak, “Healthcare waste—a serious problem for global health,” Tool for hospitals,” International Hospital Federation, https://ihf-
Healthcare (Basel), January 2023, https://www.ncbi.nlm.nih.gov/ fih.org/press-and-media/geneva-sustainability-centre-launches-
pmc/articles/PMC9858835/. sustainability-accelerator-tool-for-hospitals/.

29. “Health-care waste,” World Health Organization, February 8, 2018, 35. “APIC Announces Creation of Health Equity Fund,” Association for
https://www.who.int/news-room/fact-sheets/detail/health-care- Professionals in Infection Control and Epidemiology, June 26, 2023,
waste#:~:text=High%2Dincome%20countries%20generate%20 https://apic.org/apic-announces-creation-of-health-equity-fund/.
on,generate%20on%20average%200.2%20kg.

48
About Deloitte’s Global Health Care Sector Group
Together, evolving health
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