September 2021

Focus on resilient healthcare

This page presents the latest OECD data and policy on the impact of COVID-19 on health and health systems. It also features a curated collection of earlier OECD health data, analysis and recommendations.
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The COVID-19 crisis has generated enormous human, social and economic costs, claiming millions of lives and with many more suffering ill-health as a direct or indirect consequence of the virus. It has placed immense pressure on health care services, ones often already overstretched before the pandemic, and the pandemic is far from over.

Ensuring COVID-19 vaccines are accessible to all and containing and mitigating the virus continue to be essential. But so is making health systems stronger and more resilient, including through effective investment in primary care, health promotion and disease prevention. The pandemic has brought some encouraging signs of emerging systemic changes, with advances in digital healthcare delivery and better integrated care.

Spotlight: the burden of obesity

Obesity is a serious public health problem across the OECD area. People in the obese category are more likely to have poor health outcomes and a shorter life expectancy, partly because they face a higher risk of developing type two diabetes, several cancers, stroke, or asthma.

It is predicted that between 2020 and 2050, overweight and obesity will cause an additional 462 million cases of cardiovascular disease and 212 million new cases of diabetes, leading to a reduction in average life expectancy in the OECD of 2.7 years.

The issue was brought to the forefront in 2020 when it was noticed that people living with obesity were at greater risk of developing severe symptoms and dying from COVID-19. One study found morbidly obese patients were 2.7 times more likely to die from COVID-19 than patients of a healthy weight, and for patients of an even higher weight, the risk was 4.2 times greater.

A problem that discriminates

The pandemic and its associated measures also resulted in a reduction in physical activity for many people, and changes in how people ate and consumed alcohol. While it’s too soon to say whether the pandemic worsened obesity or not, it was found that, on average, more people gained weight than those who lost weight.

While there is no “silver bullet” solution, effective policy tools are available. Policy makers should implement comprehensive policy packages that include both “downstream” interventions focused on changing people’s behaviour as well as “upstream” interventions that change the environment in which people live, through food reformulation and increased green spaces.

It must also be recognised that obesity disproportionately affects people with a lower socio-economic status: the same people who have were disproportionately impacted by the pandemic. Targeting the needs of disadvantaged groups by subsidising healthy foods and communicating programmes in diverse languages can have a significant impact.

Read the report

Better health data, a COVID silver lining?

The pandemic forced countries to develop near real-time data on case numbers, test results, mortality, vaccinations, hospitalisations and hospital saturation in order to make public-health decisions like when to impose or lift restrictions, triggering advances in the timeliness and quality of national health datasets in numerous countries.

Before COVID-19, only a handful of countries produced daily or weekly healthcare datasets, but 23 out of 24 countries surveyed by the OECD reported improved data timeliness as a result of the pandemic.

Mortality data was particularly important. Until 2020, most countries produced mortality statistics on an annual basis. Only two countries, Latvia and Denmark, reported having mortality data available in real time prior to 2021. COVID-19 transformed this, hitting countries in drastic waves that evolved significantly on a week-by-week basis. In many cases, mortality data are now generated on a daily basis—and sometimes even multiple times daily.

Not only did more countries start producing health data regularly and rapidly, but the quality of their data improved as well. The accuracy, coverage and completeness of the datasets increased during the pandemic in 19 out of the 24 surveyed countries.

These major improvements in health data show how health systems adapted to the crisis, and are continuing to forge a path towards greater resilience.

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Care on hold: The unintended consequences of COVID-19

The pandemic caused massive disruptions in the treatment and preventative care of many unrelated health problems. With hospitals and medical professionals at capacity treating COVID-19 patients, elective surgeries like knee and hip replacements needed to be delayed.

But the disruption also affected routine yet crucial check-ups, with potentially serious consequences down the line. The proportion of women screened for breast cancer within the last two years fell by an average of 5 percentage points in 2020, compared with 2019.

