Health systems in the United Kingdom have, for many years, made the quality of care a highly visible priority, internationally pioneering many tools and policies to assure and improve the quality of care. A key challenge, however, is to understand why, despite being a global leader in quality monitoring and improvement, the United Kingdom does not consistently demonstrate strong performance on international benchmarks of quality. This report reviews the quality of health care in the England, Scotland, Wales and Northern Ireland, seeking to highlight best practices, and provides a series of targeted assessments and recommendations for further quality gains in health care. To secure continued quality gains, the four health systems will need to balance top-down approaches to quality management and bottom-up approaches to quality improvement; publish more quality and outcomes data disaggregated by country; and, establish a forum where the key officials and clinical leaders from the four health systems responsible for quality of care can meet on a regular basis to learn from each other’s innovations.
This review assesses the Mexican pension system according to the OECD best practices and guidelines, and draws on international experiences and examples to make recommendations on how to improve it. It provides an international perspective on Mexico’s retirement income provision and a short and focused review of the Mexican pension system. The review covers all components of the pension system: public and private pension provision for public and private-sector workers. It provides recommendations, using OECD’s best practices in pension design, on how to improve the Mexican pension system and thus ameliorate the retirement income that people may receive from the pension system.
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Israel has built a good healthcare system, combining universal coverage with a degree of competition and choice. However, some risks remain, at least in the medium term.
OECD countries are increasingly attempting to achieve savings through their public procurement systems, in particular in healthcare. In 2012, the State’s Employees’ Social Security and Social Services Institute in Mexico (ISSSTE) asked the OECD to review the effectiveness and integrity of its procurement system and to address bid-rigging. Many of the OECD’s recommendations led to enduring reforms at ISSSTE. In 2015 the OECD conducted a new review focusing on planning and coordination of procurement activities, market research and improvement of medical services. This report presents the findings of the review and notes the ISSSTE’s recent achievements. It also makes recommendations to support the alignment of the ISSSTE’s procurement practices with the 2015 OECD Recommendation of the Council on Public Procurement and includes action plans for priority activities.
Colombia has made major economic and social advances in recent years. The combination of strong economic growth and policies targeted at the most vulnerable groups improved considerably the living standards of the Colombian population. Today, the country enjoys higher employment and labour force participation rates than the average of OECD countries and unemployment is steadily declining. Nevertheless, despite these positive trends, deep structural problems remain. Labour informality is widespread, the rate of self-employment is high and many employees have non-regular contracts. Income inequality is higher than in any OECD country and redistribution through taxes and benefits is almost negligible. In addition, half a century of internal conflict and violence has displaced a significant part of the population, and many of them are living in extreme poverty. Despite considerable progress, violence continues to be a challenge and also affects trade union members and leaders. The Colombian Government has undertaken important reforms in recent years to address these labour market and social challenges, and the efforts are gradually paying off. However, further progress is needed to enhance the quality of jobs and well-being for all. The main trust of this report is to support the Colombian Government in tackling labour market duality, generate trust between the social partners, develop inclusive and active social policies, and get the most out of international migration.
A decade ago we published the first OECD Health System Review of Mexico. Since then, a great deal has changed, and for the better. Over the last 10 years, the publicly-subsidised health insurance plan (Seguro Popular) has extended coverage to more than 50 million people who were previously unprotected. Health service users today report a satisfaction rate of 97%.
Ten years after the introduction of publically-funded universal health insurance, the Mexican health system finds itself at a critical juncture. Unquestionably, some measures of health and health system performance have improved: those previously uninsured now use health services more often, whilst numbers reporting impoverishing health expenditure having fallen from 3.3% to 0.8%. Other indicators, however, remain worrying. Rates of survival after heart attack or stroke are markedly worse than in other OECD countries. Prevention is a particular concern: with 32% of the adult population obese, Mexico ranks as the second most obese nation in the OECD and almost 1 in 6 adults are diabetic. Other key metrics imply deep-rooted inefficiencies in the system: administrative costs, at 8.9% of total health spending, are the highest in the OECD and have not reduced over the past decade. Likewise, out-of-pocket spending has stuck at nearly 50% of total health spending - the highest in the OECD - and implies that individuals feel the need to visit private clinic despite having health insurance. In short, Mexico’s massive public investment in its health system has failed to translate into better health and health system performance to the extent wished and a programme of continued, extensive reform is needed. This report sets out the OECD’s recommendations on the steps Mexico should take to achieve this.
In the ten years since the introduction of Seguro Popular, some 50 million Mexicans previously at risk of unaffordable health care bills now have access to health insurance. The OECD Review of Health Systems: Mexico 2016 finds that the share of the population exposed to unaffordable or impoverishing health care costs has fallen from 3.3% to 0.8% of the population in the past decade.
Ageing has a wide range of impacts on individuals and society as a whole. But the consequences for health care, working life, income and well-being in general are not always what many people imagine. OECD Insights: Ageing: Debate the Issues discusses the problems, challenges, and opportunities that ageing brings to citizens and governments in developed and developing countries. Experts on demography, medical research, pensions, employment and other domains from inside and outside the OECD present their latest analyses and views on one of the most important trends shaping our societies.
La Colombie a considérablement amélioré son système de santé ces 20 dernières années avec, à la clé, un allongement de l’espérance de vie et une baisse de la mortalité infantile. Cette dernière a diminué, passant de 40 décès pour 1 000 naissances vivantes en 1970 à 12.8 ces dernières années et l’espérance de vie à la naissance a atteint 75.2 ans sur la même période.