Delivering Quality Education and Health Care to All

Preparing Regions for Demographic Change

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COVID-19 has put renewed focus on the importance of addressing longstanding challenges that OECD governments face in delivering public services, especially in regions with people spread over a wider area where economies of scale are more difficult to achieve. The physical infrastructure needed to provide good quality education and health services can be more complex and expensive in rural and remote regions that also struggle to attract and retain education and health care professionals. Acute ageing trends in many rural regions and, in some cases, a shrinking population will require sustainable policy responses that will need to be coherent with pressure to drive efficiencies in public spending. This report examines the nuances specific to the delivery of education and health care to people everywhere, offering recommendations on how to better adapt provision to the realities of today and the emerging realities of tomorrow to face the challenges of distance, demographic change and fiscal belt-tightening. The report also examines digital connectivity issues in rural and remote regions, recognising the significant scope for digital delivery of services to mitigate challenges related to distance. Finally, the report looks at governance issues, including fiscal issues, through which the delivery of these critical services is administered and paid for.


Delivering quality health services in rural communities

As costs, quality and access to healthcare are all affected by distance and density, reducing inequalities in quality healthcare provision requires a place-based dimension. This chapter compares evidence on structural trends affecting health systems across territories in OECD countries, including income and educational inequalities, exposure to risk factors, and ageing. It also discusses the organization and concentration of health services and the trade-offs between quality, access and cost of healthcare from a spatial point of view. The chapter looks at holistic and people-centred comprehensive strategies, including reinforcement of primary care and new models of care such as service integration, in order to reduce costs while increasing performance of healthcare provision in rural areas. Finally, the chapter examines innovative approaches to healthcare delivery including digital approaches and new forms of hospital and care organisation.



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