Screening for cancer can have a large impact on survival, as it is often imperative to begin medical interventions as early as possible. Diagnostic delays have been shown to increase the mortality for multiple types of cancer.

As demand for health services increases in the coming decades, governments need to be able to ensure adequate continuity of care through crises.

OECD Health portal

Mental health: The psychological impacts of COVID-19

Young people have reported much higher levels of anxiety and depression since the onset of the COVID-19 pandemic compared with the general adult population, widening existing differences.

Data from July 2021 point to 44.8% of young people reporting symptoms of anxiety in the United States, compared to 27% for all adults, while 38.6% reported depression compared with 22.1% of adults. Earlier OECD data (from March 2021) showed that young people were 30% to 80% more likely to report symptoms of either depression or anxiety in Belgium, France and the United States.

Reduced social contact and school disruptions have interrupted recent progress in integrating mental health support for young people into education systems and employment services.

More data and analysis to identify sub-groups needing more support – women, LGBTI+ and those from lower socio-economic backgrounds – will be needed to better target extra mental health resources.

> Fitter Minds, Fitter Jobs : From Awareness to Change in Integrated Mental Health, Skills and Work Policies | Report

> OECD | The power of youth: The driving force for change after COVID-19 | Discover more about youth

Spotlight: The hidden pandemic

Healthcare resilience: Our common goal

With reduced mobility during containment measures, the use of remote health consultations did help relieve the impact of some medical disruptions. This had the added benefit of helping to reach populations in already-underserved areas before the pandemic hit.

Pharmacies, often serving as a first point of contact between people and health systems, also expanded their services and remain key actors in testing and vaccination campaigns.

Although today 1 in 10 workers are employed in the health and social care sectors in OECD countries, the disruptions in medical studies due to the pandemic could compromise the capacity of health systems to face future needs. Notwithstanding the fact that the share of the population aged 80 and older in OECD countries is projected to increase from 4.6% in 2019 to 9.6% by 2050.

Increasing the capacity to train the future workforce will be essential to building resilient health systems and cope with the increasing demand for health and social care services.

> Number of medical doctors and nurses | Data insights

OECD Data portal: Health

How can governments help?

Governments need to move beyond crisis measures to build a more resilient health system capable of responding to future needs:

  • Vaccinate more people by building trust with hesitant population groups and deploy booster shots to protect against emerging COVID-19 variants and long-COVID symptoms.

  • Assure continuity of access to screenings and medical procedures to avoid compounding the health effects of the crisis.

  • Integrate mental health support into workplaces, public employment services and education systems, while targeting support to struggling groups.

  • Reduce territorial inequalities in access to care as demographic shifts occur and expand its reach through advancements, such as telehealth consultations.

  • Further increase the number of medical professionals to meet emerging healthcare demands and avoid overstretching doctors, nurses and long-term care workers.

  • Plan for population ageing and the associated increases in demand for health services when designing policies to be resilient in the long run.

Latest health insights

Ageing population

Ageing and the long-run fiscal sustainability of health care across levels of government

The demand for health services is expected to increase in the OECD area due to population ageing, while labour forces are projected to shrink, posing a significant challenge for the resilience of health systems.

Working paper

Health data

Towards an Integrated Health Information System in Korea

An integrated health information system enables the secure flow of data to advance policy objectives. This report looks at the current situation in Korea and recommends policy changes to overcome barriers.

Report

CANCER CARE

Impact of the COVID-19 pandemic on cancer care in OECD countries

In the face of COVID-19, the number of cancer-related procedures declined significantly across the world, but many countries attempted to mitigate this through innovative policy.

Working paper

Medicine

Shortages of medicines in OECD countries

While COVID-19 has exacerbated medicine shortages, the problem was pre-existing and largely the result of manufacturing and quality issues. Nevertheless, policy solutions exist.

Working paper

Health best practice

Guidebook on Best Practices in Public Health

This guidebook outlines and discusses the steps involved in selecting, implementing and evaluating policy actions and interventions to improve public health.

