Health at a glance 2007 [electronic resource] : OECD indicators

2007·7.1 MB·English

by  Organisation for Economic Co-operation and Development

Health at a Glance
2007
OECDINDICATORS
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OECD
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Health at a Glance 2007
OECDINDICATORS
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OECD
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ORGANISATIONFORECONOMICCO-OPERATION
ANDDEVELOPMENT
TheOECDisauniqueforumwherethegovernmentsof30democraciesworktogetherto
addresstheeconomic,socialandenvironmentalchallengesofglobalisation.TheOECDisalsoat
theforefrontofeffortstounderstandandtohelpgovernmentsrespondtonewdevelopmentsand
concerns,suchascorporategovernance,theinformationeconomyandthechallengesofan
ageingpopulation.TheOrganisationprovidesasettingwheregovernmentscancomparepolicy
experiences,seekanswerstocommonproblems,identifygoodpracticeandworktoco-ordinate
domesticandinternationalpolicies.
TheOECDmembercountriesare:Australia,Austria,Belgium,Canada,theCzechRepublic,
Denmark,Finland,France,Germany,Greece,Hungary,Iceland,Ireland,Italy,Japan,Korea,
Luxembourg,Mexico,theNetherlands,NewZealand,Norway,Poland,Portugal,theSlovakRepublic,
Spain,Sweden,Switzerland,Thrkey,theUnitedKingdomandtheUnitedStates.TheCommissionof
theEuropeanCommunitiestakespartintheworkoftheOECD.
OECDPublishingdisseminateswidelytheresultsoftheOrganisation’sstatisticsgatheringand
researchoneconomic,socialandenvironmentalissues,aswellastheconventions,guidelinesand
standardsagreedbyitsmembers.
ThisworkispublishedontheresponsibilityoftheSecretary-GeneraloftheOECD.The
opinionsexpressedandargumentsemployedhereindonotnecessarilyreflecttheofficial
viewsoftheOrganisationorofthegovernmentsofitsmembercountries.
AlsoavailableinFrenchunderthetitle:
Panoramadelasante2007
LESINDICATEURSDEL’OCDE
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CorrigendatoOECDpublicationsmaybefoundonlineat:www.oecd.org/publishing/corrigenda.
©OECD2007
NOdC’ooEepCxyrpDrelipoPgriuhotbtdalutiCcisltoheiniaodnrngua,nrdccirogeophiCytts,[email protected](soiCmrCeigCs(o)sCr,iFbC2o)yn2,2fo2aRr0x,ot3srr3eaunew1so4dloa5etds2i4oGDrnr9ia9ovnefd3,0st.hD-iaAPsnuevgrpeumursbistls,iisnciMasot,Ani7ot0n5o109pm02ha63o,ytPaoUbrcSieoAs,p,myFafradaaxenpco1ewr9,it7itf8ohanox6uo43tf63tw8h1r6i0i4s0t6w,t3oei4nrnfk6po7es@rch1mo9oip,[e-mail](ueflonrdtUrbeSeforsnaelnnygt)aittoso
FOREWORD
Foreword
Tm,latestedition0/HealthataGlanceillustratestheprogressthathasbeenmadeinmeasuring
theperformanceofhealthsystemssincethefirst-evermeetingofOECDHealthMinistersinMay2004.
Atthattime,HealthMinistersgaveaclearmandatefortheOECDtoworkwithnational
administrationstoimprovetheevidencebaseforcomparinghealthsystemperformanceby:
1)ensuringthatOECDHealthDatawouldbetimelyandaccurate;2)continuingtheimplementation
ofhealthaccountsinordertoimprovetheavailabilityandcomparabilityofhealthexpenditureand
financingdata;and3)developingindicatorsofqualityofcareincollaborationwithnationalexperts.
Meaningfulprogresshasbeenachievedinalloftheseareassince2004,asreflectedinthebroader
rangeofindicatorsofinputs,outputsandoutcomesofhealthsystemspresentedinthispublication.
