OECD Health Working Papers

The organisation of out-of-hours primary care in OECD countries
1815-2015 (online)
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This series is designed to make available to a wider readership health studies prepared for use within the OECD. Authorship is usually collective, but principal writers are named. The papers are generally available only in their original language - English or French - with a summary in the other.
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  N° 89   21 Sep 2016 Click to Access: 
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The organisation of out-of-hours primary care in OECD countries
Caroline Berchet, Carol Nader
Out-of-hours (OOH) services provide urgent primary care when primary care physician (PCP) offices are closed, most often from 5pm on weekdays and all day on weekends and holidays. Based on a policy survey (covering 27 OECD countries) and the existing literature, the working paper describes the...
  N° 88   27 May 2016 Click to Access: 
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Health care coverage in OECD countries in 2012
Valérie Paris, Emily Hewlett, Ane Auraaen, Jan Alexa, Lisa Simon
This paper provides a detailed description of health coverage in OECD countries in 2012. It includes information on the organisation of health coverage (residence-based vs contributory systems), on the range of benefits covered by basic health coverage and on cost-sharing requirements. It also...
  N° 87   21 Apr 2016 Click to Access: 
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  • http://www.keepeek.com/Digital-Asset-Management/oecd/social-issues-migration-health/pharmaceutical-expenditure-and-policies_5jm0q1f4cdq7-en
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Pharmaceutical Expenditure And Policies
Annalisa Belloni, David Morgan, Valérie Paris
Across OECD countries, pharmaceutical spending reached around USD 800 billion in 2013, accounting for about 20% of total health spending on average when pharmaceutical consumption in hospital is added to the purchase of pharmaceutical drugs in the retail sector. This paper looks at recent...
  N° 86   26 Nov 2015 Click to Access: 
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  • http://www.keepeek.com/Digital-Asset-Management/oecd/social-issues-migration-health/the-labour-market-impacts-of-obesity-smoking-alcohol-use-and-related-chronic-diseases_5jrqcn5fpv0v-en
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The Labour Market Impacts of Obesity, Smoking, Alcohol Use and Related Chronic Diseases
Marion Devaux, Franco Sassi
This paper examines the labour market impacts of lifestyle risk factors and associated chronic diseases, in terms of employment opportunities, wages, productivity, sick leave, early retirement and receipt of disability benefits. It provides a review of the evidence of the labour market outcomes...
  N° 85   17 Feb 2016 Click to Access: 
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  • http://www.keepeek.com/Digital-Asset-Management/oecd/social-issues-migration-health/international-comparison-of-south-african-private-hospitals-price-levels_5jrrxrzn24wl-en
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International Comparison of South African Private Hospital Price Levels
Luca Lorenzoni, Tomas Roubal
The health system in South Africa is unique in many ways. South Africa spends 41.8% of total health expenditures on private voluntary health insurance – more than any OECD country – but only 17% of the population – mostly high income citizens - can afford to purchase private insurance. Given...
  N° 84   12 Oct 2015 Click to Access: 
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Public Expenditure Projections for Health and Long-Term Care for China Until 2030
Luca Lorenzoni, David Morgan, Yuki Murakami, Chris James
In recent years, China has seen an unprecedented expansion of health insurance for its population in its quest to achieve universal health coverage. By 2011, 95% of the Chinese population was insured up from less than 50% in 2005 through public or employer-based insurance schemes. As part of...
  N° 83   01 Aug 2015 Click to Access: 
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Emergency Care Services
Caroline Berchet
Emergency departments are the front line of health care systems and play a critical role in ensuring an efficient and high-quality response for patients in stress or crisis situations. A growing demand for emergency care might however reduce patients’ satisfaction (through waiting times),...
  N° 82   08 July 2015 Click to Access: 
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Mental Health Analysis Profiles (MhAPs): Sweden
Pauliina Patana
Mental ill-health is a significant issue in Sweden, with both mild-to-moderate and severe disorders representing a significant burden of ill health. Mild and moderate mental health problems constitute the greatest number of cases, and such disorders have been on the rise over the past several...
  N° 81   08 July 2015 Click to Access: 
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Mental Health Analysis Profiles (MhAPs): England
Emily Hewlett, Kierran Horner
As part of a wider project on mental health in OECD countries, a series of descriptive profiles have been prepared, intended to provide descriptive, easily comprehensible, highly informative accounts of the mental health systems of OECD countries. These profiles, entitled ‘Mental Health...
