{"title":"The impact of technological advancements on health spending","authors":"A. Marino, L. Lorenzoni","doi":"10.1787/FA3BAB05-EN","DOIUrl":"https://doi.org/10.1787/FA3BAB05-EN","url":null,"abstract":"The measurement of the impact of technology as a driver of health care expenditure is complex since technological effects are closely interlinked with other determinants such as income and the composition and health status of a population. Furthermore, the impact of the supply of advances in technology on health expenditure cannot be considered in isolation from demand and the policy context and the broader institutional context governing the adoption of new technologies. Hence, it is the interaction of supply and demand factors and the context that determine the ultimate level of technology use.\u0000There are also important quality changes that come with technological progress that also have monetary costs and benefits attached. Modelling quality improvements, both in terms of benefits within the health system and outside (e.g. its impact on life expectancy, ageing populations, productivity and GDP), is a challenging task, and no macroeconomic models to date have tried to capture them.\u0000This paper presents a comprehensive literature review of the impact of technological advances on health expenditure growth, the ‘cost’ side of the equation.","PeriodicalId":302579,"journal":{"name":"OECD Health Working Papers","volume":"80 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132964419","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
L. Lorenzoni, Diana M. Pinto, Frederico Guanais, Tomas Plaza Reneses, Frederic Daniel, Ane Auraaen
{"title":"Health systems characteristics","authors":"L. Lorenzoni, Diana M. Pinto, Frederico Guanais, Tomas Plaza Reneses, Frederic Daniel, Ane Auraaen","doi":"10.1787/0E8DA4BD-EN","DOIUrl":"https://doi.org/10.1787/0E8DA4BD-EN","url":null,"abstract":"In 2018, the Inter-American Development Bank and the OECD launched a survey to collect information on key health systems characteristics in Latin American and Caribbean (LAC) countries. This paper presents the information provided by 21 of these countries. It describes country-specific arrangements to organise the population coverage against health risks and the financing of health spending. It depicts the organisation of health care delivery, focusing on the public/private mix of health care provision, provider payment schemes, user choice and competition among providers, as well as the regulation of health care supply and prices. Finally, this document provides information on governance and resource allocation in health systems (decentralisation in decision-making, nature of budget constraints and priority setting).","PeriodicalId":302579,"journal":{"name":"OECD Health Working Papers","volume":"16 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116460425","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Current and past trends in physical activity in four OECD countries","authors":"Sahara Graf, M. Cecchini","doi":"10.1787/22CAD404-EN","DOIUrl":"https://doi.org/10.1787/22CAD404-EN","url":null,"abstract":"Physical inactivity and sedentary behaviours have been rising throughout the OECD in recent decades. Lack of physical activity and excessive sedentary behaviour are well-known risk factors for non-communicable diseases, such as heart diseases, stroke, diabetes, and osteoporosis. As such, reducing physical inactivity and sedentary behaviours and increasing daily physical activity has become a crucial public health issue. Using nationally representative time use surveys, this paper presents the trends in physical activity (PA) and sedentary behaviours over time, in Canada, France, Germany and the United States. A particular focus of this analysis is placed on sport activities. Men and women spend between 80 and 105 minutes daily in physical activities, with women spending more time in domestic physical activity, and men more time in sports. Participation in sport activities has been increasing over time, but no global trend for time spent in sports is visible; additionally, women are consistently less likely than men to report engagement in sport activities. Meanwhile, participation in active travel has been decreasing, displaying no overall trend for duration either. Education-based inequalities for sports participation are higher in men than in women, while income-based inequalities for sports are higher in women than in men. Men and women with a low level of income are more likely to report active travel in all countries. Additional MET (metabolic equivalent) hours spent in sports and non-sports leisure PA, domestic PA, and active travel are all associated with an increase in total PA, while work-related PA as well as other activities are associated with a decrease in total PA. At the individual level, an increase in time spent in all previously mentioned activities is associated with a decrease in total time spent in sedentary behaviours.","PeriodicalId":302579,"journal":{"name":"OECD Health Working Papers","volume":"5 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126696373","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Health Spending Projections to 2030","authors":"L. Lorenzoni, A. Marino, D. Morgan, C. James","doi":"10.1787/5667F23D-EN","DOIUrl":"https://doi.org/10.1787/5667F23D-EN","url":null,"abstract":"To gain a better understanding of the financial sustainability of health systems, the OECD has produced a new set of health spending projections up to 2030 for all its member countries. Estimates are produced across a range of policy situations. Policy situations analysed include a “base” scenario – estimates of health spending growth in the absence of major policy changes – and a number of alternative scenarios that model the effect on health spending of policies that increase productivity or contribute to better lifestyles; or conversely, ineffective policies that contribute to additional cost pressures on health systems.","PeriodicalId":302579,"journal":{"name":"OECD Health Working Papers","volume":"139 38","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"120820391","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Exploring the causal relation between obesity and alcohol use, and educational outcomes","authors":"S. Vuik, M. Devaux, M. Cecchini","doi":"10.1787/7BCD4669-EN","DOIUrl":"https://doi.org/10.1787/7BCD4669-EN","url":null,"abstract":"Two of the most important health risk factors for children and young adults are obesity and alcohol use. These risk factors are known to affect health and wellbeing, but may also have an impact on educational outcomes. The objective of this study was to assess a potential causal relationship between obesity or alcohol use, and educational outcomes, in Germany, the Netherlands, New Zealand, the Russian Federation, the United Kingdom, and the United States. Longitudinal data from cohort studies was used to establish temporal precedence. To ensure the absence of alternative explanations, regression models were adjusted for known confounders; instrumental variables were