Health Care Systems

Health Care Systems

Efficiency and Policy Settings You do not have access to this content

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02 Nov 2010
9789264094901 (PDF) ;9789264094895(print)

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People in OECD countries are healthier than ever before, as shown by longer life expectancy and lower mortality for diseases such as cancer. At the same time, total spending on health care now absorbs over 9% of GDP on average in the OECD. Achieving value for money in the health care sector is an important objective in all OECD countries.

The book takes an in-depth look at health care in OECD countries today. What is the status of people’s health? How do we measure health outcomes? How do we assess the efficiency of health care systems? How are health policies and institutions linked with the performance of health care systems? The chapters explore the answers to such questions. They cover: trends in health care outcomes and spending; ways of assessing efficiency; new indicators of health care policies and institutions; and the characteristics and performance of health care systems.

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  • Foreword
    Household surveys show that being in good health is an important determinant of the well-being of people. Healthier people also tend to enjoy better access to the education system and to be more productive for a longer period of their life, thus supporting economic growth. Being in good health depends partly on life-style choices and socioeconomic factors. But treating illnesses in an effective way is also very important in this respect and a crucial determinant of longevity, which has risen rapidly – by four years on average in the OECD since 1990.
  • Acronyms
  • Executive summary
    Improving health care systems, while containing cost pressures, is a key policy challenge in most OECD countries. The recent economic and financial crisis has weighed heavily on fiscal positions – with gross government debt projected to exceed 100% of GDP in the OECD area by 2011 – and reinforced the need to improve public spending efficiency. Public spending on health care is one of the largest government spending items, representing on average 6% of GDP. Furthermore, health care costs are escalating rapidly, driven by population ageing, rising relative prices and costly developments in medical technology. Public health care spending is projected to increase by 3.5 to 6 percentage points of GDP by 2050 in the OECD area. Against this background, exploiting efficiency gains will be crucial to meet rapidly growing health care demand, without putting the public finances on an unsustainable path.
  • Health care outcomes and spending
    This chapter presents the main trends in health status in OECD countries and discusses the advantages and drawbacks of using different indicators for health care outcomes. It then portrays recent developments and cross-country variations in resources invested in the health care sector, either measured in terms of spending or by using volume and activity indicators.
  • Efficiency measures
    This chapter examines how to measure the efficiency of health care systems. It reviews the various definitions of efficiency and assesses the pros and cons of the different approaches to measure it. It then derives efficiency estimates, taking due account of the impact of lifestyle and socio-economic factors on health status. The results for OECD countries are presented and compared with other performance indicators.
  • Health care policies and institutions
    This chapter presents indicators of health care policies and institutions, drawing on new data collected by the OECD. It focuses on those policies and institutional features which most affect the supply and demand of care, equity in access and the ability of governments to control public spending. This chapter also provides a snapshot of OECD countries’ scores for each of the 20 policy and institutional indicators.
  • Linking efficiency and policy across health care systems
    After a brief overview of existing typologies, this chapter provides an empirical characterisation of health care systems based on the new OECD indicators for health policies and institutions. Six groups of countries sharing broadly similar institutions have been identified. None of these health care systems performs systematically better than another in improving the population health status in a cost-effective manner. Still the chapter shows that international comparisons allow the spotting of strengths and weaknesses for each country and of those policy reforms which could yield efficiency gains.
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