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As ageing societies are pushing a growing number of frail old people into needing care, delivering quality long-term care services - care that is safe, effective, and responsive to needs - has become a priority for governments. Yet much still remains to be done to enhance evidence-based measurement and improvement of quality of long-term care services across EU and OECD countries. This book offers evidence and examples of useful experiences to help policy makers, providers and experts measure and improve the quality of long-term care services.
This review of health care quality in Denmark examines policies related to quality and includes chapters covering primary and integrated care, hospital specialisation and equity. It finds that with a dense array of disease- and service-focused quality initiatives, and with information on the quality of care stored in separate data repositories, Denmark needs to create effective links and synergies between them to drive up quality in the healthcare system as a whole, rather than in disconnected elements. Primary care will be central in meeting Denmark's future healthcare challenges of an ageing population with multiple chronic conditions. Therefore, an urgent need is to create a national vision of how a modernised primary care sector will fulfill this new coordination role. National standards, clinical guidelines, accreditation of clinical pathways and targeted financial incentive programmes could support this role, along with more transparent and formalised continual professional development. To facilitate quality improvement from the ambitious hospital rationalisation, Denmark should collect and disseminate data on the quality of individual physicians as well as the hospitals. Undergraduate training and medical research should be reviewed in light of the new service arrangements. Close surveillance will be needed to monitor whether certain patient groups forego healthcare because travel times to providers are too long. Limited data availability complicate Denmark's ability to monitor its commitment to equitable healthcare. There is an urgent need for renewed action to tackle risk factors of chronic ill-health that disproportionately affect low-income groups. Better information on the impact of user-charges on unmet need in low-income groups is needed.
Aid plays an important role in reducing poverty and inequality, stimulating growth, building capacity, promoting human development and accelerating the achievement of the Millennium Development Goals. Effective aid is critical both to maximise the impact of aid and to achieve long-term, sustainable development. Aid to the health sector has increased substantially over the last 20 years from USD 5 billion in 1990 to USD 21.8 billion in 2007. Consisting of a growing and diverse range of actors, aid to the health sector faces complex governance and management challenges: for example, donors inadvertedly invest in duplicate and fragmented efforts, while partners are unable to take full responsibility and leadership. By reviewing these challenges against the aid effectiveness principles outlined in the landmark 2005 Paris Declaration and 2008 Accra Agenda for Action, this report provides insight and expounds lessons from the health sector to the broader challenges of aid effectiveness. Health, then, is used as a "e;tracer"e; sector to help assess the risks and benefits of the diverse range of actors, and promote co-ordination and coherence among development programmes. This work is the result of a collaboration between the Working Party on Aid Effectiveness - an inclusive, international forum with the aim of improving aid delivery - through its Task Team on Health as a Tracer Sector and the World Trade Organization.
This book examines how new scientific developments in understanding how the brain works can help educators and educational policy makers develop new and more efficient methods for teaching and developing educational policies. This new "e;science of learning"e; is providing insights into how to improve reading and mathematical skills and highlights the significance of the distinction between nature and nurture in learning and brain development. The book focuses on the importance of developing a trans-disciplinary approach where teachers, the medical profession, and scientists work together.
More than five million new cases of cancer are diagnosed every year in OECD countries. Mortality rates are declining, but not as fast as for other big killers such as heart disease, and cancer survival rates show almost a four-fold difference across countries. In short, many countries are not doing as well as they could in the fight against cancer. Cancer Care: Assuring Quality to Improve Survival surveys the policy trends in cancer care over recent years and looks at survival rates to identify the why some countries are doing better than others. It sets out what governments should do to reduce the burden of cancer in their countries. As well as an adequate level of resourcing, a comprehensive national cancer control plan appears critical, emphasising initiatives such as early detection and fast-track treatment pathways. Countries also need better data, particularly for patients' experiences of care, in order to provide high quality, continuously improving cancer care.
Over the past decade, many OECD countries have introduced new policies to tackle excessive waiting times for elective surgery with some success. However, in the wake of the recent economic downturn and severe pressures on public budgets, waiting times times may rise again, and it is important to understand which policies work. In addition, the European Union has introduced new regulations to allow patients to seek care in other member states, if there are long delays in treatment. This book provides a framework to understand why there are waiting lists for elective surgery in some OECD countries and not in others. It also describes how waiting times are measured in OECD countries, which differ widely, and makes recommendations for best practice. Finally, it reviews different policy approaches to tackling excessive waiting times. Some countries have introduced guarantees to patients that they will not wait too long for treatment. These policies work only if they are accompanied by sanctions on health providers to ensure the guarantee is met or if they allow greater choice of health-care providers including the private sector. Many countries have also introduced policies to expand supply of surgical services, but these policies have generally not succeeded in the long-term in bringing down waiting times. Given the increasing demand for elective surgery, some countries have experimented with policies to improve priorisation of who is entitled to elective surgery. These policies are promising, but difficult to implement.
