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The health system in Spain stands out for its impressive life gains during the past decades. Across OECD countries, Spain currently ranks second in terms of life expectancy at birth and at 65 years old, only behind Japan. However, factors such as a high share of out of pocket spending or a relatively low level of health professionals continue to impair higher health system performance.
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Despite financial strains, Portugal has shown a great level of commitment towards improving the quality and efficiency of its health system while maintaining a universal public system. However, although progress has been achieved, certain areas demand further scrutiny such as access to health care services – especially among the most vulnerable population – quality of care, healthier lifestyles and the long-term care system.
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Latvia’s health system broadly delivers effective care to the population within a context of significantly fewer resources compared to most OECD countries. However, there are important challenges to maintain and improve the performance of its health system.
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Japan continues to enjoy strong health outcomes and the longest life expectancies in the OECD. Its health spending has risen more quickly than in other OECD countries in recent years, partly due to population ageing. Within tight fiscal constraints, Japan must ensure the financial sustainability of its health system while orienting it toward an increasingly older population.
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Although the annual growth rate in health spending in Iceland is now close to zero, health expenditure per capita remains largely above the OECD average. Iceland reports good health outcomes and tobacco and alcohol consumption are relatively low. Increasing obesity rates, problems in access to care and poor quality of hospital care, however, are important challenges threatening the health of the Icelandic population.
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The Luxembourg health care system achieves good results relatively efficiently. Luxembourg is, however, lagging behind other OECD countries with high volume of antibiotics prescribed and high rates of avoidable hospital admissions. Population ageing and increasing risk factors are other important challenges that demand further scrutiny.
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The Austrian health system generally provides good access to health care services through a relatively high degree of human and physical resources. However, primary care could be strengthened in order to avoid unnecessary hospitalisations and a stronger focus on mental ill-health is needed. Efforts are also required to prevent the spread of risk factors such as harmful alcohol and tobacco consumption.
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The Estonian health system has relatively high numbers of doctors, hospital beds and medical services, in spite of modest levels of financial resources for health (6% of GDP in 2014). The outcomes are however mixed compared to other OECD countries.
Latest estimates point to slowly rising health spending growth, according to OECD Health Statistics 2016. While health spending growth remains somewhat below pre-crisis rates, it has tended to follow economic growth more closely since 2013. This is in contrast to the years leading up to the economic crisis, when growth in health spending strongly outpaced that in the rest of the economy.
The objective of the HCQI Project is to develop a set of indicators based on comparable data and which can be used to raise questions for further investigation on quality differences across countries.