Providing specialised medical care can lead to better care quality and efficiency. Many OECD countries have reorganised hospital services to concentrate complex medical care - such as cardiology, stroke treatment, traumatology, and oncology - in specialised centres. This approach aims to ensure access to medical expertise, strengthen patient safety, and avoid underutilising costly medical equipment.
Hospital Care
Across the OECD, countries are experiencing both population ageing and more people living with chronic conditions, both of which drive demand for hospital care. Rising healthcare expenditure and health workforce shortages are exacerbating these challenges. In response, countries are implementing policies to improve the efficiency and effectiveness of hospital systems to ensure provision of accessible, and high-quality care.
Key messages
Over the past decades, the proportion of medical procedures carried out on an outpatient basis has increased substantially across OECD countries. This shift has been made possible by medical innovations that enhance patient safety and health outcomes, while reducing costs by shortening treatment length. OECD data track how common procedures - such as treating tonsillitis, cataract surgery, and gall-bladder removal – are delivered across healthcare systems This information helps us understand how hospitals are organised and where there may be opportunities to improve care.
Effective coordination among providers is a key driver of health system performance, shaping how seamlessly care is integrated for individuals with chronic conditions or those requiring long-term care. In recent years, some OECD countries have gone further by encouraging hospital collaboration in order to use resources more efficiently within acute care. This may involve different hospitals rotating staff, redistributing patients, sharing data, and collaborating on joint procurement.
Context
Hospital accessibility
Timely access to hospital care is essential for good health outcomes. When people cannot reach treatment quickly, especially in emergencies, the risks of complications or even death increase. In 2023, across 14 OECD countries, almost everyone living in cities was within a 45-minute drive of a hospital. But in rural areas, 17% of residents had to travel more than 45 minutes to reach the closest hospital.
Trends in outpatient surgeries
Minimally invasive surgeries have been performed in an outpatient setting in many OECD countries for years. Common procedures such as cataract surgery and tonsil removal (tonsillectomies) are now mostly done as same-day surgeries, meaning patients go home without needing an overnight stay. Gall-bladder removal (cholecystectomy) is also increasingly carried out this way thanks to better surgical techniques that speed up recovery and reduce hospital stays. However, countries vary in how widely they use day surgery. These differences point to opportunities to learn from one another about how care is organised, the role of financial incentives for hospitals, and how providers coordinate treatment.
Heart attack mortality rates
Heart attacks (acute myocardial infarction, or AMI) are still one of the leading causes of death in many OECD countries. The 30-day mortality rate after hospital admission for a heart attack is an important measure of how well health systems respond. It reflects not only the quality of hospital care—such as timely procedures like angioplasty (PCI) or bypass surgery—but also what happens before the patient reaches the hospital. Fast and accurate diagnosis, early treatment (including the use of defibrillators and essential medications), efficient ambulance dispatch, and quick transport to a hospital that can provide the right care all play a crucial role.
