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Tackling Wasteful Spending on Health

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Following a brief pause after the economic crisis, health expenditure is rising again in most OECD countries. Yet, a considerable part of this health expenditure makes little or no contribution to improving people's health. In some cases, it even results in worse health outcomes. Countries could potentially spend significantly less on health care with no impact on health system performance, or on health outcomes. This report systematically reviews strategies put in place by countries to limit ineffective spending and waste. On the clinical front, preventable errors and low-value care are discussed. The operational waste discussion reviews strategies to obtain lower prices for medical goods and to better target the use of expensive inputs. Finally, the report reviews countries experiences in containing administrative costs and integrity violations in health.

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Administrative spending in OECD health care systems: Where is the fat and can it be trimmed?

Administrative tasks are essential at all levels of the health care system, from ministries and insurers to health providers. Many tasks are vital to ensure access, equity and quality of health care provision. Other activities may be of limited use, adding no value for patients.This chapter looks into differences in administrative costs at the level of the health care system, for both health care facilities and individual health workers. Some differences are related to the way health care is financed. Many countries see the need to tackle inefficiencies in health care administration. The most promising strategies to increase efficiency are centred on simplifying procedures – partly by making better use of ICT – and optimising the size of administrative bodies to generate economies of scale. Additionally, regulatory changes can have an enormous and immediate effect on administrative costs and the administrative workload of health providers.

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