OECD work on health Y-Ling CHI, Health Policy Analyst, Health Division, Organisation of Economic Cooperation and Development

Outline of the presentation 1.How the OECD works 2.OECD projects

50 years of OECD 1961, OECD founded as the successor to the ‘OEEC’, itself set up by the Marshall Plan 2011 celebrations: what has been achieved, but also reflect on long-term trends Conference in June

How we work Health Committee twice a year. Some business (PWB; key projects); some policy discussion Lots of expert groups: –HCQI –Health Data –SHA –Economics of Prevention –Ad hoc groups (LTC, Nurses) 4

Secretariat people on health. Budget around €4.5m per year Don’t give grants; most work in-house Half the money from general OECD resources, half from ‘Voluntary Contributions’. EC is a major provider of VCs Secondments 5

Projects Major axis of work: –Data collection health status, health financing, health organization etc. –Quality of care –Workforce project –Prevention project –Pharmaceutical  + smaller projects to address the need of the national govts as defined as the Health Committee (long term care, inequality in service use, waiting times project, pay for performance, mental health etc.)

HCQI: Cancer survival rates Better indicator than mortality to measure effects of health system Five-year relative survival rates Cervical cancer Breast cancer Note: Survival rates are age-standardised to the International Cancer Survival Standards Population. Source: OECD Health Care Quality Indicators Data 2011.

Significant differences in cancer survival for major cancers (e.g. breast cancer). –Emphasize the need for national cancer registries –Ideally, one needs data on cancer stage Early diagnosis/screening has played important role in improving survival Governance of cancer (e.g. cancer plan that is funded) is correlated with improved survival Cancer

Primary care quality : avoidable admissions balanced scorecare (z normalised scores) Source: OECD Health Care Quality Indicators Database, 2009

Quality Reviews What policies and approaches work best in improving health care quality? –Country reviews of quality of health care build on available information on quality indicators to inform policymakers about what works and what does not work in different countries. –First review of Korea to be completed by third quarter 2011.

Economics of prevention under-investment in prevention

Financial Impact of prevention of obesity Intervention costs and savings Impact on health expenditure Physician-dietician counselling

New skills for new jobs in health: Project objectives Methods & scenarios Review and comparison of novel modelling approaches Scenario development Skill challenges Skill mis- match in the health sector Skill transferability in health occupations Policy review Education: capacities and incentives Working conditions (including retirement policies) 13

New mental health project Builds on project in employment looking at the rising rate of mental disability Increased burden of mental disorders in OECD country Rising levels of spending levels on mental health Value for money? –New payment systems for mental health (ex: DRG, P4P etc.)

Models of care for mental health Numbers of psychiatric beds –New levels of models of care for mental disorders/ de institutionalization –Chile : more hospital based model. OECDEfficiencyOECD projects

Pharmaceutical policies Economic evaluation to make reimbursement decisions (Korea, soon in Germany, France) Price regulation to be introduced where it did not exist (the UK and Germany) Development of risk-sharing agreements (UK, ITA, SWE) Price reductions and increase in rebates (Czech) Promote generic use and benefit from price competition in generic markets (all) 16

Variations in medical practice Appendectomy procedures per 100,000 population, 2007

Help! Growing demand for LTC will have major financial implications Source: Help Wanted? Providing and Financing Long-term Care, OECD Publishing, May 2011.

Long-term OECD Help Wanted? Providing and Financing Long- term Care (OECD Publishing, May 2011) reviews good-practice policies on financing, formal and informal provision of LTC. New follow-up work reviews evidence and analyses policies to measure and improve quality in long-term care.

Thanks for listening! Find lots of data at: 20