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OVERVIEW OF RECENT AND FUTURE ACTIVITIES ON HEALTH AT THE OECD
Joint session of Health Accounts Experts
and Health Data Correspondents
23 October 2014
OECD Health Committee Programme of
Work on Health
1. OECD Health Statistics and Health at a Glance
(monitoring health and health systems)
2. Health care quality
3. Value for money in health systems
4. Economics of prevention
5. Health workforce policies
6. Long-term care
7. Ageing Unequally (horizontal project) -2015/16
8. Health Ministerial meeting (2016)
3
• Aim is to benchmark the efforts of countries to
manage and measure health care quality and
provide advice on reforms for improvement
• Latest reviews:
Sweden (December 2013)
Norway (May 2014)
Czech Republic (June 2014)
• Upcoming reviews: Turkey, Italy, Australia,
Japan, Portugal and UK
http://www.oecd.org/health/health-
systems/health-care-quality-reviews.htm
Contact: [email protected]
Quality - System level
Quality Reviews: Raising Standards
4
Quality: disease level - Report on CVD
• Report to be published early next year
• Despite the success, rising levels of obesity and diabetes are threatening prospects for further gains.
• Ageing population will lead to greater demand and complexity of health care needs.
• Greater resources improves quality of CVD and diabetes care
– Gains are not automatic and depends on how resources are allocated and managed
– Performance is linked to access to care, quality of care initiatives and payment systems
• Substantial scope for further improvements along the entire pathway of CVD and diabetes care remain
• Strengthening lifestyle policies, primary care (prevention/long term care) and acute care
Contact: [email protected]
5
Quality: disease level - Report on CVD
AUS
AUT
BEL
CANCHL
DNK
EST
FIN
FRA
DEU
HUN
ISRITA
KORLUX
MEX
NLD
NZL
NORPOL
SVK
SVN
ESP
SWE
CHE
TUR
GBR
USA
-20
02
04
06
0
Dia
be
tes*
ho
spita
l ad
mis
sion
s p
er
100
0 d
iab
etic
pa
tien
ts
5 10 15 20 25 30Number of hospital admissions per 1000 population
Diabetes-related avoidable admissions: controlling for prevalence and hospitals
6
• Support countries to make better use of existing data
to measure and improve the quality of health care
• Advisory panel of experts in law, privacy regulation,
IT, health policy, statistics, research and civil society.
• 8 high-level recommendations and practical examples
to help countries strengthen health data governance
to enable data to be used safely.
• Report and workshop on data governance in May
2015
Quality: Health data infrastructure
Contact: Jillian Oderkirk (HD)
7
• Objectives of the project: 1. Document geographic variations in health care
not only across countries but also within countries
2. Analyse possible causes of medical practice variations
3. Explore policy options to reduce unwarranted variations and improve
resource allocation
• Focused on hospital medical admissions and a
selected set of diagnostic and surgical procedures
• 13 countries participated
Final report launched at a conference in Berlin on
15-16 September 2014
Value for money: Geographic
Variations in Health Care
Contact: Valerie Paris and Gaetan Lafortune
8
Geographic variations in health care
Example of knee replacement
Source: Geographic Variations in Health Care: What Do We Know and What Can Be Done to Improve Health System
Performance?, OECD Publishing, p.47. http://dx.doi.org/10.1787/9789264216594-en.
9
• Two main streams of work:
1. Measuring coverage: – Paper on cot-sharing by function of care and mechanisms to protect
people from high copayments to be published before the end of this year as Health Working Paper.
2. Benefit basket: what is paid or not by public/collective systems?
– A new paper will examine how countries define the benefit package and make decisions for coverage of borderline cases.
– It will include a few case studies.
– Draft report to be discussed at the December Health Committee.
Public and private boundaries in health care
Contact: [email protected]
10
• Joint Senior Budget Officials and Health Committee network
• Key topics: – OECD survey of budget officials : Budgeting for health, practices
and challenges.
– Can we speak about a ‘post-crisis’ fiscal outlook for health spending?
– User charges and co-payments: how useful and how dangerous?
– Controlling health care expenditure in decentralised environments.
– Financing universal health care: the need for close co-operation between health and budget Ministries.
– The challenges of using open data in health policy.
• Joint Network publication in 2015
Financial sustainability of health systems (HD-GOV)
Contacts: [email protected] (HD)
[email protected] (GOV)
Economics of prevention: Alcohol
Alcohol Consumption Trends, Europe
5.0
7.5
10.0
12.5
15.0
17.5
20.0
1980 1985 1990 1995 2000 2005 2010
Litr
es o
f p
ure
alc
oh
ol p
er c
apit
a, 1
5+
Finland France Sweden Germany Italy Ireland Belgium OECD-Europe
12
Men Women
• Discussion on policies to address harmful alcohol consumption at Health Committee meeting in December.
