International Health Care

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International Health Care using OECD data

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International Health Care

  1. 1. Baruch College/Mount Sinai School of Medicine Program in Health Care Administration and PolicyInternational Health Care BUS9100 Lecture 12BRaymond R. Arons, Dr. P.H, M.P.H
  2. 2. Lecture 12B 2 Baruch College/Mount Sinai School of Medicine Program In Health Care Administration and Policy BUS 9100: The Social and Governmental Environment of the Business of Health Care Lecture 12C International Health Care Systems-OECD 2009 Raymond R. Arons, Dr. P.H, M.P.H Health at a Glance 2009 OECD Indicators Released on December 8, 2009 http://www.oecd.org/health/healthataglanceCopyright © 2010 Raymond R. Arons, Teaneck, NJ, USA
  3. 3. Lecture 12B 3 1. HEALTH STATUS • Life expectancy and mortality • Chronic diseasesCopyright © 2010 Raymond R. Arons, Teaneck, NJ, USA
  4. 4. Lecture 12B 4 Life expectancy at birth has increased by more than 10 years in OECD countries since 1960, reflecting a sharp decrease in mortality rates at all agesSource: OECD Health Data 2009, OECD (http://www.oecd.org/health/healthdata). Infant mortality has decreased sharply in OECD countries, associated with improvements in socio-economic status and health careSource: OECD Health Data 2009, OECD (http://www.oecd.org/health/healthdata).Copyright © 2010 Raymond R. Arons, Teaneck, NJ, USA
  5. 5. Lecture 12B 5 Mortality rates from cardiovascular diseases have also declined, although they still vary considerably Ischemic heart disease mortality rates, Stroke mortality rates, 1980-2006 1980-2006Source: OECD Health Data 2009, OECD (http://www.oecd.org/health/healthdata). Life expectancy at age 65 in OECD countries stands, on average, at over 20 years for women and close to 17 years for menSource: OECD Health Data 2009, OECD (http://www.oecd.org/health/healthdata).Copyright © 2010 Raymond R. Arons, Teaneck, NJ, USA
  6. 6. Lecture 12B 6 However, the prevalence of chronic diseases such as diabetes is rising, due to population ageing but also to changes in Prevalence estimates of diabetes, adults aged 20-79 years, 2010 lifestyleNote: The data are age-standardised to the World Standard Population.Source: International Diabetes Federation (IDF) (2009), “Diabetes Atlas, 4th edition”. 2. RISK FACTORS FOR HEALTH • Among children • Among adultsCopyright © 2010 Raymond R. Arons, Teaneck, NJ, USA
  7. 7. Lecture 12B 7 About 1/3 of 15-year-olds have already been drunk at least twice in their life 2005-06Source: HBSC Survey 2005-2006, Currie et al. (2008). Only 1 in 8 15-year-olds undertake physical exercise daily in France and Switzerland 2005-06Source: HBSC Survey 2005-2006, Currie et al. (2008).Copyright © 2010 Raymond R. Arons, Teaneck, NJ, USA
  8. 8. Lecture 12B 8 The share of children eating fruit on a daily basis has increased, particularly among girls … but less than half of all children have taken up this good habitSource: HBSC Survey 2001-2002 and 2005-2006, Currie et al. (2004, 2008). Obesity among adults is increasing in all OECD countries. More than one in three Americans are obese1. Australia, Czech Republic (2005), Japan, Luxembourg, New Zealand, Slovak Republic (2007), UnitedKingdom and United States figures are based on health examination surveys, rather than health interviewsurveys.Source: OECD Health Data 2009, OECD (http://www.oecd.org/health/healthdata).Copyright © 2010 Raymond R. Arons, Teaneck, NJ, USA
  9. 9. Lecture 12B 9 3. HEALTH WORKFORCE • Number of physicians, nurses and other health professionals • Training and remuneration of physicians and nurses Access and quality of care depends on the number and training of health professionalsSource: The looming crisis of the health workforce: How can OECD countries respond? (OECD, 2008).Copyright © 2010 Raymond R. Arons, Teaneck, NJ, USA
  10. 10. Lecture 12B 10 The number of physicians per capita has increased in all OECD countries since 1990, except in Italy 2007 (or latest year 1990-2007 (or nearest year) available)1. Ireland, the Netherlands, New Zealand and Portugal provide the number of all physicians entitled to practiserather than only those practising.2. Data for Spain include dentists and stomatologists.Source: OECD Health Data 2009, OECD (http://www.oecd.org/health/healthdata). The number of medical graduates has increased in several OECD countries since 2000, after 15 years of stability or declineSource: OECD Health Data 2009, OECD (http://www.oecd.org/health/healthdata).Copyright © 2010 Raymond R. Arons, Teaneck, NJ, USA