Report

MEDICAL GRADUATES

A growing need for doctors

How do countries compare on the number of medical graduates in a given year?

OECD data

Long-term care

Rising from the COVID 19 crisis: Policy responses in the long-term care sector

COVID‑19 hit the long-term care sector hard. The brief assesses the emergency preparedness of the sector and highlights the lessons learned in the pandemic.

Policy responses

Mental health & work

Fitter Minds, Fitter Jobs

Countries have unevenly progressed towards achieving an integrated approach to mental health policy, but COVID has helped raise awareness of the importance of good mental health for all life domains.

Report

Vaccinating the world

Vaccines continue to be our best tool in the fight against COVID-19. Not only does vaccination reduce the likelihood of dying or hospitalisation, but it also is effective at preventing ‘long COVID’.

However, while some populations have had multiple booster doses, large parts of the world remain without basic protection due to access and hesitancy.

International cooperation can boost access in rural and developing countries- a necessity not only for international solidarity and economic flow, but also for slowing the outbreak of future variants of the virus.

Discover the vaccines story

Browse all related resources

This inventory pulls together OECD analysis and data on healthcare systems and workers. It covers topics both directly and indirectly related to many of the issues arising in the context of the global coronavirus (COVID-19) crisis, from the resilience of health systems to the public health threats caused by pandemics or fake pharmaceuticals,