• Report to be published Q1 next year Contact: [email protected]
Economics of prevention: Alchool
-0.08
-0.08
-0.03
0.00
0.00
0.02
0.04
0.04
0.07
0.07
0.07
0.07
0.09
0.18
0.29
Germany
England
Finland
Canada
France
Ireland
Switzerland
Australia
Spain
New Zealand
Japan
Hungary
USA
Korea
Chile
People with less educationmore likely to drink at risk
People with more education more likely to drink at risk
not shown because less than 1% of women report heavy drink
-0.20
-0.17
-0.15
-0.14
-0.12
-0.11
-0.10
-0.08
-0.06
-0.06
-0.04
0.00
0.06
0.13
England
France
Finland
Germany
Canada
Ireland
Switzerland
Hungary
Australia
Spain
USA
Japan
New Zealand
Korea
People with less educationmore likely to drink at risk
People with more education more likely to drink at risk
Hazardous Drinking and Education
13
Health Workforce
• Three main streams of work:
– Changes in domestic education and training policies for
doctors and nurses
– Recent trends in health workforce migration
– Extent of skills mismatch in health sector (with possible follow-
up work to improve data and evidence for policy evaluation)
• Co-operation with other international organisations
– EC (Action Plan, Joint Action on Health Workforce Planning
and Forecasting)
– WHO (Health Workforce Department, Headquarters)
Contact: [email protected]
14
Skills mismatch of doctors and nurses compared
with other technical/professional occupations
Multinomial logistic regression, odds-ratios; controlling for country, age, and sex
Source: PIAAC Survey, 2011-12 (calculations by OECD Secretariat)
0.54
1.67
0.84
1.14
1.00 1.00
0.00
0.50
1.00
1.50
2.00
Overskilled Underskilled
Physicians
Nurses
Other workers
Australia, inflow of doctors Canada, inflow of nurses
Growing education and training efforts of doctors and
nurses in many OECD countries has slowed down the
growth of foreign-trained workers, without stopping it
United States, inflow of nurses United Kingdom, inflow of doctors
16
Long-Term Care
• Dementia:
– Follow-up to the G8 Dementia Summit (legacy events,
WDC, Envoy)
– Joint OECD-OBI-IHPME Workshop “Can big data help?”
in Toronto on 15 September 2014
• New project on measuring gaps in social protection
for long-term care
Contact: [email protected]
17
WORK WITH OTHER INTERNATIONAL ORGANISATIONS
18
• Establishment of Health Care Quality Improvement
Network in Asia/Pacific with WHO WPRO and SEARO
(third meeting: Bangkok, 27-28 November 2014)
• OECD doing joint work with Asia/Pacific Observatory on
Health Systems on provider payment methods
(publication to be released in April 2015)
• More work with candidate countries to the OECD:
Reviews of Colombia, Latvia
• More work also with Brazil, China, India, Indonesia,
Russia, South Africa in Health Statistics, Health at a
Glance, SHA, HCQI
Cooperation with WHO and non-OECD countries
• Workshop on how to use health accounts to improve health financing and expenditure decisions, April 1-4, 2014, Paris. – Better linking the production and use of health accounts to inform policy.
– Addressed demands around sustainable health care financing
– Attended by 23 low and middle-income countries incl. all Key Partner countries
– 14 bilateral/multilateral agencies incl. WHO, World Bank, Gates Foundation, USAID
• Moving forward: – Brazil - Country-specific SHA training course (September 2014)
– Indonesia – joint workshop planned with World Bank (late 2014/ early 2015)
– China - interest in organising workshop on policy use and forecasting
– Symposium planned with WB (mid-2015)
– Japan funded the project - OECD now seeking long-term funding to develop this programme further in the future.
SHA Training Course at OECD
20
RECENT AND UPCOMING PUBLICATIONS
21
Making Mental Health Count:
The Social and Economic Costs of Neglecting Mental Health
Care
http://www.oecd.org/els/health-systems/mental-health-
systems.htm
OECD Reports
Geographic Variations in Health Care:
What Do We Know and What Can Be Done to Improve
Health System Performance?
http://www.oecd.org/els/health-systems/medical-practice-
variations.htm
22
• No. 68 - Health Spending Continues to Stagnate in
Many OECD Countries (February 2014)
• No. 69 – Geographic Imbalances in Doctor Supply
and Policy Responses (March 2014)
• No. 71-74 – Mental Health Analysis Profiles (Italy,
Finland, Netherlands, Scotland) (July 2014)
• No. 75 – Comparing Hospital and Health Prices and
Volumes Internationally (August 2014)
• No. 76 – Health, Austerity and Economic Crisis
(September 2014) http://www.oecd.org/els/health-systems/health-working-papers.htm
Health Working Papers
23
Health at a Glance: Europe 2014 (late November; tbc)
http://www.oecd.org/els/health-systems/health-at-a-
glance-europe.htm
Upcoming editions of Health at a Glance
Health at a Glance: Asia/Pacific 2014 (27 November)
http://www.oecd.org/els/health-systems/health-at-a-
glance-asia-pacific.htm
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