  N° 80   01 May 2015 Click to Access: 
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Assessing the impacts of alcohol policies
Michele Cecchini, Marion Devaux, Franco Sassi
Alcohol policies have significant potential to curb alcohol-related harms, improve health, increase productivity, reduce crime and violence, and cut government expenditure. The WHO Global Strategy to reduce the harmful use of alcohol provides a menu of policy options based on international...
  N° 79   01 May 2015 Click to Access: 
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Alcohol consumption and harmful drinking
Marion Devaux, Franco Sassi
Harmful alcohol consumption is one of the leading causes of ill health and premature mortality worldwide. This paper illustrates trends and social disparities in alcohol consumption and harmful drinking in 20 OECD countries. Analyses are based on individual-level data from national health and...
  N° 78   27 Mar 2015 Click to Access: 
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Tapering payments in hospitals
Grégoire de Lagasnerie, Valérie Paris, Michael Mueller, Ankit Kumar
This study covers "tapering scale" mechanism in hospital payments, i.e. mechanisms linking unit prices to the volume of services produced. This paper begins with an overview of hospital services and hospital payment methods in OECD countries, focusing more specifically on DRG-based payment. It...
  N° 77   05 Sep 2014 Click to Access: 
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Wage-setting in the Hospital Sector
James Buchan, Ankit Kumar, Michael Schoenstein
This paper examines wage setting mechanisms for health workers in hospitals across eight different OECD countries. It describes similarities and differences and how fixed or fluid these approaches have been in recent years through health system reforms, labour market dynamics and economic...
  N° 76   01 Sep 2014 Click to Access: 
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Health, Austerity and Economic Crisis
Kees van Gool, Mark Pearson
The economic crisis that started in 2008 has had a profound impact on the lives of citizens. Millions of people lost their job, saw their life-savings disappear and experienced prolonged financial hardship. The economic crisis has also led a number of OECD governments to introduce austerity...
  N° 75   26 Aug 2014 Click to Access: 
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  • http://www.keepeek.com/Digital-Asset-Management/oecd/social-issues-migration-health/comparing-hospital-and-health-prices-and-volumes-internationally_5jxznwrj32mp-en
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Comparing Hospital and Health Prices and Volumes Internationally
Francette Koechlin, Paul Konijn, Luca Lorenzoni, Paul Schreyer
Health services account for a large and increasing share of production and expenditure in OECD and Eurostat countries but there are also noticeable differences between countries in expenditure per capita. Whether such differences are due to more services being consumed or whether they reflect...
  N° 74   07 July 2014 Click to Access: 
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Mental Health Analysis Profiles (MhAPs): Scotland
Alessia Forti
As part of a wider project on mental health in OECD countries, a series of descriptive profiles have been prepared, intended to provide descriptive, easily comprehensible, highly informative accounts of the mental health systems of OECD countries. These profiles, entitled ‘Mental Health...
  N° 73   25 Aug 2014 Click to Access: 
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  • http://www.keepeek.com/Digital-Asset-Management/oecd/social-issues-migration-health/mental-health-analysis-profiles-mhaps-netherlands_5jz158z60dzn-en
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Mental Health Analysis Profiles (MhAPs): Netherlands
Alessia Forti, Chris Nas, Alex van Geldrop, Gerdien Franx, Ionela Petrea, Ype van Strien, Patrick Jeurissen
As part of a wider project on mental health in OECD countries, a series of descriptive profiles have been prepared, intended to provide descriptive, easily comprehensible, highly informative accounts of the mental health systems of OECD countries. These profiles, entitled ‘Mental Health...
  N° 72   10 July 2014 Click to Access: 
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Mental Health Analysis Profiles (MhAPs): Finland
Pauliina Patana
As part of a wider project on mental health in OECD countries, a series of descriptive profiles have been prepared, intended to provide descriptive, easily comprehensible, highly informative accounts of the mental health systems of OECD countries. These profiles, entitled ‘Mental Health...
  N° 71   07 July 2014 Click to Access: 
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Mental Health Analysis Profiles (MhAPs): Italy
Alessia Forti
As part of a wider project on mental health in OECD countries, a series of descriptive profiles have been prepared, intended to provide descriptive, easily comprehensible, highly informative accounts of the mental health systems of OECD countries. These profiles, entitled ‘Mental Health...
