OECD says according to the new report – Health at a Glance 2015: Healthcare improving too slowly to meet rising strain of chronic diseases
Too many lives are still lost in OECD countries because healthcare quality is improving too slowly to cope with ageing populations and the growing number of people with one or more chronic diseases, according to a new OECD report.
The new edition of Health at a Glance provides a set of dashboards allowing readers to visualise the relative performance of different OECD countries on selected indicators. These dashboards show that all countries have wide scope for improving the quality of health care and tackling unhealthy lifestyles, such as obesity and harmful alcohol consumption.
No country consistently performs at the top of the country ranking on key indicators of quality of care, even those that spend the most on health. There is room for improvement in all countries in the prevention, early diagnosis and treatment of different health problems.
The United States, for example, is doing well in providing acute care for people having a heart attack or a stroke and preventing them from dying, but is not performing well in preventing avoidable hospital admissions for people with chronic conditions such as asthma and diabetes. The reverse is true in Portugal, Spain and Switzerland, which have relatively low rates of hospital admissions for certain chronic conditions, but relatively high rates of mortality for patients admitted to hospital for a heart attack or stroke.
Finland and Sweden do relatively well in saving the lives of people following diagnosis for cervical, breast or colorectal cancer, but the survival rates for these types of cancer is lower in Chile, Poland, the Czech Republic, the United Kingdom and Ireland.
Congestive heart failure (CHF), asthma and chronic obstructive pulmonary disease (COPD are considered to be prevalent long-term conditions, for which effective treatment can be delivered in primary care. This can reduce deterioration in people living with these conditions and prevent their admission to hospital.
In Israel, hospitalization rates are low for CHF but high for Asthma and COPD compared to the OECD average. The age adjusted hospitalization rate ( ages 15+) for CHF in Israel fell from 277.5 per 100,000 in 2008 to 233.9 in 2013, as compare to the OECD average of 256.9 and 244.4 . Israel’s hospitalization rate for COPD in 2013 was 206.6, a bit higher than the OECD average (198.3). Hospitalization rates due to Asthma were 54.1 and 52.3 in Israel and the OECD average respectively.
Asthma and COPD hospital admission in adults, 2013 (or nearest year)
Age-sex standardised rates per 100 000 population
Congestive heart failure hospital admission in adults, 2008 and 2013 (or nearest years)
Age-sex standardised rates per 100 000 population
A good indicator of acute care quality is 30-day due acute myocardial infarct (AMI) case fatality rate. This indicator decreased substantially between 2003 and 2013 in most OECD countries. Thirty-day mortality after admission to hospital for AMI in Israel is low compared to the OECD average, as is the 30-day mortality rate after admission for stroke.
Thirty-day mortality after admission to hospital for AMI based on patient data, 2003 to 2013 (or nearest years)
Age-sex standardised rate per 100 admissions of adults aged 45 years and over
Thirty-day mortality after admission to hospital for ischemic stroke based on patient data, 2003 to 2013
Age-sex standardised rate per 100 admissions of adults aged 45 years and over (or nearest years)
Breast cancer is the most prevalent form of cancer in women across OECD countries. Breast cancer survival reflects early diagnosis as well as improved treatments. In Israel, breast cancer five-year survival is relatively high as are mammography screening rates. Mortality rates are relatively high, although they have been falling over the last ten years.
Colorectal cancer five-year relative survival and cervical cancer five-year relative survival are high in Israel compared to most OECD counties. Mortality rates are near the average for colorectal cancer and relatively low for cervical cancer.
Breast cancer mortality in women, 2003 to 2013 (or nearest years)
Age-standardised rates per 100 000 women (Three-year average)
Another indicator of quality of care in hospitals is hip fracture surgery 48 hours after admission to hospital. In Israel, this rate increased between 2003 (70%) and 2013 (85%).
Hip fracture surgery initiation after admission to hospital, 2003 to 2013 (or nearest years)
% of patients aged 65 years and over being operated within two days
The influenza vaccination rate among the elderly population (65+) is relatively high in Israel – 61% compare to 48% on average in OECD countries (2013). The vaccination rate in Israel has increased since 2003 (44%), compared to a small decrease in the OECD average.
Influenza vaccination coverage, population aged 65 and over, 2013 (or nearest year)
Health at a Glance 2015 shows that pharmaceutical spending reached around USD 800 billion across OECD countries in 2013. This amounts to about 20% of total health spending on average In Israel, the share of pharmaceutical spending is about 15% of total health expenditure. The growth of retail pharmaceutical spending has slowed in recent years in most OECD countries, while spending on pharmaceuticals in hospital has increased in some. . In Israel, the purchase of pharmaceuticals by households from the business sector, increased on average by 10% between the years 2009-2011 (at current prices). Many countries have implemented policies to boost the generic market, which has contributed to the slowdown or reduction in pharmaceutical spending, but the share of the generic market still remains relatively low in countries such as Switzerland, Italy, Greece and Japan.
Despite the recent slowdown in spending growth, ageing populations and the high cost of new specialty drugs for diseases like cancer and hepatitis will likely cause spending to rise again, says the OECD.
New specialty drugs are expected to account for 50% or more of pharmaceutical spending growth within the next five years. While some of these high-price medicines bring great benefits to patients, others provide only marginal improvement in the health of patients and are not cost-effective.
The consumption of antidepressants has grown quickly since 2000, nearly doubling on average across OECD countries. There is evidence in several countries where consumption is high, such as Australia and the United Kingdom, that there is some over-prescription. At the same time, however, consumption may need to increase in others, such as Korea and Estonia, in order to address unmet needs for people suffering from depression.
Health at a Glance 2015 also shows that overall health expenditure continues to
grow slowly in many OECD countries in line with GDP growth, although health spending fell in 2013 for a third or fourth consecutive year in a number of European countries like Greece, Italy and Portugal. In Israel, health expenditure per capita, at constant prices, increased by about 2% on average, between the years 2009-2013, similar to the increase in 2005-2009.
Health expenditure per capita, 2013 (or nearest year)