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16/06/2022
Report
Illicit Trade in High-Risk Sectors
Trade in illicit alcohol products is an attractive target for organised crime, as both the market and potential profits are large, in some cases requiring little investment. The illicit alcohol trade not only fuels criminal networks, but also poses significant risks to public health and safety. This report structures and enhances existing evidence on illicit alcohol trade. It examines the nature and scope of illicit trade in the sector, assesses the impacts of illicit trade on socio-economic development, and identifies the factors driving illicit trade in the sector.
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07/06/2022
Report
Healthy Eating and Active Lifestyles
Overweight and obesity affects over half of all men and women in OECD countries. This has significant health and economic consequences. As part of OECD’s work on promoting best practices in public health, this report outlines policy recommendations on how to address two leading overweight risk factors: poor diet and lack of physical activity. Policy recommendations are drawn from a review of high-priority interventions implemented in OECD and EU27 countries.
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24/05/2022
Paper
International comparisons of the quality and outcomes of integrated care
Across OECD countries, two in three people aged over 65 years live with at least one chronic condition often requiring multiple interactions with different providers, making them more susceptible to poor and fragmented care. This has prompted calls for making health systems more people-centred, capable of delivering high-quality integrated care. Despite promising, mostly local-level, experiences, systems remain fragmented, focused on acute care and unsuitable to solve complex needs. Moreover, assessing and comparing the benefits of integrated care remains difficult given the lack of technically sound, policy-relevant indicators. This report presents the results of the first OECD pilot of a new generation of indicators to support international benchmarking of quality of integrated care. Lessons from the pilot call for further work on: (1) expanding work on indicator development; (2) performing policy analysis to understand cross-country variations on governance models and health financing; (3) upscaling data linkage; and (4) measuring care fragmentation.
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19/05/2022
Report
Society at a Glance: Asia/Pacific 2022
This fifth edition of Society at a Glance: Asia/Pacific provides an overview of social indicators for the region. Quantitative evidence on social indicators such as poverty, social expenditures, and demographic trends across countries in Asia and the Pacific helps economies identify where they can learn from the experience of other countries. Chapter 1 introduces this volume and provides readers with a guide to help them interpret OECD Social Indicators. The remainder of the publication presents the indicators in a standardised format: one page of figures and accompanying text, pointing the reader to sources and potential caveats with measurement issues. The indicators are grouped into five chapters: general context, self-sufficiency, equity, health and social cohesion. Each chapter holds five indicators, but the health chapter includes an additional indicator to illustrate recent trends in cases and deaths related to the COVID-19 pandemic.
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11/05/2022
Report
Health Data Governance for the Digital Age
Health data are essential to modern health care delivery, health system management and research and innovation, and must be well governed to foster their use while protecting privacy and data security. The 2016 OECD Recommendation on Health Data Governance provides a roadmap towards more harmonised approaches to health data governance across countries. It recommends implementing national health data governance frameworks and sets out the key principles to follow when doing so, while promoting trans-border co-operation in data governance and interoperability. This report provides an overview of the implementation of the Recommendation from 2016-2021 and finds that while there are examples of good progress, overall many Adherents are still working towards implementation in areas including data sharing, accessibility, quality, interoperability and security and privacy protections. Efforts to support the implementation and dissemination of the Recommendation will continue for the next reporting cycle (2022-27) with a focus on cybersecurity, harmonising health data governance to allow for multi-country projects and improving global health data interoperability.
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10/05/2022
Report
Management of Pharmaceutical Household Waste
Pharmaceutical household waste from expired or unused medicine does not only offer zero therapeutic benefit, but also contributes to environmental pollution when disposed of via improper routes. Medicines discarded in sinks and flushed down toilets enter sewage waters and, if not filtered out, leak into aquatic systems. Disposal of unused or expired medicines via solid household waste can also result in pharmaceutical residues entering the environment if this waste is illegally dumped, or destined for landfills. In addition to environmental risks, unused or expired medicine not only constitutes wasted healthcare resources, but also presents a possible public health risk of accidental or intentional misuse and poisoning if extracted from waste bins. Preventing pharmaceutical household waste and ensuring the effective collection and environmentally sound treatment of unavoidable waste is thus an important policy objective. This report provides an overview of available data on pharmaceutical consumption and disposal practices across OECD countries, reviews existing collection schemes and provides recommendations to best prevent, collect and treat unused or expired medicines in order to avoid their leakage into the environment.
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05/05/2022
Paper
Impact of the COVID-19 pandemic on cancer care in OECD countries