  N° 70   12 June 2014 Click to Access: 
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  • http://www.keepeek.com/Digital-Asset-Management/oecd/social-issues-migration-health/pricing-and-competition-in-specialist-medical-services_5jz2lpxcrhd5-en
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Pricing and competition in Specialist Medical Services
Ankit Kumar, Grégoire de Lagasnerie, Frederica Maiorano, Alessia Forti
Major disparities in the cost of health care have made the pricing of specialist and hospital services a contentious issue in South Africa, particularly in the private sector. To help inform policy debate, this paper profiles selected experiences on the pricing of health services, competition...
  N° 69   03 Apr 2014 Click to Access: 
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  • http://www.keepeek.com/Digital-Asset-Management/oecd/social-issues-migration-health/geographic-imbalances-in-doctor-supply-and-policy-responses_5jz5sq5ls1wl-en
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Geographic Imbalances in Doctor Supply and Policy Responses
Tomoko Ono, Michael Schoenstein, James Buchan
Doctors are distributed unequally across different regions in virtually all OECD countries, and this causes concern about how to continue to ensure access to health services everywhere. In particular access to services in rural regions is the focus of attention of policymakers, although in some...
  N° 68   03 Apr 2014 Click to Access: 
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  • http://www.keepeek.com/Digital-Asset-Management/oecd/social-issues-migration-health/health-spending-continues-to-stagnate-in-many-oecd-countries_5jz5sq5qnwf5-en
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Health Spending Continues to Stagnate in Many OECD Countries
David Morgan, Roberto Astolfi
The global economic crisis which began in 2008 has had a dramatic effect on health spending across OECD countries. Estimates of expenditure on health released back in 2012 showed that, for the first time, health spending had slowed markedly or fallen across many OECD countries after years of...
  N° 67   18 Nov 2013 Click to Access: 
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  • http://www.keepeek.com/Digital-Asset-Management/oecd/social-issues-migration-health/measuring-and-comparing-health-care-waiting-times-in-oecd-countries_5k3w9t84b2kf-en
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Measuring and Comparing Health Care Waiting Times in OECD Countries
Luigi Siciliani, Valerie Moran, Michael Borowitz
Waiting times for elective (non-emergency) treatments are a key health policy concern in several OECD countries. This study describes common measures on waiting times across OECD countries from administrative data. It focuses on common elective procedures, like hip and knee replacement, and...
  N° 66   11 Dec 2013 Click to Access: 
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The Role of Fiscal Policies in Health Promotion
Franco Sassi, Annalisa Belloni, Chiara Capobianco
Taxes and other fiscal measures on health-related commodities are in widespread use. Alcoholic beverages and tobacco products have been subjected to taxation for a long time in most countries. Several OECD governments have passed legislation to increase existing taxes or to introduce new taxes...
  N° 64   11 Oct 2013 Click to Access: 
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  • http://www.keepeek.com/Digital-Asset-Management/oecd/social-issues-migration-health/managing-hospital-volumes-germany-and-experiences-from-oecd-countries_5k3xwtg2szzr-en
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Managing Hospital Volumes: Germany and Experiences from OECD Countries
Ankit Kumar, Michael Schoenstein
To help inform a conference organised by the Germany Ministry of Health (BMG) and the OECD on ‘Managing Hospital Volumes’ on the 11th April 2013, the OECD Secretariat produced this paper giving an international perspective on Germany’s situation and the current policy debate. It provides a...
  N° 63   11 July 2013 Click to Access: 
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Value in Pharmaceutical Pricing
Valérie Paris, Annalisa Belloni
This study analyses how 14 OECD Countries refer to "value" when making decisions on reimbursement and prices of new medicines. It details the type of outcomes considered, the perspective and methods adopted for economic evaluation when used; and the consideration of budget impact. It describes...
  N° 62   26 June 2013 Click to Access: 
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Health Workforce Planning in OECD Countries
Tomoko Ono, Gaetan Lafortune, Michael Schoenstein
Health workforce planning aims to achieve a proper balance between the supply and demand for different categories of health workers, in both the short and longer-term. Workforce planning in the health sector is particularly important, given the time and cost involved in training new doctors and...