Theproduction0/HealthataGlancewouldnothavebeenpossiblewithoutthecontribution
ofOECDHealthDataNationalCorrespondents,HealthAccountsExperts,andexpertsinvolvedinthe
HealthCareQualityIndicatorsProjectinthe30OECDcountries.TheOECDgratefullyacknowledges
theirefforttosupplymostofthedataandqualitativeinformationcontainedinthispublication.The
OECDalsoacknowledgesthecontributionofotherinternationalorganisations,especiallytheWorld
HealthOrganisationandEurostat,forsharingsomeofthedatapresentedinthisreport.
ThispublicationwaspreparedbyateamfromtheOECDHealthDivisionundertheco-ordination
ofGaetanLafortune.Chapter1waspreparedbyDavidMorgan;Chapter2byGaetanLafortuneand
MichaeldeLooper(fromtheAustralianInstituteofHealthandWelfare);Chapter3byFrancoSassi;
Chapter4byJeremyHurst,FrancescaColombo,RieFujisawa,MariaHofmarcher,PierreMoi'se,
ValerieParisandGaelleBalestat;Chapter5byDavidMorganandSandraHopkins;andChapter6by
SandraGarcia-Armesto,NiekKlazingaandSoerenMattke(fromRAND).Thechartsandtablesinthe
firstfivechapterswerepreparedbyGaelleBalestat,CarolineBerchetandDavidMorgan,whilethe
chartsandtablesforChapter6werepreparedbyMariaLuisaGilLapetraandLihanWei.This
publicationbenefitedfrommanycommentsandsuggestionsbyElizabethDocteurandPeterScherer.
HEALTHATAGLANCE2007:OECDINDICATORS-ISBN978-92-64-02732-9-©OECD2007 3

TABLEOFCONTENTS
TableofContents
Introduction 7
Chapter1. DemographicandEconomicContext 11
1.1.Totalpopulationandpopulationstructure 12
1.2.Fertilityrates 14
1.3.Grossdomesticproductandincomeinequality 16
Chapter2. HealthStatus 19
2.1.Lifeexpectancyatbirth 20
2.2.Lifeexpectancyatage65 22
2.3.Prematuremortality 24
2.4.Mortalityfromheartdiseaseandstroke 26
2.5.Mortalityfromcancer 28
2.6.Mortalityfromroadaccidents 30
2.7.Suicide 32
2.8.Infantmortality 34
2.9.Infanthealth:lowbirthweight 36
2.10.Dentalhealthamongchildren 38
2.11.Perceivedhealthstatus 40
2.12.AIDSincidence 42
Chapter3. Non-medicalDeterminantsofHealth 45
3.1.Tobaccoconsumption 46
3.2.Alcoholconsumption 48
3.3.Overweightandobesity 50
Chapter4. HealthCareResourcesandUtilisation 53
4.1.Medicalandnursinggraduates 54
4.2.Practisingphysicians 56
4.3.Practisingnurses 58
4.4.Remunerationofhealthprofessionals(physiciansandnurses) 60
4.5.Acutecarehospitalbeds,availabilityandoccupancyrates 62
4.6.Long-termcarebedsinhospitalsandnursinghomes 64
4.7.Medicaltechnologies 66
4.8.Consultationswithdoctors 68
4.9.Hospitaldischarges 70
4.10.Averagelengthofstayinhospitals 72
4.11.Cardio-vascularprocedures 74
4.12.Treatmentofrenalfailure(dialysisandkidneytransplants) 76
4.13.Caesareansections 78
HEALTHATAGLANCE2007:OECDINDICATORS-ISBN978-92-64-02732-9-©OECD2007 5
TABLEOFCONTENTS
4.14.Cataractsurgeries,ambulatoryandinpatient 80
4.15.Pharmaceuticalconsumption 82
Chapter5. HealthExpenditureandFinancing 85
5.1.Healthexpenditurepercapita 86
5.2.Healthexpenditureinrelationtogrossdomesticproduct(GDP) 88
5.3.Healthexpenditurebyfunction 90
5.4.Pharmaceuticalexpenditure 92
5.5.Financingofhealthcare 94
5.6.Healthinsurancecoverage(publicandprivate) 96
Chapter6. QualityofCare 99
