HOW DATA CAN DRIVE IMPROVEMENTS IN HEALTH SYSTEMS Mark Pearson Head, OECD Health Division Japanese Health Economics Association 21 July, 2012

Structure of my talk 1.A cautionary tale: don’t ask me which health system is ‘the best’ 2.Getting better international measures of health inputs 3.Getting better international measures of health outputs 4.Prices and volumes of activity

1.WHICH SYSTEM IS BEST?

4 Source: OECD, 2010 Efficiency of the health sector DEA analysis

If we spent better, what would we get?

Groups of countries sharing broadly similar institutions

Efficiency varies more within groups of countries than across them OECD average

Le Corbusier: villa Savoye

What do we currently spend on health?

２.BETTER INTERNATIONAL MEASURES OF INPUTS

SHA Accounting Framework Service Provision Health Financing Healthcare Consumption What types of health goods and services are consumed? Who pays? Who provides the service? Source: Adapted from IHAT for SHA 2011 Three dimensions of health accounting

SHA 2011: What is new and improved? Refined boundary setting Continuity facilitated: – Functions, Providers, Financing New health care classifications: – Factors of provision – Financing revenues Introduction of capital classification – Separate reporting for current and capital Consistent labelling and categories introduced: –Link to intl. standards - SNA 2008, provider classifications (e.g. ISIC) –Larger compatibility between functions of care and providers –Closer correspondence to financing “functions” of revenue raising, pooling and purchasing

A need to clarify the boundaries of LTC Different division between health and social care Restricted boundary of LTC in health

Policy use of internationally comparable data In 2007, per capita spending on pharmaceuticals in Greece was second only to the US USD PPP

3.BETTER INTERNATIONAL MEASURES OF OUTPUTS

Increasing life expectancy, but in good health?

What factors account for increases in life expectancy? Contributions to changes in life expectancy WomenMen Health care spending Smoking Alcohol Diet0.02 Pollution Education GDP Observed changes

Cancer

Care for acute exacerbation of chronic conditions

Care for chronic conditions

Patient safety

4. PRICES AND VOLUME

Where the Japanese health system does MORE than other countries JapanRank compared with OECD countries OECD average Doctor consultations per capita 1 st 6.8 per capita Practising nurses 10.1 per 1000 population 11 th 8.7 per 1000 population Hospital beds 8.1 per 1000 population 1 st 3.4 per 1000 population MRI units 43.1 per million population 1 st 12.5 per million population CT scanners 97.3 per million population 1 st 22.8 per million population Source: OECD Health Data 2012.

Widespread availability of medical technology Source: OECD Health Data 2012.

Where the Japanese health system does LESS than other countries JapanRank compared with OECD countries OECD average Practising physicians 2.2 per 1000 population 29 th 3.1 per 1000 population Hospital discharges per 1000 population 28 th per 1000 population Source: OECD Health Data 2012.

Comparative hospital price level, 2009

Per capita volumes of hospital services, 2009

Service levels were maintained in Ireland…

…while growth in health prices continued in the United States Source: Martin et at, Health Affairs (2012) Factors Accounting For Growth In Personal Health Care Spending, Selected Periods 2000–10.

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