  N° 61   25 Mar 2013 Click to Access: 
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  • http://www.keepeek.com/Digital-Asset-Management/oecd/social-issues-migration-health/international-variations-in-a-selected-number-of-surgical-procedures_5k49h4p5g9mw-en
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International Variations in a Selected Number of Surgical Procedures
Klim McPherson, Giorgia Gon, Maggie Scott
This paper summarises recent international data on rates of five surgical procedures (i.e. caesarean, hysterectomy, prostatectomy, hip replacement and appendectomy) across OECD countries. It examines trends over time and compares age- and sex-specific rates for a recent year, for a sub-set of...
  N° 60   29 Jan 2013 Click to Access: 
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  • http://www.keepeek.com/Digital-Asset-Management/oecd/social-issues-migration-health/health-spending-growth-at-zero_5k4dd1st95xv-en
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Health Spending Growth at Zero
David Morgan, Roberto Astolfi
Health spending slowed markedly or fell in many OECD countries recently after years of continuous growth, according to OECD Health Data 2012. As a result of the global economic crisis which began in 2008, a zero rate of growth in health expenditure was recorded on average in 2010, and...
  N° 59   31 Oct 2012 Click to Access: 
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A Comparative Analysis of Health Forecasting Methods
Roberto Astolfi, Luca Lorenzoni, Jillian Oderkirk
Concerns about health expenditure growth and its long-term sustainability have stimulated the development of health expenditure forecasting models in many OECD countries. This comparative analysis reviewed 25 models that were developed by, or used for, policy analysis by OECD member countries...
  N° 58   10 July 2012 Click to Access: 
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  • http://www.keepeek.com/Digital-Asset-Management/oecd/social-issues-migration-health/income-related-inequalities-in-health-service-utilisation-in-19-oecd-countries-2008-2009_5k95xd6stnxt-en
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Income-Related Inequalities in Health Service Utilisation in 19 OECD Countries, 2008-2009
Marion Devaux, Michael de Looper
This Working Paper examines income-related inequalities in health care service utilisation in OECD countries. It extends a previous analysis (Van Doorslaer and Masseria, 2004) to 2008-2009 for 13 countries, and adds new results for 6 countries, for doctor and dentist visits, and cancer...
  N° 57   30 Aug 2011 Click to Access: 
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  • http://www.keepeek.com/Digital-Asset-Management/oecd/social-issues-migration-health/the-impact-of-pay-increases-on-nurses-labour-market_5kg6jwn16tjd-en
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The Impact of Pay Increases on Nurses' Labour Market
James Buchan, Steven Black
Nurses are usually the most numerous professionals in the healthcare workforce, and their contribution is a core component in attaining the policy objectives of improved productivity, quality of care and effectiveness in the health sector. The recent global economic crisis, and its related...
  N° 56   14 Apr 2011 Click to Access: 
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Description of Alternative Approaches to Measure and Place a Value on Hospital Products in Seven OECD Countries
Luca Lorenzoni, Mark Pearson
This paper provides a description of the classification systems used to measure hospital services in selected OECD countries: Australia, Canada, France, Germany, Norway, United Kingdom (England), and the United States. Three classifications are relevant: those on diagnoses; on procedures; and...
  N° 55   31 Jan 2011 Click to Access: 
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  • http://www.keepeek.com/Digital-Asset-Management/oecd/social-issues-migration-health/mortality-amenable-to-health-care-in-31-oecd-countries_5kgj35f9f8s2-en
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Mortality Amenable to Health Care in 31 OECD Countries
Juan G. Gay, Valérie Paris, Marion Devaux, Michael de Looper
This study assesses the potential of the concept of "mortality amenable to health care" as an indicator of outcome for health care systems. It presents estimates of the mortality amenable to health care in 31 OECD countries for the period 1997-2007. It measures the sensitivity of this indicator...
  N° 54   08 July 2010 Click to Access: 
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Nurses in Advanced Roles
Marie-Laure Delamaire, Gaetan Lafortune
Many countries are seeking to improve health care delivery by reviewing the roles of health professionals, including nurses. Developing new and more advanced roles for nurses could improve access to care in the face of a limited or diminishing supply of doctors. It might also contain costs...