The COVID-19 pandemic has disrupted primary and secondary prevention efforts as well as routine cancer care including diagnosis and treatment. The number of cancer-related procedures declined across countries. Many of the OECD countries also faced challenges in maintaining and further improving cancer care quality and outcomes during the pandemic. This paper compiles initial findings from a subset of OECD countries covering the period from March 2020 to August 2021. It illustrates how several of these countries attempted to mitigate the impact of COVID-19 on cancer care systems. There have been examples of adapting treatment guidelines, changing clinical practices and reducing backlogs to minimise negative impacts of the pandemic on cancer patients. Several of the countries also undertook more frequent monitoring and in-depth analysis of cancer care performance. The analyses confirm that strong health information infrastructure is crucial for developing resilient health systems that provide effective, timely and people-centred cancer care.
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04/04/2022
Policy response
Global supply chains at work: A tale of three products to fight COVID-19
The goods needed to vaccinate, protect and test during the COVID-19 pandemic are produced across many different countries. This brief tells the tale of three products ‒ vaccines, face masks and tests ‒ and highlights the role of trade in the fight against COVID-19. International markets and global supply chains played a pivotal role during the COVID-19 pandemic: first, by helping countries avail themselves of the goods needed to address the pandemic; second, by providing a means to ease temporary supply constraints; and third, by enabling access to key components to ramp up production to meet surging demand.
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04/04/2022
Paper
Understanding differences in vaccination uptake among OECD countries
Resolving stark differences between rich and poor countries in vaccine coverage against COVID is a global policy priority for 2022. However, even among OECD countries, there currently remain surprisingly large differences in vaccine coverage and this paper attempts to explain these differences, including the role that policy has played. The main findings are: vaccination has had massive health and economic benefits; vaccine hesitancy can be overcome, although there remains a link with historical flu and MMR vaccination rates; well-designed vaccine passes can boost coverage; trust in government and other public institutions matter, although the link to vaccine coverage is not straight-forward; demographic structure and policy stances towards vaccinating children play a role in explaining differences in overall population vaccination rates; mandatory vaccination has been implemented or is being considered in a few OECD countries, although it is too early to assess the effects. Finally, case studies of the most successful vaccination campaigns provide additional illumination, which cannot easily be captured in multi-country correlations.
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24/03/2022
Paper
Shortages of medicines in OECD countries
Even in wealthy economies, access to medicines is increasingly affected by medicine shortages – an issue exacerbated with the onset of the COVID-19 pandemic. The aim of this paper was to examine the extent and nature of medicine shortages in OECD countries (pre-COVID-19) and explore the reasons for this growing global problem. Although differences in monitoring mechanisms make multi-country analyses challenging, a sample of 14 OECD countries reported a 60% increase in the number of shortage notifications over the period 2017-2019. While the complexity of pharmaceutical manufacturing and supply chains hampers root cause analyses, available literature suggests that shortages, as reported by marketing authorisation holders, are predominantly due to manufacturing and quality issues. Nevertheless, commercial factors - and the policy settings that influence them - may play an important role. Although several OECD countries have implemented policy measures to mitigate, monitor and prevent shortages, more robust data and further analyses of root causes and effective policy responses are needed. The way forward should involve a global approach that engages all relevant actors and looks beyond the health care sector alone.
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17/03/2022
Report
Dangerous Fakes
Illicit trade in counterfeit goods causes economic damage by reducing sales and profits as well as innovation incentives in legitimate industries. At the same time, some counterfeits can be of low quality and create significant additional risks, including health risks (fake pharmaceuticals or food products), safety risks (counterfeit automotive spare parts, fake batteries) and environmental risks (fake chemicals or pesticides). This study presents detailed information on the value of counterfeit trade in such dangerous fake goods, analyses changes in the volumes and composition of the goods, and maps key trade routes. The evidence in this report can be used to raise awareness of the risks of this trade and its implications for health and environmental policy.
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08/03/2022
Report
Guidebook on Best Practices in Public Health
This guidebook outlines and discusses the steps involved in selecting, implementing and evaluating policy actions and interventions to improve public health. The guidebook is applicable to all types of public health interventions such as those addressing alcohol and tobacco consumption, obesity, physical inactivity, multimorbidity and mental health as well as infectious diseases. Although designed primarily for policy makers, the guidebook is also a useful reference for other stakeholders such as those responsible for delivering an intervention.
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15/02/2022
Paper
Establishing standards for assessing patient-reported outcomes and experiences of mental health care in OECD countries
Patient-reported measures are a critical tool for improving policy and practice in mental health care. However, to date, the use of patient-reported measures in mental health care is limited to a small number of countries and settings—and there is a pressing need, both within and across countries, to consistently and effectively measure the effects and impact of care for patients who use mental health care services. The PaRIS pilot data collection on mental health included 15 data sources from 12 countries, collected over the course of 2021. While the scope of included data varied, the results demonstrate increased adoption of national and subnational efforts to capture patient-reported information in mental health care systems. Analysis of data collected through the PaRIS mental health pilot documents, in general, positive patient-reported experiences of mental health care. The results also suggest improvement in patient-reported outcomes for those receiving mental health care services.
