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The French health care system performs relatively well. Health outcomes are better than the OECD average and citizens enjoy good access to care. However, France is lagging behind other OECD countries in some areas including for example antibiotics prescribing or alcohol consumption.
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Finland appears to have a high performing health system, with remarkable good quality in both primary and hospital care. The country also achieves good health status at relatively low level of health spending. Despite these advances, there are specific areas where improvements can be made such as preventing the spread of obesity and addressing gaps in mental health.
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The growth rate in health spending per capita in Canada has slowed down markedly in recent years, being close to zero in real terms since 2011. Life expectancy in Canada is one year higher than the OECD average, but rising alcohol consumption and obesity rates are growing risk factors to health. Canada could further improve the quality of care in order to cope better with rising prevalence of chronic diseases.
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The Australian health system is a complex mix of federal and state government funding and responsibility, making it difficult for patients to navigate. Despite its complexity, Australia’s universal health system achieves good results relatively efficiently.
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.
Colombia’s record in extending health insurance and health services to its population is impressive. In 1990, around 1 in 6 of the population had health insurance. Now, nearly 97% do, with greatest expansion occurring amongst poorer households. Likewise, in 1993 out-of-pocket spending made up 52% of total national expenditure on health. By 2006, this had fallen to less than 15%. Although Colombia has high rates of income inequality (with a Gini coefficient of 53.5 in 2012, compared to the OECD average of 32.2), access to health care services is much more equal. In urban populations, for example, 1.8% of children aged less than two years of age are recorded as having received no routine vaccinations, compared to 1.0% of rural children. Colombia nevertheless faces important challenges to maintain and improve the performance of its health system. This report looks at Colombia’s health care system in detail and offers recommendations on what Colombia can do to ensure accessibility, quality, efficiency and sustainability.
Australia’s health system functions remarkably well, despite operating under a complex set of institutions that make coordinating patient care difficult. Complications arising from a split in federal and state government funding and responsibilities are central to these challenges. This fragmented health care system can disrupt the continuity of patient care, lead to a duplication of services and leave gaps in care provision. Supervision of these health services by different levels of government can manifest in avoidable impediments such as the poor transfer of health information, and pose difficulties for patients navigating the health system. Adding to the Australian system’s complexity is a mix of services delivered through both the public and private sectors. To ease health system fragmentation and promote more integrated services, Australia should adopt a national approach to quality and performance through an enhanced federal government role in steering policy, funding and priority setting. The states, in turn, should take on a strengthened role as health service providers, with responsibility for primary care devolved to the states to better align it with hospital services and community care. A more strategic role for the centre should also leave room for the strategic development of health services at the regional level, encouraging innovation that is responsive to local population need, particularly in rural and remote areas.
This new edition of Health at a Glance presents the most recent comparable data on the performance of health systems in OECD countries. Where possible, it also reports data for partner countries (Brazil, China, Colombia, Costa Rica, India, Indonesia, Latvia, Lithuania, Russian Federation and South Africa). Compared with the previous edition, this new edition includes a new set of dashboards of health indicators to summarise in a clear and user-friendly way the relative strengths and weaknesses of OECD countries on different key indicators of health and health system performance, and also a special focus on the pharmaceutical sector. This edition also contains new indicators on health workforce migration and on the quality of health care.
Too many lives are still lost in OECD countries because healthcare quality is improving too slowly to cope with ageing populations and the growing number of people with one or more chronic diseases, according to a new OECD report.
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.