The book presents a background study of DRG-based payment systems, drawing on the experience of implementing such hospital funding arrangements internationally, including an overview of developments in the Asia and Pacific region. It underscores the need for countries to be clear about their purpose and objective for introducing Diagnosis Related Groups, as well as their place in health-care financing reform, and for policy-makers to reflect on the importance of country-specific starting points, objectives and context in which the hospital payment reforms are being implemented. Chapter 4 – written by Yuki Murakami and Luca Lorenzoni – investigates the evidence regarding the impact on cost, quality and efficiency of the introduction of a DRG-based payment system.
The global fleet of powered two-wheelers (PTWs) is constantly increasing. In many countries, motorcycles, scooters and mopeds play a significant role in mobility, particularly in many of the world’s large cities. As such, PTWs are becoming an important component of the transport system. However, they represent an important challenge for road safety. PTW riders are at far more risk than car drivers per kilometre ridden in terms of fatalities and severe injuries entailing long-term disability. Moreover, they have not benefited from safety improvements at the same pace as car occupants over recent decades. Addressing the issue of PTW safety is thus an essential contribution to the success of the United Nations’ Decade of Action for Road Safety, which aims at halving the expected number of road deaths worldwide by 2020.
This report reviews recent trends in powered two-wheeler crashes, the factors contributing to these crashes and their severity. It describes a set of countermeasures targeting user behaviours, the use of protective equipment, the vehicles and the infrastructure. Finally, it discusses motorcycle safety strategies in the context of a safe system.
All countries are investing in health data. There are however significant cross-country differences in data availability and use. Some countries stand out for their innovative practices enabling privacy-protective data use while others are falling behind with insufficient data and restrictions that limit access to and use of data, even by government itself. Countries that develop a data governance framework that enables privacy-protective data use will not only have the information needed to promote quality, efficiency and performance in their health systems, they will become a more attractive centre for medical research. After examining the current situation in OECD countries, a multi-disciplinary advisory panel of experts identified eight key data governance mechanisms to maximise benefits to patients and to societies from the collection, linkage and analysis of health data and to, at the same time, minimise risks to the privacy of patients and to the security of health data. These mechanisms include coordinated development of high-value, privacy-protective health information systems, legislation that permits privacy-protective data use, open and transparent public communication, accreditation or certification of health data processors, transparent and fair project approval processes, data de-identification and data security practices that meet legal requirements and public expectations without compromising data utility and a process to continually assess and renew the data governance framework as new data and new risks emerge.
Tackling mental ill-health of the working-age population is becoming a key issue for labour market and social policies in OECD countries. OECD governments increasingly recognise that policy has a major role to play in keeping people with mental ill-health in employment or bringing those outside of the labour market back to it, and in preventing mental illness. This report on Austria is the eighth in a series of reports looking at how the broader education, health, social and labour market policy challenges identified in Sick on the Job? Myths and Realities about Mental Health and Work (OECD, 2012) are being tackled in a number of OECD countries. It concludes that the Austrian system provides good opportunities in principle for improving labour market inclusion of people with mental ill-health but that structural fragmentation of responsibilities limits the means of the federal government to develop coherent health and work policies. Successful structural reform requires including a range of actors responsible for policy implementation to achieve coordination across institutions and better integrated service delivery.
Dans un nouveau rapport, l’OCDE indique que l’Autriche doit faire davantage pour aider les personnes présentant des troubles de la santé mentale à trouver un emploi ou à rester sur le marché du travail.
Les coûts des soins de santé augmentent si rapidement dans les économies avancées qu’en l’absence de réformes, ils atteindront un niveau intenable d’ici à 2050, d’après un nouveau rapport de l'OCDE.
The health systems we enjoy today, and expected medical advances in the future, will be difficult to finance from public resources without major reforms. Public health spending in OECD countries has grown rapidly over most of the last half century. These spending increases have contributed to important progress in population health: for example, life expectancy at birth has increased, rising on average by ten years since 1970. The challenge now is to sustain and enhance these achievements in a context of tight fiscal constraints in many countries combined with upward pressure on health spending from factors such as new technological advances and demographic changes. Finding policies that can make health spending more sustainable without compromising important achievements in access and quality requires effective co-operation between health and finance ministries. Sound governance and co-ordination mechanisms are therefore essential to ensure effective policy choices. Prepared by both public finance and health experts, this report provides a unique detailed overview of institutional frameworks for financing health care in OECD countries. One of the main features of this book is a comprehensive mapping of budgeting practices and governance structure in health across OECD countries.
La mauvaise santé mentale fait payer un lourd tribut aux personnes concernées, aux entreprises et à l’économie de manière générale. Les problèmes de santé mentale sont à l’origine d’une perte très importante de l’offre potentielle de main-d’œuvre, de taux élevés de chômage et engendrent des absences maladie et une baisse de productivité au travail. Ce rapport de synthèse, qui fait suite à un rapport introductif (« Mal-être au travail ? Mythes et réalités sur la santé mentale et l'emploi ») et à neuf études par pays, propose un résumé des résultats recueillis dans les pays qui ont participé à l’étude et avance des arguments en faveur d’une intervention plus forte des pouvoirs publics.
The book introduces several models for assessing health and economic policies in relation to NCDs; shows how the models can be used for different diseases or risk factors; and provides case studies of those models’ application in various countries in the Americas. The ultimate goal is to help policymakers find the best strategies for cost-effective and evidence-based NCD interventions.
The results of the survey provide a useful overview of quality strategies and policies, and show increasing commitment to quality of care in the Asia/Pacific region. The outcome of this study confirms the importance of the WHO-OECD expert network to facilitate communication/dissemination of evidence on quality improvement programmes and policies among countries.