Introduction 100
Careforacuteconditions
6.1.In-hospitalcase-fatalityratefollowingacutemyocardialinfarction 104
6.2.In-hospitalcase-fatalityratefollowingstroke 106
Careforcancer
6.3.Survivalforcolorectalcancer 108
6.4.Survivalandscreeningforbreastcancer 110
6.5.Survivalandscreeningforcervicalcancer 112
Careforchronicconditions
6.6.Avoidablehospitaladmissionandmortalityrateforasthma 114
6.7.Annualeyeexamsfordiabetics 116
Careforcommunicablediseases
6.8.Influenzavaccinationforelderlypeople 118
6.9.Childhoodvaccinationprogrammes 120
Bibliography 123
AnnexA.StatisticalAnnex 133
AnnexB.DefinitionofHealthExpenditureandMethodologicalNotes
onDataComparability 191
AnnexC.ListofVariablesinOECDHealthData2007 193
AnnexD.DiseaseandInjuryCategoriesandICDCodes 194
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6 HEALTHATAGLANCE2007:OECDINDICATORS-ISBN978-92-64-02732-9-©OECD2007
INTRODUCTION
Introduction
HealthataGlance2007allowsreaderstocomparehealthsystemsandtheirperformance
acrossanumberofkeydimensions,usingacoresetofindicatorsofhealthandhealth
systemsthatwereselectedfortheirpolicyrelevanceaswellasonthebasisofthe
availabilityandcomparabilityofdata.
TheOECDhaslongbeenaninternationalleaderinthedevelopmentoftoolsand
collectionofdataforassessingtheperformanceofhealthsystems.Overthepast15years,
OECDHealthDatahasservedasthemostauthoritativesourceofcomparablestatisticson
healthandhealthsystemsinOECDcountries.Allthedataandmeta-datapresentedinthis
publication,withtheexceptionofthenewchapteronhealthcarequalityindicators,are
extractedfromOECDHealthData2007.
Policycontext
Healthexpenditureaccountedforabout4%ofGDPwhentheOECDwasfounded
in1960,buttheaverageacrossOECDcountriesisnow9%,anditisclosetoorabove11%in
severallargenationaleconomies.Thehealthsectorofnationaleconomieshasgrown
dramaticallyinimportanceovertime,yetgreatcross-countryvariationpersists,andnot
onlyinspending.
Althoughhealthsystemsdifferwidelyintheirdesign,intheinputstheyuseandthe
outcomestheyattain,policymakersinallOECDcountriessharethecommonoverallgoalof
achievinghigh-performinghealthsystems(OECD,2004a).Thesepolicyobjectivesinclude:
•improvingpopulationhealthstatusandhealthoutcomesofmedicalinterventions;
•fosteringadequateandequitableaccesstocare;
•increasinghealth-systemresponsiveness;
•increasingtheefficiencyofhealthsystems;and
•ensuringsustainablecostsandfinancing.
HealthataGlance2007providesinformationonhowhealthsystemsareperforming
withrespecttoseveralofthesepolicyobjectivesaswellassomeofthecontextual
informationnecessarytounderstandcross-countrydifferencesandchangesin
performanceovertime.Althoughgapspersistininformationonhealthsystemsandinthe
technicalabilitytoassessandcompareperformanceacrossarangeofdimensions,the
OECDisworkingwithdataandperformancemeasurementexpertsinitsmemberstatesto
fillthesegaps.Notably,this2007editionofHealthataGlanceincludes,forthefirsttime,a
chapteronhealthcarequality,developedinresponsetogrowingpolicyinterestin
assessing,comparingandimprovingthequalityofcareprovidedtopatients,thereby
ensuringgoodvalueformoneyspentonhealth.