  N° 53   08 July 2010 Click to Access: 
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  • http://www.keepeek.com/Digital-Asset-Management/oecd/social-issues-migration-health/comparing-price-levels-of-hospital-services-across-countries_5km91p4f3rzw-en
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Comparing Price Levels of Hospital Services Across Countries
Francette Koechlin, Luca Lorenzoni, Paul Schreyer
Health services account for a large and increasing share of production and expenditure in OECD countries but there are also noticeable differences between countries in expenditure per capita. Whether such differences are due to more services consumed in some countries than in others or whether...
  N° 52   26 May 2010 Click to Access: 
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  • http://www.keepeek.com/Digital-Asset-Management/oecd/social-issues-migration-health/guidelines-for-improving-the-comparability-and-availability-of-private-health-expenditures-under-the-system-of-health-accounts-framework_5kmbrcg0clvc-en
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Guidelines for Improving the Comparability and Availability of Private Health Expenditures Under the System of Health Accounts Framework
Ravi P. Rannan-Eliya, Luca Lorenzoni
This paper reports on a project to improve the comparability and availability of private health expenditure under the joint health accounts questionnaire (JHAQ) data collection. The JHAQ is a framework for joint data collection in the area of health expenditure data developed by OECD, Eurostat,...
  N° 51   29 Mar 2010 Click to Access: 
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  • http://www.keepeek.com/Digital-Asset-Management/oecd/social-issues-migration-health/effective-ways-to-realise-policy-reforms-in-health-systems_5kmh377l4n9x-en
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Effective Ways to Realise Policy Reforms in Health Systems
Jeremy Hurst
Sometimes it is argued that the content of a reform is less important in determining whether or not it receives public and legislative approval than the timing of the proposal; the way in which the reform is presented; the discussions with stakeholders; and a multitude of other factors. The...
  N° 50   28 Apr 2010 Click to Access: 
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  • http://www.keepeek.com/Digital-Asset-Management/oecd/social-issues-migration-health/health-systems-institutional-characteristics_5kmfxfq9qbnr-en
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Health Systems Institutional Characteristics
Valérie Paris, Marion Devaux, Lihan Wei
In 2008, the OECD launched a survey to collect information on the health systems characteristics of member countries. This paper presents the informaton provided by 29 of these countries in 2009. It describes country-specific arrangements to organise the population coverage against health risks...
  N° 49   21 May 2010 Click to Access: 
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  • http://www.keepeek.com/Digital-Asset-Management/oecd/social-issues-migration-health/the-challenge-of-financing-health-care-in-the-current-crisis_5kmfkgr0nb20-en
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The Challenge of Financing Health Care in the Current Crisis
Peter Scherer, Marion Devaux
The ratio of health expenditure to GDP, which in macroeconomic terms is an indicator which summarises the financing needs of a national health system, is likely to rise in countries for which the GDP falls. Over the past four decades, health expenditure has risen in most countries at a faster...
  N° 48   20 Nov 2009 Click to Access: 
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  • http://www.keepeek.com/Digital-Asset-Management/oecd/social-issues-migration-health/improving-lifestyles-tackling-obesity-the-health-and-economic-impact-of-prevention-strategies_220087432153
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Improving Lifestyles, Tackling Obesity: The Health and Economic Impact of Prevention Strategies
Franco Sassi, Michele Cecchini, Jeremy Lauer, Dan Chisholm
Overweight and obesity rates have been increasing relentlessly over recent decades in all industrialised countries, as well as in many lower income countries. OECD analyses of trends over time support the grim picture drawn in the international literature and so do projections of overweight...
  N° 47   23 Nov 2009 Click to Access: 
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  • http://www.keepeek.com/Digital-Asset-Management/oecd/social-issues-migration-health/health-care-quality-indicators-project_220112312723
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Health Care Quality Indicators Project
Saskia Drösler, Patrick Romano, Lihan Wei
This paper reports on the progress in the research and development of the set of patient safety indicators developed by the Health Care Quality Indicators project. The indicators presented here have been recommended by an expert group for further consideration in international reporting on the...
  N° 46   15 June 2009 Click to Access: 
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  • http://www.keepeek.com/Digital-Asset-Management/oecd/social-issues-migration-health/education-and-obesity-in-four-oecd-countries_223688303816
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Education and Obesity in Four OECD Countries
Franco Sassi, Marion Devaux, Jody Church, Michele Cecchini, Francesca Borgonovi
An epidemic of obesity has been developing in virtually all OECD countries over the last 30 years. Existing evidence provides strong suggestions that such epidemic has affected certain social groups more than others. In particular, education appears to be associated with a lower likelihood of...