used to address endogeneity caused by reverse causality and potential unobserved confounders; and fixed effects analyses were used to correct for unobserved time-invariant confounders. The results suggest that the presence of obesity during childhood, as well as alcohol consumption during childhood, can have a negative impact on educational performance and future educational attainment.","PeriodicalId":302579,"journal":{"name":"OECD Health Working Papers","volume":"37 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121774440","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Health literacy for people-centred care","authors":"L. Moreira","doi":"10.1787/D8494D3A-EN","DOIUrl":"https://doi.org/10.1787/D8494D3A-EN","url":null,"abstract":"In the 21st century care, the old paradigm “because the doctor said so” no longer holds. Individuals are now seeking ways to understand their health options and take more control over their health decisions. But this is not an easy task. Professionals continue to use medical jargon, drug instructions are not always clear, and health information in clinical settings continue to be complex and challenging to navigate. Widespread access to digital technologies offset some of these barriers by democratising access to health information, providing new ways to improve health knowledge and support self care. Nonetheless, when health information is misused or misinterpreted, it can wrongly influence individuals’ preferences and behaviour, jeopardise their health, or put unreasonable demands on health systems.","PeriodicalId":302579,"journal":{"name":"OECD Health Working Papers","volume":"36 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121984209","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The economics of patient safety in primary and ambulatory care","authors":"Ane Auraaen, L. Slawomirski, N. Klazinga","doi":"10.1787/BAF425AD-EN","DOIUrl":"https://doi.org/10.1787/BAF425AD-EN","url":null,"abstract":"Building on published patient safety research literature, this paper aims to broaden the existing knowledge base on safety lapses occurring in primary and ambulatory care settings.\u0000The findings of this paper show that safety lapses in primary and ambulatory care are common. About half of the global burden of patient harm originates in primary and ambulatory care, and estimates suggest that nearly four out of ten patients experience safety issue(s) in their interaction with this setting. Safety lapses in primary and ambulatory care most often result in an increased need for care or hospitalisations. Available evidence estimates the direct costs of safety lapses – the additional tests, treatments and health care – in primary and ambulatory care to be around 2.5% of total health expenditure. Safety lapses resulting in hospitalisations each year may count 6% of total hospital bed days and more than 7 million admissions in the OECD.","PeriodicalId":302579,"journal":{"name":"OECD Health Working Papers","volume":"27 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115349262","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Investing in medication adherence improves health outcomes and health system efficiency","authors":"Rabia Khan, Karolina Socha-Dietrich","doi":"10.1787/8178962C-EN","DOIUrl":"https://doi.org/10.1787/8178962C-EN","url":null,"abstract":"Poor adherence to medications affects approximately half of the patient population, leading to severe health complications, premature deaths, and an increased use of healthcare services. The three most prevalent chronic conditions – diabetes, hypertension, and hyperlipidaemia – stand out regarding the magnitude of avoidable health complications, mortality, and healthcare costs. There are three broad reasons behind these low rates of adherence to chronic disease medications. Firstly,the problem of poor adherence has rarely been explicitly included in national health policy agendas. Secondly, interventions tend to attribute the problem exclusively to patients, while the evidence suggests that health system characteristics – in particular the quality of patient-provider interaction, procedures for refilling prescriptions, or out-of-pocket costs – are lead drivers. Thirdly, patients with chronic conditions frequently feel left out of the decision about their therapy and are inclined to rebuff. This paper identifies enablers that are needed for improving adherence to medication at the system level.","PeriodicalId":302579,"journal":{"name":"OECD Health Working Papers","volume":"31 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123903261","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Trends in life expectancy in EU and other OECD countries","authors":"V. Raleigh","doi":"10.1787/223159AB-EN","DOIUrl":"https://doi.org/10.1787/223159AB-EN","url":null,"abstract":"This paper reports on trends in life expectancy in the 28 EU countries and some other high-income OECD countries, and examines potential explanations for the slowdown in improvements in recent years. The slowdown in improvements in life expectancy since 2011 has been greatest in the USA, where life expectancy has fallen in recent years, and the UK, but France, Germany, Sweden and Netherlands have also seen a sharp slowdown. Overall, the pace of mortality improvement has slowed in several EU countries and Australia and Canada since 2011. Diseases of older ages are major contributors to the slowdown. Improvements in cardiovascular (CVD) disease mortality have slowed in many countries, respiratory diseases, including influenza and pneumonia, have claimed excess lives in some winters, and deaths from dementia and Alzheimer's disease are rising. In some countries, notably the USA and the UK, mortality improvements have also slowed or even reversed among working age adults because of the rising numbers dying from drug-related accidental poisoning. The report also considers wider contributing factors. Although some risk factors, such as smoking, excessive alcohol consumption, high blood pressure and cholesterol levels, continue to decline in most EU countries, the prevalence of obesity and diabetes continues to rise. Adverse trends in inequalities could also have an impact if some population groups experience lower gains in longevity than others, thereby reducing the overall gain. Looking ahead, it is unclear whether the current slowdown in mortality improvements in some EU countries and the USA is a long-term trend or not, whether the slowdown in major killers such as CVD will persist, and whether or not the excess winter mortality seen in some years becomes a regular feature given population ageing and increasing numbers of frail, older people. The timely monitoring and investigation of mortality trends, including through international collaboration where possible, can facilitate early implementation of remedial strategies.","PeriodicalId":302579,"journal":{"name":"OECD Health Working Papers","volume":"5 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116525374","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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