Health policies and data – OECD
16/9/14 – Health care use varies widely across countries but can also
vary as much or more within countries. Governments should do more to
improve their health systems to prevent unnecessary interventions and
ensure that everyone has the same access to quality healthcare, wherever
they live, according to a new OECD report.
Geographic Variations in Health Care analyses
the geographic variations across a range of high-volume and high-cost
health care activities, such as heart bypass or knee replacement
operations.
Some of the variations observed in the 13 OECD countries* are
unwarranted, says the report, and ought to be tackled so that
high-quality health systems deliver the care patients need.
The number of patients admitted to a hospital for a reason other than
surgery, for example, is twice as high in Australia, Germany and Israel
than in Canada, Portugal and Spain. Admission rates also vary widely
within countries: in some parts of Australia, Canada, England, Finland,
Italy or Portugal, a patient is two to three times more likely to be
admitted to hospital than in other parts of those countries.
A patient is also three times more likely to undergo cardiac
revascularisation procedures in Germany and Israel than in countries
with the lowest levels of intervention. In most countries, these
procedures have the highest level of variation across geographical
areas. Knee replacement rates vary by more than five-fold within Canada,
Portugal and Spain, and by two-to three-fold across geographic areas in
most OECD countries.
Caesarean section rates are on the rise. The probability to give
birth by C-section is 50% higher in Italy, Portugal, Australia,
Switzerland and Germany than in the other participating countries.
C-section rates vary little within countries, except in Italy where they
vary by six-fold across provinces.
To tackle unwarranted variations in health care use, governments should put in place:
- Public reporting and target setting. Canada,
the Netherlands, Spain, and the United Kingdom have public reporting on
health care utilisation by geographic area. Italy sets regional targets
to encourage more appropriate use of caesarean sections, and Belgium
sets targets for reducing exposure to radiation from imaging tests.
- Policies targeting providers. Providers
receive feedbackon utilisation ofcardiac care in Ontario (Canada) and
caesarean sections in Belgium. Spain has a monitoring system to support
compliance with clinical guidelines for C-sections and financial
incentives show some promise in England, France and Korea.
- Patient centred approaches. Tools to
support shared patient doctor decision-making are used in the United
States and the United Kingdom. Patient outcome measurement after
surgical procedures is used in Sweden and the United Kingdom to indicate
to what extent patients have benefitted from the intervention or not.
The report’s main findings will be presented at a joint conference held by the OECD and the Bertelsmann Foundation on 16th September 2014 in Berlin (www.faktencheck-gesundheit.de).
For more information including detailed country notes, see: http://www.oecd.org/health/health-systems/medical-practice-variations.htm
via Health policies and data – OECD.
via Health policies and data – OECD.