  11. 11. Lecture 12B 11 The share of physicians trained abroad has increased in several OECD countries since 2000, but not in CanadaSource: OECD Health Data 2009, OECD (http://www.oecd.org/health/healthdata). The number of nurses per capita has increased in all OECD countries since 2000, except in Australia, the Netherlands and the Slovak Republic 2007 (or latest year available) 2000-2007Source: OECD Health Data 2009, OECD (http://www.oecd.org/health/healthdata).Copyright © 2010 Raymond R. Arons, Teaneck, NJ, USA
  12. 12. Lecture 12B 12 The number of nursing graduates has increased in some OECD countries since 2000, including France, Switzerland and the United StatesSource: OECD Health Data 2009, OECD (http://www.oecd.org/health/healthdata). The remuneration of nurses in Luxembourg and the United States is 4 to 6 times higher than in the Slovak Republic and Hungary 2007 (or latest year available)Source: OECD Health Data 2009, OECD (http://www.oecd.org/health/healthdata).Copyright © 2010 Raymond R. Arons, Teaneck, NJ, USA
  13. 13. Lecture 12B 13 4. Consumption of health goods and services • Diagnostics and treatments • Pharmaceuticals The number of MRI units and CT scanners is increasing in all OECD countries. Japan has the highest number per capita 2007 (or latest year available)Source: OECD Health Data 2009, OECD (http://www.oecd.org/health/healthdata).Copyright © 2010 Raymond R. Arons, Teaneck, NJ, USA
  14. 14. Lecture 12B 14 The United States has the highest number of MRI and CT exams per capita, followed by Luxembourg, Belgium and Iceland 2007 (or latest year available)1. Only include exams for out-patients and private in-patients (excluding exams in public hospitals).Note: Several countries, including Japan, have not provided any data.Source: OECD Health Data 2009, OECD (http://www.oecd.org/health/healthdata). The average length of stay for acute care has fallen in nearly all OECD countries Average length of stay for acute careSource: OECD Health Data 2009, OECD (http://www.oecd.org/health/healthdata).Copyright © 2010 Raymond R. Arons, Teaneck, NJ, USA
  15. 15. Lecture 12B 15 The average length of stay for normal delivery has become shorter in all OECD countries, even if large variations still exist 2007 (or latest year available)Source: OECD Health Data 2009, OECD (http://www.oecd.org/health/healthdata). Rates of caesarean delivery have increased in all OECD countries. On average, 1 birth out of 4 involved a C-section in 2007, against 1 out 7 in 1990 1990-2007 (or nearest year)Source: OECD Health Data 2009, OECD (http://www.oecd.org/health/healthdata).Copyright © 2010 Raymond R. Arons, Teaneck, NJ, USA
  16. 16. Lecture 12B 16 The consumption of pharmaceuticals is increasing across OECD countries, particularly for antidiabetics and Antidiabetics antidepressants Antidepressants* DQD : Defined Daily DoseSource: OECD Health Data 2009, OECD (http://www.oecd.org/health/healthdata). 5. QUALITY OF CARE • Life threatening conditions (cancers and acute myocardial infarctions) • Chronic diseasesCopyright © 2010 Raymond R. Arons, Teaneck, NJ, USA
  17. 17. Lecture 12B 17 Cancer survival rates are increasing in all OECD countries Five-year relative survival Cervival cancer rates Breast cancerNote: Survival rates are age standardised to the International Cancer Survival Standards Population. 95%confidence intervals are represented by H in the relevant figures.Source: OECD Health Care Quality Indicators Data 2009 (OECD). In-hospital mortality rates following heart attack are decreasing in all OECD countriesNote: Rates are age-sex standardised to 2005 OECD population (45+). 95% confidence intervals are representedby H.Source: OECD Health Care Quality Indicators Data 2009 (OECD).Copyright © 2010 Raymond R. Arons, Teaneck, NJ, USA