Genetic tests are being developed at an impressive rate and a significant number has already reached the market. Substantial involvement of the private sector has led to unprecedented growth in commercial genetic testing services and in trade of such services. This trend is expected to increase as knowledge gained from the mapping of the human genome and of single nucleotide polymorphisms (SNPs) is applied to the identification of disease-causing genes and of inherited differences in drug response. The potential socio-economic and ethical impacts are staggering. This report provides a state-of-the art review of advances in genetic testing and of main international policy concerns drawing from the OECD workshop on "e;Genetic Testing: Policy Issues for the New Millennium"e;, held in Vienna on 23-25 February 2000.
At a time when ever more information is available about the quality of health care, the challenge for policy makers is to better understand the policies and approaches that sit behind the numbers. Korea is the first country report in a new OECD series evaluating the quality of health care across OECD countries - whether care is safe, effective and responsive to patients' needs. OECD Reviews of Health Care Quality examine what works and what does not work, both to benchmark the efforts of countries and to provide advice on reforms to improve quality of health care. This series of individual country reviews will be followed by a final summary report on the lessons learnt for good policy practices.
This report evaluates Australia's progress in reducing the pollution burden, improving natural resource management, integrating environmental and economic policies, and strengthening international co-operation. The analyses presented are supported by a broad range of economic and environmental data.
A System of Health Accounts 2011 provides a systematic description of the financial flows related to the consumption of health care goods and services. As demands for information increase and more countries implement and institutionalise health accounts according to the system, the data produced are expected to be more comparable, more detailed and more policy relevant. This new edition builds on the original OECD Manual, published in 2000, and the Guide to Producing National Health Accounts to create a single global framework for producing health expenditure accounts that can help track resource flows from sources to uses. The Manual is the result of a four-year collaborative effort between the OECD, WHO and the European Commission, and sets out in more detail the boundaries, the definitions and the concepts responding to health care systems around the globe - from the simplest to the more complicated.
Five years after the first Review of Switzerland's health system, the OECD and the World Organization combined their expertise again to report on progress and implementation of health reforms in the Swiss health system. In addition to taking stock of the good overall performance of the Swiss health system, the two organizations propose concrete ways to help the system be more efficient and prepare for the future health needs of the Swiss population. The report focuses on three important issues: health insurance markets, health workforce planning and management and governance of the health system.
Every person aspires to a good life. But what does "e;a good or a better life"e; mean? This report looks at the most important aspects that shape people's lives and well-being: income, jobs, housing, health, work and life-balance, education, social connections, civic engagement and governance, environment, personal security and subjective well-being. It paints a comprehensive picture of well-being in OECD countries and other major economies, by looking at people's material living conditions and quality of life across the population. The report responds to the needs of citizens for better information on well-being and of policy makers to give a more accurate picture of societal progress. The report finds that well-being has increased on average over the past fifteen years: people are richer and more likely to be employed; they enjoy better housing conditions and are exposed to lower air pollution; they live longer and are more educated; they are also exposed to fewer crimes. But differences across countries are large. Furthermore, some groups of the population, particularly less educated and low-income people, tend to fare systematically worse in all dimensions of well-being considered in this report: for instance they live shorter lives and report greater health problems; their children obtain worse school results; they participate less in political activities; they can rely on lower social networks in case of needs; they are more exposed to crime and pollution; they tend to be less satisfied with their life as a whole than more educated and higher-income people. How's Life? is part of the OECD Better Life Initiative, launched by the Organization on the occasion of its 50th Anniversary. The OECD Better Life Initiative aims to promote "e;Better Policies for Better Lives"e;, in line with the OECD's overarching mission. One of the other pillars of the OECD Better Life Initiative is the Your Better Life Index ( www.oecdbetterlifeindex.org ), an interactive composite index of well-being that aims at involving citizens in the debate on societal progress.
When the OECD was founded in 1961, health systems were gearing themselves up to deliver acute care interventions. Sick people were to be cured in hospitals, then sent on their way again. Medical training was focused on hospitals; innovation was to develop new interventions; payment systems were centred around single episodes of care. Health systems have delivered big improvements in health since then, but they can be slow to adapt to new challenges. In particular, these days, the overwhelming burden of disease is chronic, for which 'cure' is out of our reach. Health policies have changed to some extent in response, though perhaps not enough. But the challenge of the future is that the typical recipient of health care will be aged and will have multiple morbidities. This book examines how payment systems, innovation policies and human resource policies need to be modernised so that OECD health systems will continue to generate improved health outcomes in the future at a sustainable cost.
