Payers for health care are pursuing a variety of policies as part of broader efforts to improve the quality and efficiency of care. Payment reform is but one policy tool to improve health system performance that requires supportive measures in place such as policies with well-developed stakeholder involvement, information on quality, clear criteria for tariff setting, and embedding evaluation as part of the policy process. Countries should not, however, underestimate the significant data challenges when looking at price setting processes. Data access and ways to overcome its fragmentation require well-developed infrastructures. Policy efforts highlight a trend towards aligning payer and provider incentives by using evidence-based clinical guidelines and outcomes to inform price setting. There are signs of increasing policy focus on outcomes to inform price setting. These efforts could bring about system-wide effects of using evidence along with a patient-centred focus to improve health care delivery and performance in the long-run.
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Although increasing, life expectancy in the Czech Republic, at 78.3 years, was still below the OECD average of 80.5 years in 2013. The Czech Republic presents above average levels of risk factors such as tobacco, alcohol consumption and obesity. To cope with the expected rise in chronic diseases, the Czech Republic will have to shift care from the hospital sector and strengthen preventive health care.
At the OECD, we have calculated that about 50% of all the antimicrobials prescribed by healthcare facilities in our member countries do not meet prescription guidelines. In healthcare services such as long-term care facilities and general practices up to 70% and 90% respectively of antibiotics may be prescribed for inappropriate reasons.
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In the past 30 years Korea has gone from having a limited medical infrastructure, fragmented financing and limited population coverage, to a health care system characterised by universal coverage, one of the highest life expectancies in the world while still having one of the lowest levels of health expenditure among OECD countries.
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Israel has built a universal health system at relatively low-cost. Health spending was 7.5% of GDP in 2013, below the OECD average of 8.9% although the health spending share of GDP has been increasing rapidly, particularly in recent years. Israel has developed a sophisticated programme to monitor quality of primary care.
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Norway has an impressive and comprehensive health system, but it is facing several challenges over the coming years. The shift in the need for care from an ageing population will weigh heavily on the Norwegian health care system, demanding for more skilled health care personnel as well as strengthening of community care.
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Between 2009 and 2013, public spending on health fell by EUR 5.2 billion – representing a 32% drop in real-terms. This reduction clearly represents a shock for the system to adsorb, even though it is clear that there were inefficiencies in the Greek system (for example, inappropriate prescribing, weak primary care, imbalances in the mix of health professionals).
This paper looks at recent trends in pharmaceutical spending across OECD countries. It examines the drivers of recent spending trends, highlighting differences across therapeutic classes, and then looks at emerging challenges for policy makers in the management of pharmaceutical spending.
“Mental health issues exact a high price on individuals, their families, employers and the economy,” said OECD Secretary-General Angel Gurría, “Policymakers have been too slow to act. Strong political leadership is needed to drive reform and tackle this issue.”
Expenditure by disease data based on national health accounts can provide valuable information for use in policy analysis. In order to move further in this important area, it is necessary both to refine the definitions and approach that is followed, but also to demonstrate that such accounts can be developed in a cost-effective manner under the framework of the System of Health Accounts.