Self-service aspects of health maintenance: assessment of current trends

Costs of traditional health services are increasing faster than their productivity and quality in most developed countries. This process is part of a broader trend: increasing costs of services in general, relative to growth of productivity and quality. In some service sectors, these trends are increasingly counterbalanced by perceptible shifts toward self-help, self-service, and voluntarism. Such services as health maintenance are much slower to respond in a similar way because of their ingrained ‘external service’ nature. One reason is that traditional health services only secondarily stress illness prevention and health maintenance, and concentrate on professional delivery of ‘sick-care’ rather than health care. Illness prevention remains the responsibility of each individual to be met through self-help. We argue – using simplified analytic models – that a shift toward more emphasis on self-service and self-help in maintaining health is likely and will increase the average number of disability-free years of life in a community. We discuss the implications of new self-help supporting products and technologies facilitating mutual support and aid in health maintenance.