Are breast cancer survival rates higher in the United States than in the United Kingdom and France? Are a patient's chances of dying within 30 days after admission to a hospital with a heart attack lower in Canada than in Korea? Are surgeons in some countries more likely to leave "e;foreign bodies"e; behind after operations or make accidental punctures or lacerations rates when performing surgery? The need for answers to these kinds of questions and the value of measuring the quality of health care are among the issues addressed in this publication. Many health policies depend on our ability to measure the quality of care accurately. Governments want to increase "e;patient-centeredness"e;, improve co-ordination of care, and pay providers of high-quality care more than those who underperform. However, measuring the quality of health care is challenging. The OECD's Health Care Quality Indicator project has overcome some of the problems, though many remain. If policy makers are serious about improving the body of evidence on the quality of care, they need to improve their health information systems. This publication describes what international comparable quality measures are currently available and how to link these measures to quality policies such as accreditation, practice guidelines, pay-for-performance, national safety programmes and quality reporting.
Across the OECD, nearly 19 million people are living with dementia. Millions of family members and friends provide care and support to loved ones with dementia throughout their lives. Globally, dementia costs over USD 1 trillion per year and represents one of the leading causes of disability for elderly adults. These numbers will continue to rise as populations age. Until a cure or disease-modifying treatment for dementia is developed, the progress of the disease cannot be stopped. This report presents the most up-to-date and comprehensive cross-country assessment of the state of dementia care in OECD countries. In recent years, OECD countries have enhanced their efforts to provide high-quality dementia care during diagnosis, early and advanced dementia, but improving measurement is necessary for enhancements in care quality and outcomes for people with dementia. The report advises a set of policies that can help countries to improve diagnosis, strengthen access to care services, improve the quality of care, and support the families and carers of people living with dementia. Measuring and comparing the services that are delivered to people with dementia and the outcomes they achieve is a crucial part of improving dementia care. Most health systems have very poor data on dementia care and countries should work to strengthen the measurement of quality and outcomes of dementia care.
Pharmacogenetics helps us understand the relationship between an individual's genetic make-up and the way medicines work for each person. This book reviews the use of pharmacogenetics across all stages of the health innovation cycle from research through to uptake by doctors and patients. It focuses on how to optimise the use of pharmacogenetics to deliver effective innovations for public health, and design policies that enhance their economic and social benefits. The book argues for large-scale studies to validate the biomarkers that underpin pharmacogenetics and policies to share the cost and risk of using pharmacogenetics to improve the use of existing medicines. Governments and others need to align regulatory, reimbursement and other incentives and work with industry to measure better the impacts of pharmacogenetics. Health systems need to take positive steps to adapt to the use of pharmacogenetics and ensure that health professionals receive adequate training.
Rising public health care spending remains a problem in virtually all OECD and EU member countries. As a consequence, there is growing interest in policies that will ease this pressure through improved health system performance. This report examines selected policies that may help countries better achieve the goal of improved health system efficiency and thus better value for money. Drawing on multinational data sets and case studies, it examines a range policy instruments. These include: the role of competition in health markets; the scope for improving care coordination; better pharmaceutical pricing policies; greater quality control supported by stronger information and communication technology in health care; and increased cost sharing.
This book records the trends in road accident statistics for the period 1993 and 1994 in ECMT Member countries, five associate Member countries (Australia, Canada, Japan, the Russian Federation and the United States) and one observer country (Morocco). It provides data on the trends from 1980 to 1994 in these countries, individually and as a whole, in numbers of motor vehicles, accidents causing casualties, and in numbers killed and casualties (killed and injured). It also highlights a number of factors to be taken into account in any analysis of road accidents and provides a dynamic assessment of the reality on our roads.
Confidence in a country's health care system requires indemnification and deterrence systems that adequately cover liability, provide fair compensation for injury, and deter medical malpractices. Over the last years, in many OECD countries, these systems have experienced difficulties resulting in high-risk specialty physicians and surgeons leaving the practice and the development of expensive and useless-if not risky-defensive medicine. This publication surveys and assesses various types of mechanisms and reforms that best limit and indemnify medical accidents. Reasons for difficulties faced by some compensation and prevention regimes, given the specificities of national circumstances and in particular of health care systems, are examined. The study offers a series of unique and focused policy options for establishing more efficient indemnification and deterrence systems to cope with medical accidents.
