Publications & Documents

Good mental health is a vital part of people’s well-being, and the COVID-19 pandemic brought renewed attention to its importance. However, discussions so far have not focused sufficiently on how governments should best monitor it at the broader population level, and on how to consider both mental ill-health and positive mental states. This report supports national statistical offices and other data producers in collecting high-quality measures of population mental health outcomes in a more frequent, consistent and internationally harmonised manner. It documents existing measurement practice across OECD countries, discusses the advantages and limitations of available measurement tools, and recommends priority measures to adopt in household, social and health surveys. Measuring Population Mental Health is the first of two reports as part of an assessment of mental health and well-being in the context of the OECD's work on measuring well-being.

The provision of key health technologies and products such as vaccines and antibiotics is insufficient in purely competitive and volume-based markets, requiring new revenue streams for sustainability. Recent developments in health innovation suggest that innovative collaborative mechanisms can be effective in addressing this issue. In the domains of vaccines and antibiotics, these approaches should incorporate shared research investment, long-term access planning, the provision of manufacturing infrastructure, supply chains, and financial returns. Collaborative approaches such as subscription models could be piloted at the regional level, while other models could be developed to delink innovation, manufacturing, and access from sales volume and revenue. Finally, blended finance instruments from the development field could encourage greater collaboration among established and emerging stakeholders in health innovation. These stakeholders should work together to create, test, access, and implement more collaborative approaches to health innovation to share upfront investments, mitigate risks of failure, and accelerate market access.

The COVID 19 pandemic has disproportionately hit some vulnerable population groups. Those living in deprived areas, migrant population, and ethnic minorities are at higher risk of catching and dying from the virus than other groups, and they also face significant indirect health impacts of the COVID-19 pandemic - both mental health impacts and disruption of routine care. The working paper gathers evidence on the direct and indirect health impacts of the COVID-19 on the poor population and the ethnic minorities. It reviews factors underlying these inequalities, and maps policy interventions adopted by OECD countries to help address the disproportionate impacts of the COVID-19 pandemic on vulnerable population groups.

The COVID-19 pandemic has highlighted that access to timely health spending data is crucial for informed policy-making. This Health Working Paper summarises and compares the methodologies applied in around half of OECD countries to estimate public and private health spending for the most recent year (i.e., t-1) as well as the approaches taken by the OECD Secretariat to fill existing data gaps for the remaining OECD countries. For the first time, the paper also explores the feasibility of nowcasting health spending for the current year (i.e., t) and examines data sources that could be potentially useful in such an exercise. While this review should help OECD countries that do not yet have experience in estimating health spending for year t-1 to improve the timeliness in their data reporting, the paper also analyses the applicability of the methods in low- and middle-income countries.

The COVID-19 pandemic had massive consequences for societies and health systems across the OECD and beyond. Health systems were not resilient enough. Resilient health systems plan and are ready for shocks, such as pandemics, economic crises or the effects of climate change. They are able to minimise the negative consequences of crises, recover as quickly as possible, and adapt to become better performing and more prepared. Smart, targeted investments in health system resilience are needed to improve health and ensure the next shock is less disruptive and costly. This report reviews the lessons of the COVID-19 pandemic and applies them to build policy recommendations to ensure the global community is ready for the next crisis. The reviews and recommendations cover health system issues – including workforce, digitalisation, continuity of care and mental health – and other topics, including long-term care, supply chains and international co-operation.

This report calls on policy makers to step up the policy response to increase physical activity. Being physically active is one of the most important things people can do to improve their physical and mental health. It helps prevent a range of non-communicable diseases such as cardiovascular disease and cancer, and improves mental health and cognitive functioning, among other benefits. Nevertheless, too many Europeans are physically inactive. One in three European adults do not meet the WHO physical activity guidelines, and almost half never exercise or play sport. The report describes patterns and trends of insufficient physical activity in Europe. It reviews the detrimental impact that current physical inactivity levels have on population health and health expenditure. The report provides policy makers with options to address insufficient physical activity, drawing on case studies from across Europe.

Ensuring affordable access to novel medicines has been identified as a policy priority among OECD and EU countries, yet systematic monitoring of the various dimensions of access is lacking. Previous efforts to measure access have focused primarily on one or at most two of these dimensions, such as availability and affordability, but a more holistic picture is needed. The OECD undertook a pilot study in EU Member States that aimed to determine the utility and feasibility of routine, cross-national monitoring of access to medicines across multiple dimensions. The work included a desk review to define the dimensions of access and associated indicators, followed by an OECD survey to explore the feasibility of collecting and analysing the relevant data for a convenience sample of 15 recently authorised product/indication pairs. This working paper presents key learnings from the desk review and country survey to which 21 EU Member States responded, with a focus on exploring the utility and feasibility of the processes of monitoring and measurement.

With more chronic conditions and an ageing population, a growing share of the population will need end-of-life care, reaching close to 10 million people by 2050. While end-of-life care services help improve quality of life through relieving pain and other symptoms, currently, there are substantial gaps in the provision of services. More than half of deaths still occur in hospital across OECD countries, despite home generally being the preferred place of death, because of lack of appropriate services and poor care co-ordination. There are marked inequalities in access with people from higher education twice as likely to receive end-of-life care services than those with low education. Planning, recording of wishes and shared decision-making fall short of what is desirable, with only one-quarter of wishes being recorded in the form of advance directives. People at the end of life do not always receive appropriate symptom relief, while others suffer from overtreatment. This report suggests avenues to improve care for the dying by enhancing measurement and monitoring of quality and rethinking funding and governance models of care. End-of-life care could also be improved by increasing knowledge among health care staff across different care settings, and making communication around the topic more person-centred.