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19/01/2022
Paper
Developing international benchmarks of patient safety culture in hospital care
Improving patient safety culture (PSC) is a significant priority for OECD countries as they work to improve healthcare quality and safety—a goal that has increased in importance as countries have faced new safety concerns connected to the COVID-19 pandemic. Findings from benchmarking work in PSC show that there is significant room for improvement. Across included survey findings from OECD countries, less than half (46% ) of surveyed health workers believe that important patient care information is transferred across hospital units and during shift changes. Just two-in-five surveyed health workers in OECD countries believe the staffing levels at their workplace are appropriate for ensuring patient safety (40%) or that mistakes and event reports would not held against them (41%). International benchmarking is a feasible and useful addition to exiting measurement initiatives on safety culture and may help accelerate necessary improvements in patient safety outcomes.
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18/01/2022
Blog article
Do COVID certificates spur vaccination take-up? A snapshot of the recent evidence
Many OECD countries are in the grip of a new surge of COVID infections, hospitalisations, and deaths despite no shortage in supply of highly effective vaccines, especially in protecting against severe forms of the disease. COVID certificates, certifying vaccination status or a negative test, have been under consideration in many countries and mandated in some as a condition for population to access certain social and professional gatherings. Arguments for and against supporting their adoption have focused on its contribution to reduce transmission and severe forms of disease as well as on ethical concerns. In this context, one question that arises is how effective are COVID certificates in raising vaccination rates. Early and casual observations suggest that it has had a significant impact, but a rigorous assessment is needed to address the question.
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21/12/2021
Report
Development Co-operation Report 2021
Digital transformation is revolutionising economies and societies with rapid technological advances in AI, robotics and the Internet of Things. Low- and middle-income countries are struggling to gain a foothold in the global digital economy in the face of limited digital capacity, skills, and fragmented global and regional rules. Political stability, democracy, human rights and equality also risk being undermined by weak governance and the abuse of digital technology. The 2021 edition of the Development Co-operation Report makes the case for choosing to hardwire inclusion into digital technology processes, and emerging norms and standards. Providing the latest evidence and policy analysis from experts in national governments, international organisations, academia, business and civil society, the report equips international development organisations with the latest guidance and good practices that put people and the sustainable development goals at the centre of digital transformation.
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16/12/2021
Report
Health for the People, by the People
Health systems have to meet the changing needs of an increasingly assertive population and an ever more complex health policy context. Digitalisation, population ageing, chronic diseases, new pandemic threats, and evolving expectations of what health services should deliver – and how – have raised questions of whether health systems meet the needs and facilitate engagement of the people. Agreement is widespread that a shift towards more people-centred health systems is needed. But how this is done, and what a more people-centred health system looks like, is far less settled. The OECD Framework and Scorecard for People-Centred Health Systems identifies critical dimensions of people-centredness for health systems and benchmarks the progress countries have made towards a more people-centred approach to health. It considers the implications of the COVID-19 pandemic on people-centredness, and identifies key policies – and policy challenges – to assist the development of more people-centred health systems across OECD countries.
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16/12/2021
Policy response
Rising from the COVID 19 crisis: Policy responses in the long-term care sector
COVID‑19 hit the long-term care sector hard. This brief looks at mortality rates in care homes, as well as the policy responses undertaken during the pandemic. The brief assesses the emergency preparedness of the sector and highlights the lessons learned, including policies to reduce isolation, testing strategies, care workforce and co‑ordination with the health care sector.
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13/12/2021
Report
France: Country Health Profile 2021
This profile provides a concise and policy-relevant overview of health and the health system in France as part of the broader series of the State of Health in the EU country profiles. It provides a short synthesis of: the health status in the country; the determinants of health, focussing on behavioural risk factors; the organisation of the health system; and the effectiveness, accessibility and resilience of the health system. This edition has a special focus on the impact of COVID‑19. This profile is the joint work of the OECD and the European Observatory on Health Systems and Policies, in co-operation with the European Commission.
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13/12/2021
Report
Germany: Country Health Profile 2021
This profile provides a concise and policy-relevant overview of health and the health system in Germany as part of the broader series of the State of Health in the EU country profiles. It provides a short synthesis of: the health status in the country; the determinants of health, focussing on behavioural risk factors; the organisation of the health system; and the effectiveness, accessibility and resilience of the health system. This edition has a special focus on the impact of COVID‑19. This profile is the joint work of the OECD and the European Observatory on Health Systems and Policies, in co-operation with the European Commission.
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