The large and growing human and financial cost of dementia provides an imperative for policy action. It is already the second largest cause of disability for the over-70s and it costs $645bn per year globally, and ageing populations mean that these costs will grow.
There is no cure or effective treatment for dementia, and too often people do not get appropriate health and care services, leading to a poor quality of life. Our failure to tackle these issues provides a compelling illustration of some of today’s most pressing policy challenges. We need to rethink our research an innovation model, since progress on dementia has stalled and investment is just a fraction of what it is for other diseases of similar importance and profile. But even then a cure will be decades away, so we need better policies to improve the lives of people living with dementia now. Communities need to adjust to become more accommodating of people with dementia and families who provide informal care must be better supported. Formal care services and care institutions need to promote dignity and independence, while coordination of health and care services must be improved. But there is hope: if we can harness big data we may be able to address the gaps in our knowledge around treatment and care.
OECD countries are developing strategies to improve the quality of life of those affected by dementia and to support long-term efforts for a disease-modifying therapy or cure. The OECD jointly hosted an international workshop in Toronto with the Ontario Brain Institute (OBI) and the Institute of Health Policy, Management and Evaluation (IHPME), University of Toronto on 14-15 September 2014. The aim of the workshop was to advance international discussion of the opportunities and challenges, as well as successful strategies, for sharing and linking the massive amounts of population-based health and health care data that are routinely collected (broad data) with detailed clinical and biological data (deep data) to create an international resource for research, planning, policy development, and performance improvement. The workshop brought together leading researchers and academics, industry and non-government experts to provide new insights into the opportunities and challenges in making “broad and deep” data a reality – from funding to data standards, to data sharing, to new analytics, to protecting privacy, and to engaging with stakeholders and the public. Government leadership and public-private partnership will be needed to create and sustain big data resources, including financing for data infrastructure and incentives for data sharing.
This report reviews the quality of health care in Italy, seeks to highlight best practices, and provides a series of targeted assessments and recommendations for further improvements to quality of care. Italy’s indicators of health system outcomes, quality and efficiency are uniformly impressive. Life expectancy is the fifth highest in the OECD. Avoidable admission rates are amongst the very best in the OECD, and case-fatality after stroke or heart attack are also well below OECD averages. These figures, however, mask profound regional differences. Five times as many children in Sicily are admitted to hospital with an asthma attack than in Tuscany, for example. Despite this, quality improvement and service redesign have taken a back-seat as the fiscal crisis has hit. Fiscal consolidation has become an over-riding priority, even as health needs rapidly evolve. Italy must urgently prioritise quality of its health care services alongside fiscal sustainability. Regional differences must be lessened, in part by giving central authorities a greater role in supporting regional monitoring of local performance. Proactive, coordinated care for people with complex needs must be delivered by a strengthened primary care sector. Fundamental to each of these steps will be ensuring that the knowledge and skills of the health care workforce are best matched to needs.
Au cours des dernières décennies, l’Italie a considérablement amélioré la qualité de ses soins de santé, mais elle doit encore réduire les fortes disparités régionales qui subsistent, selon une nouvelle étude de l’OCDE.
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Despite cuts in recent years, health spending as a share of GDP in Ireland remains slightly higher than the EU average and pharmaceutical spending in particular remains relatively high.
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Le poids des dépenses hospitalières dans les dépenses de santé s’avère très élevé en France malgré des efforts pour développer des modes de prise en charge moins coûteux.
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Progress has been made to reduce smoking rates and alcohol consumption in Germany, but obesity is on the rise as in most other EU countries. As in other EU countries, spending for prevention in Germany accounts only for around 3% of current health spending.
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Excellent population health status and good outcomes associated with acute care reflect a high-performing health system in Norway. Norway’s good health system comes at a cost – Norway’s per capita health expenditure is the highest in Europe.
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The number of doctors in the UK has grown more rapidly than in any other EU countries since 2000; the number per capita remains lower than the EU average. There has been a sharp drop in deaths from heart attacks in the UK since 2000, reflecting reductions in important risk factors like smoking and better treatments.
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Italy's indicators of health status and quality of care remain among the best in the EU. Italy spent 9.2% of its GDP on health in 2012, slightly more than the EU average of 8.7%.