Tackling Wasteful Spending on Health
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.
Low-value health care with high stakes: Promoting the rational use of antimicrobials
Inappropriate use of antimicrobials is perhaps one of the most threatening forms of wasteful clinical care. This is because inappropriate use of antimicrobials encourages the development of antimicrobial resistance (AMR). This chapter builds on available evidence to present a comprehensive set of policy actions to promote an effective use of antimicrobials. The chapter is divided into five sections. The first section analyses trends in consumption and estimates the share of inappropriate use of antimicrobials in OECD countries. This is followed by an assessment of the current and future health and economic burden caused by inappropriate use of antimicrobials and AMR. Section three spells out the main determinants underlying inappropriate antimicrobial use. Section four assesses the potential effectiveness of policy actions to promote an effective use of antimicrobials. Special emphasis is devoted to education and information activities; to organisational changes; and to a broader use of new technologies. A final section summarises the key policy implications of the chapter.
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