This book provides new insights about learning bysynthesising existing and emerging findings from cognitive and brain science and exploring how this new information might impact teaching, parenting, and educational policy making.It shows what the latest brain imaging techniques and other advances in the neurosciences actually reveal about how the brain develops and operates at different stages in life from birth to old age and how the brain is involved in acquiring skills such as reading and counting. It also presents scientific insights into what happens when the brain malfunctions in conditions such as dyslexia or Alzheimer's disease. China Education Daily nominated this book as one of the "e;100 most influential education books for teachers"e; on December 15, 2011.
At a time when ever more information is available about the quality of health care, the challenge for policy makers is to better understand the policies and approaches that sit behind the numbers. This book examines whether care in Israel is safe, effective and responsive to patients' needs. It examines what works and what does not work, both to benchmark the efforts of countries and to provide advice on reforms to improve quality of health care.
This book is a unique source of up-to-date estimates of agricultural support in OECD member countries.It provides a comprehensive description and assessment of policy developments in these countries and contains a special section on the agricultural support in two non-member countries-Russia and the Ukraine. OECD Agricultural Policies was previously published annually under the title Agricultural Policies in OECD Countries: Monitoring and Evaluation.Starting with this edition, OECD Agricultural Policies: At a Glance will be published every other year, alternating with OECD Agricultural Policies: Monitoring and Evaluation, a more detailed examination of the topic.
This series of seven policy studies were the source material for the synthesis report of The OECD Health Project, Towards High-Performing Health Systems. They cover lessons from experience in health system reform, improving the technical quality of health care, income-related inequality in health care, matching supply with demand for physicians and nurses, excessive waiting times, costs and benefits of private health insurance, and ageing-related spending projections.
This volume offers a synthesis of findings from recent OECD studies undertaken as part of the three-year Health Project, an initiative geared towards answering many of the key questions facing today's health policy makers. It provides information and analysis on a wide variety of topics, such as new and emerging health-related technologies, long-term care, private health insurance, health-care cost control, equity of access across income groups, health workforce planning and productivity, and waiting times for elective surgery. Building on international experience and grounded in new data on cross-country differences, this report offers an up-to-date map of the road to performance improvement.
This publication examines the innovation system in pharmaceutical biotechnology in eight OECD countries - Belgium, Finland, France, Germany, Japan, the Netherlands, Norway and Spain. The report summarises the results of in-depth studies, providing a comparative analysis of participating countries' performance in science and innovation in biopharmaceuticals. It highlights specific characteristics of the national biopharmaceutical innovation systems in terms of their international openness and the specific role of demand-side factors in the innovation process. Major systemic failures affecting the functioning of the biopharmaceutical innovation systems are identified. Based on rich evidence, the report draws policy recommendations to foster innovation in biopharmaceuticals advocating an integrated policy approach.
The relationship between environment and children's health has been the subject of increasing interest these last ten years. For example, many OECD member countries are reporting asthma epidemics exacerbated by air pollution: in the United States nearly 1 in 13 school-age children (approximately 4.8 million) has asthma, and the rate is increasing more rapidly in school-age children than in any other group. The importance of this issue has resulted in a growing number of epidemiological studies aiming at better understanding and better characterising the relationship between environmental pollution and the health of children. However, in many respects, the valuation of children's health strongly differs from the valuation of adults' health and constitutes a real challenge for analysts as well as for decision-makers. Consequently, this book proposes an in depth analysis of the main methodological difficulties associated with estimating the social value of a reduction in risk to children. Questions such as how to elicit children's preferences, what valuation methodology and benefit measure to choose, how to discount benefits to children's health, and how to account for economic uncertainties in this specific context of economic valuation will be systematically examined in order to define key policy implications and to pave the way for further research.
This book describes the strengths and weaknesses of the Mexican health system in terms of access to health care, quality of care, efficiency of supply of services and the financial sustainability of the system. The report also evaluates reforms to the system with particular emphasis on the recently-introduced System of Social Protection in Health ("e;Sistema de Proteccion Social en Salud"e;) and assesses remaining policy challenges facing the Mexican Authorities.
Revised version with also a new chapter closing the loop as of November 2018If you work in health(care), this is your update on the future. This book is about the digital transformation that healthcare is facing. Its not a prediction, blueprint nor is it a manual. But it is giving some insights on what is happening to health(care) and how you might best prepare for the future thats coming. It addresses all levels: physicians, nurses, patients, IT, board members & governments.
The landscape of health care is changing rapidly, both on an organizational and a technological level. This book gathers medical anthropologists to examine the ways that both patients and health care workers are being affected by new policies, market, and technologies. Contributors cover a wide range of topics, including vaccination, disability, migration, and self-medication, making clear that not only are changing circumstances leading to the emergence of new socialities, but they are also driving new ethics and moralities.