Structureofthepublication
HealthataGlance2007isorganisedasfollows:
Chapter1providessomeindicatorsofthedemographicandeconomiccontextwithin
whichhealthsystemsoperateindifferentOECDcountries.
HEALTHATAGLANCE2007:OECDINDICATORS-ISBN978-92-64-02732-9-©OECD2007 7
INTRODUCTION
Chapter2onHealthStatushighlightsevidenceoflargevariationsacrosscountriesin
lifeexpectancyandothermeasuresofpopulationhealthstatus.
Chapter3onNon-medicalDeterminantsofHealthfocusesonselectedriskfactorsrelated
tomodifiablelifestylesandbehaviours.
Chapter4onHealthCareResourcesandUtilisationcomparesthesupplyofhealthcare
providersandthenumberofnewmedicalandnursinggraduates,inacontextofgrowing
concernsthatcurrentorfutureshortagesofhealthprofessionalsmayimpedeaccessto
care.Italsopresentsindicatorsprovidingsomepartialmeasuresofefficiencyinhealth
servicedelivery,suchastheannualnumberofconsultationsperdoctor,averagelengthof
staysinhospitalsfordifferentconditions,andtheextenttowhichhigh-volumeprocedures
suchascataractsurgeriesarenowperformedwithoutanovernightstayinhospitalsin
differentcountries.
Chapter5onHealthExpenditureandFinancingassesseshowmuchOECDcountries
spendonhealthoverallandfordifferenttypesofhealthservicesandgoods,aswellashow
thesehealthservicesandgoodsarepaidforindifferentcountries(i.e.,themixbetween
publicfunding,privatehealthinsurancewhereitexists,andout-of-pocketpaymentsby
patients).Italsoincludesnewinformationontheextenttowhichpopulationsbenefitfrom
healthcoverage(publiclyfinancedandprivateinsurance),animportantdeterminantof
accesstocareandfinancialprotection.
Chapter6onQualityofCarepresentsafirstsetofindicatorsofqualityofcare.Reflecting
progressmadeinthedevelopmentofindicatorsforuseinmakingcross-countrycomparisons,
itfocusesonqualitywithrespecttoacutecare,cancercare,carerelatedtochronicdiseases
andcarerelatedtocommunicablediseases.Thisnewchapterincludesanumberofoutcomes
measuressuchassurvivalratesfollowingheartattack,strokeandcancer.
Presentationofindicators
Textandcharts
Eachofthetopicscoveredinthedifferentchaptersofthispublicationispresented
overtwopages.Thefirstprovidesabriefcommentaryhighlightingthekeyfindings
conveyedbythedata,definesindicatorsanddisclosesanysignificantnationalvariations
fromthatdefinitionwhichmightaffectdatacomparability.Onthefacingpageisasetof
charts.Thesechartstypicallyshowcurrentlevelsoftheindicatorand,wherepossible,
trendsovertime.Insomecases,anadditionalchartrelatingtheindicatortoanother
variableisincluded.WhereanOECDaverageisincludedinachart,itistheunweighted
averageofthecountriespresented,unlessotherwisespecifiedintheaccompanyingnotes.
Tables
Additionaldataarepresentedinthestatisticalannex(AnnexA)attheendofthis
publication.Wheredataforindividualcountriesarenotavailablefortheyearsselected,
thetablespresentthemostrecentdataavailable,normallyuptothepreviousorfollowing
threeyears.
Thetablescontainuptotwosummarystatistics.Theconsistentaveragereferstothe
unweightedaverageofonlythosecountriesforwhichdataareavailableoverallthe
consideredtimeperiods,inordertopresentinformationforaconsistentgroupofcountries
overtime.Countriesomittedfromtheaverage(duetodatagaps)arelistedunderthetable.
Inadditiontotheconsistentaverageovertime,thelatestaverageispresentedinmost
cases.Thislatestaveragerelatestotheaverageforthelatestyearavailableonly,foras
manycountriesaspossible.
8 HEALTHATAGLANCE2007:OECDINDICATORS-ISBN978-92-64-02732-9-©OECD2007