Life expectancy has recovered and is on an upward trajectory. Life expectancy averaged 81.1 years across OECD countries in 2023. However, it remained below pre‑pandemic levels in 13 OECD countries.
In total, there were over 3 million premature deaths in 2023 among people aged under 75 that could have been avoided through better prevention and healthcare interventions. Diseases of the circulatory system and cancer are the two leading causes of death, accounting for almost half of all deaths in OECD countries.
For men, external causes – including suicide, accidents and violence – is the leading cause of potential years of life lost, whereas for women it is cancer. Women live longer than men, but they also spend more years in poor health (6.3 years after age 60, compared to 5.0 years for men).
Amongst primary care users aged 45 and older, 82% reported having at least one chronic condition, and 52% two or more, on average across the OECD countries participating in the Patient-Reported Indicators Surveys (PaRIS).
Mental ill-health remains a concern, particularly amongst young people. On average, 52% of 15‑year‑olds reported multiple health complaints including feeling low, having repeated headaches or dizziness in 2022, up from 37% in 2014.
Executive summary
Copy link to Executive summaryWhile countries have recovered from the pandemic, fundamental health challenges remain
Copy link to While countries have recovered from the pandemic, fundamental health challenges remainHealth systems account for around a tenth of economic output and employment
Copy link to Health systems account for around a tenth of economic output and employmentIn 2024, OECD countries spent 9.3% of their GDP on health. This is down from the peak reached during the COVID‑19 crisis, but higher than pre‑pandemic levels. In 16 OECD countries, health spending accounts for more than 10% of GDP.
Projections point to spending from public sources as a share of GDP growing on average by 1.5 percentage points (p.p.) by 2045, driven largely by technological change, rising expectations of what healthcare can achieve, and ageing populations.
Yet health spending already makes up 15% of government spending, a share that has increased slightly in most OECD countries over the past decade. Raising this share further may be challenging in many countries, given competing policy priorities and public finance constraints.
The health workforce is growing, with about one in every nine jobs being in health or social care, on average across OECD countries. This looks set to increase further as demand for healthcare continues to increase. Foreign-trained workers are helping to fill gaps, with on average 20% of all doctors trained abroad in 2023, up from 16% in 2010.
Healthcare quality and access indicators show improvements over time
Copy link to Healthcare quality and access indicators show improvements over timeHealth indicators show continued improvement in the quality of acute care services. For example, the chance of survival after a heart attack or stroke is higher now than a decade ago: 30‑day mortality rates following a heart attack averaged 6.5% in 2023, down from 8.2% in 2013, and for ischaemic stroke the figures were 7.7% in 2023 and 9.3% in 2013.
Primary care is helping to keep people well and out of hospital, with avoidable hospital admissions falling in 28 of 30 OECD countries over the last decade. Patient satisfaction with primary care services is high, including amongst those with more complex needs: on average 87% of primary care users aged 45 and older with chronic conditions rated the care they received positively, and 78% trusted the last healthcare professional they saw.
Health system performance can be further improved, though more health spending does not always guarantee better outcomes
Copy link to Health system performance can be further improved, though more health spending does not always guarantee better outcomesDespite most countries having universal healthcare systems, some access problems remain. Waiting times remain a policy challenge in several countries. Socio‑economic disparities are large, with people in the lowest income quintile 2.5 times more likely to report unmet medical care needs than those in the highest income quintile.
Patient safety is an important concern – for example, only 44% of physicians and nurses perceived staff levels and work pace to be safe. And whilst safe prescribing in primary care has on average slightly improved over time, in terms of reduced volumes of antibiotics and opioids prescribed, these improvements have been small in most countries.
Overall, countries with higher health spending have better health outcomes, but this is not always the case. For example, eight countries spend less than average on health as a share of GDP but still achieve better (lower) avoidable mortality rates.
A renewed focus on value‑for-money is essential for healthy populations and sustainable health systems, with preventive interventions playing a key role
Copy link to A renewed focus on value‑for-money is essential for healthy populations and sustainable health systems, with preventive interventions playing a key roleCombatting risk factors for health throughout the lifecycle is key to long-term health gains at low cost. Yet obesity rates continue to rise in over four‑fifths of OECD countries, with 54% of adults overweight or obese, and 19% obese, on average. Harmful alcohol use is a concern, with 27% of adults reporting binge‑drinking at least once per month. Whilst smoking rates have fallen, 15% of adults still smoke daily, and vaping rates are increasing.
These risk factors extend to children. Amongst 15‑year‑olds, 20% were overweight or obese; 38% consumed alcohol in the last month; 15% smoked and 20% vaped at least monthly, on average across OECD countries. Some risky behaviours start even earlier in life: on average, 15% of 13‑year‑olds and 5% of 11‑year‑olds reported drinking alcohol in the last month.
Many preventive and primary healthcare interventions are highly cost-effective in addressing these risk factors. Yet prevention spending only accounted for 3%, and primary healthcare spending 14%, of total health spending in 2023. The priority given to both prevention and primary healthcare spending is largely unchanged since a decade ago, with increases in prevention spending during the pandemic proving to be temporary.
Improving the efficiency of input use is critical. Revisiting the health staff mix is one way in which efficiency can be enhanced, yet growth in the number of nurses and nursing graduates has been slower than for doctors and medical graduates. Innovation in service delivery also has great potential, notably through greater use of digital health. Here, indicators highlight some promising developments: for example the role of teleconsultations continues to grow and comprised 13% of all doctor consultations in 2023.