  N° 45   20 Mar 2009 Click to Access: 
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  • http://www.keepeek.com/Digital-Asset-Management/oecd/social-issues-migration-health/the-obesity-epidemic-analysis-of-past-and-projected-future-trends-in-selected-oecd-countries_225215402672
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The Obesity Epidemic: Analysis of Past and Projected Future Trends in Selected OECD Countries
Franco Sassi, Marion Devaux, Michele Cecchini, Elena Rusticelli
This paper provides an overview of past and projected future trends in adult overweight and obesity in OECD countries. Using individual-level data from repeated cross-sectional national surveys, some of the main determinants and pathways underlying the current obesity epidemic are explored, and...
  N° 44   17 Mar 2009 Click to Access: 
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  • http://www.keepeek.com/Digital-Asset-Management/oecd/social-issues-migration-health/the-long-term-care-workforce-overview-and-strategies-to-adapt-supply-to-a-growing-demand_225350638472
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The Long-Term Care Workforce: Overview and Strategies to Adapt Supply to a Growing Demand
Rie Fujisawa, Francesca Colombo
This working paper offers an overview of the LTC workforce and reviews country responses to a growing demand for LTC workers. In the context of ageing societies, the importance of long-term care is growing in all OECD countries. In 2005, long-term care expenditure accounted for slightly over 1%...
  N° 43   09 Mar 2009 Click to Access: 
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  • http://www.keepeek.com/Digital-Asset-Management/oecd/social-issues-migration-health/measuring-disparities-in-health-status-and-in-access-and-use-of-health-care-in-oecd-countries_225748084267
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Measuring Disparities in Health Status and in Access and Use of Health Care in OECD Countries
Michael de Looper, Gaetan Lafortune
Most OECD countries have endorsed as major policy objectives the reduction of inequalities in health status and the principle of adequate or equal access to health care based on need. These policy objectives require an evidence-based approach to measure progress. This paper assesses the...
  N° 42   16 Feb 2009 Click to Access: 
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  • http://www.keepeek.com/Digital-Asset-Management/oecd/social-issues-migration-health/policies-for-healthy-ageing_226757488706
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Policies for Healthy Ageing
Howard Oxley
This paper reviews policies in the area of healthy ageing. With the ageing of OECD countries’ population over coming decades, maintaining health in old age will become increasingly important. Successful policies in this area can increase the potential labour force and the supply of non-market...
  N° 41   18 Dec 2008 Click to Access: 
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  • http://www.keepeek.com/Digital-Asset-Management/oecd/social-issues-migration-health/the-remuneration-of-general-practitioners-and-specialists-in-14-oecd-countries_228632341330
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The Remuneration of General Practitioners and Specialists in 14 OECD Countries
Rie Fujisawa, Gaetan Lafortune
This paper provides a descriptive analysis of the remuneration of doctors in 14 OECD countries for which reasonably comparable data were available in OECD Health Data 2007 (Austria, Canada, the Czech Republic, Denmark, Finland, France, Germany, Hungary, Iceland, Luxembourg, Netherlands,...
  N° 40   16 Oct 2008 Click to Access: 
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  • http://www.keepeek.com/Digital-Asset-Management/oecd/social-issues-migration-health/international-mobility-of-health-professionals-and-health-workforce-management-in-canada_228478636331
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International Mobility of Health Professionals and Health Workforce Management in Canada
Jean-Christophe Dumont, Pascal Zurn, Jody Church, Christine LeThi
This report examines the role played by immigrant health workers in the Canadian health workforce but also the interactions between migration policies and education and health workforce management policies. Migrant health worker makes a significant contribution to the Canadian health workforce....
  N° 39   21 Oct 2008 Click to Access: 
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  • http://www.keepeek.com/Digital-Asset-Management/oecd/social-issues-migration-health/pharmaceutical-pricing-and-reimbursement-policies-in-germany_228483137521
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Pharmaceutical Pricing and Reimbursement Policies in Germany
Valérie Paris, Elizabeth Docteur
This paper describes pharmaceutical pricing and reimbursement policies in Germany, considering them in the broader environment in which they operate, and assesses their impact on the achievement of a number of policy goals. Pharmaceutical coverage is comprehensive, with a high level of public...
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