Launch of OECD's Health at a Glance 2015 in London

1. OECD’S HEALTH AT A
GLANCE 2015 – WHAT
INSIGHTS FOR THE UK?
Mark Pearson, Deputy Director
Directorate for Employment, Labour and Social Affairs

2. Health at a Glance 2015 – How does the
UK perform?
• A leader in innovative
health policies, but not
on OECD international
benchmarks
• Based on OECD 2015
benchmarking, the UK is
a middling-to-low
performer on 3 out of 4
key domains – health
status, risk factors,
and quality
• UK is only excelling
relative to OECD peers
access

3. Health status: middling performance
compared to OECD peers
Health status indicators UK in the OECD
Life expectancy at birth –
Men
Life expectancy at birth -
women
Life expectancy at 65 - men
Life expectancy at 65 -
women
Mortality from
cardiovascular diseases
14th/34
24th/34
14th/34
23rd/34
9th/34
3

4. Risk factors: lagging behind OECD peers
Health risk indicators UK in the OECD
Smoking in adults
Alcohol consumption
Obesity in adults
Overweight and obesity in
children
20th/34
19th/34
27th/34
32nd/34
4

5. 20th/23
Quality: a mixed and mediocre picture
Health status indicators UK in the OECD
Asthma and COPD hospital
admission
Diabetes hospital admission
Case-fatality for heart attach
(admission-based)
Case-fatality for stroke
(admission-based)
Cervical cancer survival
22nd/32
5th/29
20th/32
19th/31
21st/23
5
Breast and colorectal cancer
survival

6. Access: a strong performance
Health status indicators UK in the OECD
Share of out of pocket medical
expenditure in household
consumption
Unmet medical care needs
Unmet dental care needs
Waiting times – cataract
surgery (median)
Waiting times – knee
replacement (median)
3rd/34
9th/23
8th/24
4th/14
2nd/14
6

7. Resource levels are still relatively low

8. UK per capita spend on health is below the
OECD average
Health expenditure per capita USD PPP, 2013 (or nearest year)
Note: Expenditure excludes investments, unless otherwise stated.
1. Includes investments.
2. Data refers to 2012.
Source: OECD Health Statistics 2015, http://dx.doi.org/10.1787/health-data-en; WHO Global Health Expenditure Database.
USD PPP
8713
6325
5862
5131
4904
4819
4553
4553
4371
4351
4256
4124
3866
3713
3677
3663
3453
3442
3328
3235
3077
2898
2514
2511
2428
2366
2275
2040
2010
1719
1653
1606
1573
1542
1530
1471
1380
1216
1121
1048
941
864
649
293
215
0
1000
2000
3000
4000
5000
6000
7000
8000
9000
Public Private

9. Average growth rate per capita in real terms has
been flat since 2009
Annual average growth rate in per capita health expenditure, real terms, 2005 to 2013 (or
nearest year)
1. Mainland Norway GDP price index used as deflator. 2. CPI used as deflator.
Source: OECD Health Statistics 2015, http://dx.doi.org/10.1787/health-data-en.
5.4
-0.4
5.3
1.3
3.5
0.5
3.4
0.4
3.2
5.4
3.6
3.5
6.7
3.2
3.4
11.3
4.1
-2.3
1.5
2.2
1.7
5.0
1.9
1.7
2.3
3.3
1.7
2.9
2.8
8.4
1.3
1.9
3.2
9.0
5.9
-7.2
-4.3
-4.0
-3.0
-1.7
-1.6
-0.8
-0.4
-0.3
-0.2
-0.1
0.3
0.3
0.5
0.6
0.6
0.6
0.8
0.9
1.0
1.0
1.2
1.2
1.3
1.5
1.7
1.7
2.0
2.0
2.3
2.5
3.6
3.9
5.4
6.4
-10
-5
0
5
10
15
2005-2009 2009-2013
Annualaveragegrowthrate(%)

10. High bed occupancy rate (rising slightly from 2000
to 2010) which suggests efficient use of
resources…
Occupancy rate of curative (acute) care beds, 2000 and 2013 – latest data is
2010 for the United Kingdom

11. … and short (and falling) average lengths of
stay in hospitals
Average length of stay in hospitals, 2000 and 2013

12. UK is already doing well at increasing the volume
of generic pharmaceuticals in the market
Source: Health at a Glance 2015
Trend in share of generics (in volume) in pharmaceutical market, 2000 to 2013
UK
Germany
Italy
Switzerland

13. Lower than average numbers of doctors…
Practicing doctors per 1 000 population, 2000 and 2013
6.3
5.0
4.3
4.3
4.1
4.0
4.0
3.9
3.8
3.7
3.6
3.6
3.4
3.4
3.4
3.3
3.3
3.3
3.3
3.2
3.0
3.0
2.8
2.8
2.8
2.7
2.6
2.6
2.6
2.3
2.2
2.2
2.2
1.9
1.8
0
1
2
3
4
5
6
7
2013 2000Per 1 000 population
1. Data include not only doctors providing direct care to patients, but also those working in the health sector as managers, educators, researchers, etc. (adding
another 5-10% of doctors). 2. Data refer to all doctors licensed to practice (resulting in a large over-estimation of the number of practising doctors in
Portugal, of around 30%).
Source: OECD Health Statistics 2015, http://dx.doi.org/10.1787/health-data-en.

14. Access to care is good… but health risk factors
are undermining population health

15. Access in the UK is good – low out-of-
pocket spending
Out-of-pocket medical spending as a share of final household consumption, 2013

16. Access in the UK is good – low unmet need
Unmet care needs for medical examination, by income level, 2013
• UK has very little unmet
need for medical
examination, and very low
variation in need by income
• Waiting times for planned
interventions are now lower
than in most other OECD
countries
• Coverage of vaccinations,
for example influenza for
the over 65s, is also good
and has been improving.

17. Health risk factors are undermining
population health: obesity…
Obesity among adults, 2013 (or nearest year)

18. Health risk factors are undermining
population health: smoking…
Change in daily smoking in adults, 2000 and 2013 (or nearest year)

19. Health risk factors are undermining
population health: alcohol
Alcohol consumption among adults, 2000 and 2013 (or nearest year)

20. UK is a quality policy innovator… but quality
of care outcomes are mediocre

21. In some areas quality outcomes are good…
• On some indicators
UK is doing well –
which reflects well on
the primary care
sector
• ‘Avoidable admissions’
for diabetes and
congestive heart
failure are low, as are
amputations for
diabetics
• Though antibiotic
prescribing is slightly
above the OECD
average, prescribing of
2nd line antibiotics is
very low
Major lower extremity amputation in adults with diabetes,
2013 (or nearest year)

22. Care seems to being delivered in a timely
way
Hip fracture surgery initiation after admission to hospital, 2013 (or nearest year)

23. Outcomes for acute care are mediocre
Thirty-day mortality after admission to hospital for AMI based on admission
data, 2003 to 2013 (or nearest years)

24. Outcomes for acute care are mediocre
Thirty-day mortality after admission to hospital for ischemic stroke based on
admission data, 2003 to 2013 (or nearest years)

25. Above average screening rates but below
average survival for cancer

26. Conclusions
• Access to care is very good, but population health
is undermined by high levels of smoking,
drinking and obesity.
• England is the pioneer in quality policies, but
basics are still not done right -- investing in
community care; adequate staffing so that
procedures and guidelines can be properly
followed; flow and quality of clinical information
• Per capita spending on health is close to the
OECD average, but below peers such as Ireland,
the Netherlands, Germany, France or Australia.

27. Thank you - http://www.oecd.org/health/health-at-a-glance.htm
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