  18. 18. Lecture 12B 18 Treatment for chronic diseases is not optimal. Too many persons are admitted to hospitals for asthma … Asthma admission rates, population aged 15 and over, 20071. Does not fully exclude day cases.2. Includes transfers from other hospital units, which marginally elevates rates.Source: OECD Health Care Quality Indicators Data 2009 (OECD). … too many persons are admitted to hospitals for diabetes complications, highlighting the need to improve primary care Diabetes acute complications admission rates, population aged 15 and over, 20071. Does not fully exclude day cases.2. Includes transfers from other hospital units, which marginally elevates rates.Source: OECD Health Care Quality Indicators Data 2009 (OECD).Copyright © 2010 Raymond R. Arons, Teaneck, NJ, USA
  19. 19. Lecture 12B 19 6. ACCESS TO CARE • Financial barriers • Geographic barriers Low-income populations more often report unmet care needs due to cost, but there are large variations across countries Unmet care need* due to costs, by income group, 2007* Did not get medical care, missed medical test, treatment or follow-up, did not fill prescription or misseddoses.Source: Commonwealth Fund (2008).Copyright © 2010 Raymond R. Arons, Teaneck, NJ, USA
  20. 20. Lecture 12B 20 All OECD countries have achieved universal or near-universal health care coverage, except Turkey, Mexico and the United States 2007Source: OECD Health Data 2009, OECD (http://www.oecd.org/health/healthdata). The distribution of physicians within countries is often uneven, limiting access to care in rural areas Physician density in rural and urban regionsSource: AIHW (2008c); CIHI (2005); DREES (2008); NCHS (2007).Copyright © 2010 Raymond R. Arons, Teaneck, NJ, USA
  21. 21. Lecture 12B 21 Low-income populations more often report unmet dental care needs due to cost Unmet need for a dental examination due to costs, 2004Source: Davis et al. (2007). 7. HEALTH EXPENDITURE • Expenditure • FinancingCopyright © 2010 Raymond R. Arons, Teaneck, NJ, USA
  22. 22. Lecture 12B 22 Health expenditure per capita varies widely across OECD countries. The United States spends almost two-and-a-half times the OECD average 20071. Health expenditure is for the insured population rather than resident population.2. Current health expenditure.Source: OECD Health Data 2009, OECD (http://www.oecd.org/health/healthdata). OECD countries allocate about 9% of their GDP to health. This share varies from 16% in the United States to less than 6% in Mexico and Turkey % GDP 20 16.0 Public expenditure Private expenditure 15 11.0 10.8 10.4 10.2 10.1 10.1 9.9 9.8 9.8 9.6 9.2 9.3 9.1 8.9 8.9 8.7 8.7 8.5 8.4 8.2 10 8.1 7.7 7.6 7.4 7.3 6.8 6.8 6.4 5.9 5.7 5 0 United… Slovak… Czech… Netherlands1 Canada Sweden Luxembourg3 Portugal New Zealand2 Germany Hungary Mexico Japan Finland Greece Norway OECD Spain Belgium1 Korea Denmark Austria Poland France United States Iceland Switzerland Turkey Australia Ireland Italy1. Public and private expenditures are current expenditures (excluding investments).2. Current health expenditure..3. Health expenditure is for the insured population rather than resident population. 42Source: OECD Health Data 2009, OECD (http://www.oecd.org/health/healthdata).Copyright © 2010 Raymond R. Arons, Teaneck, NJ, USA
  23. 23. Lecture 12B 23 The share of GDP allocated to health is increasing in all OECD countries, mostly due to new medical technologies and population ageingSource: OECD Health Data 2009, OECD (http://www.oecd.org/health/healthdata). Across OECD countries, health expenditure has grown by slightly more than 4% annually over the past ten years Annual average real growth in per capita health expenditure, 1997-2007Source: OECD Health Data 2009, OECD (http://www.oecd.org/health/healthdata).Copyright © 2010 Raymond R. Arons, Teaneck, NJ, USA
  24. 24. Lecture 12B 24 The public sector is the main source of financing in most OECD countries. Only in the United States and Mexico do public sources account for less than 50% of health financing 20071. Share of current health expenditure.Source: OECD Health Data 2009, OECD (http://www.oecd.org/health/healthdata). Higher health spending per capita is generally associated with higher life expectancy, although this link tends to be less pronounced in countries with higher spending. Other factors also influence life expectancy … 2007 (or latest year available)Source: OECD Health Data 2009, OECD (http://www.oecd.org/health/healthdata).Copyright © 2010 Raymond R. Arons, Teaneck, NJ, USA

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