Friday, November 25, 2011

Health:medical care improving but better prevention and management of chronic diseases needed to cut costs,says OECD

OECD.23/11/2011.The quality of medical care is improving in OECD countries, with higher survival rates for life-threatening diseases, according to a new OECD report. Health at a Glance 2011 shows that, on average across the OECD, only 4% of people hospitalised after a heart attack now die within 30 days following hospital admission, down from 8% in 2000.

Survival rates for different types of cancer are also increasing, thanks to earlier detection and better treatments. The five-year survival rate for women diagnosed with breast cancer in 2004 was 84% in 2009 across OECD countries, up from 79% for those diagnosed in 1997.
But there is a need for better prevention and management for chronic diseases, such as asthma and diabetes, with too many people unnecessarily admitted to hospitals:

Asthma should be treated effectively by primary care providers. Yet, on average, 50 out of 100 000 adults in OECD countries are admitted to hospitals for asthma each year.  In the Slovak Republic, the United States and Korea, hospital admission rates for asthma are at least twice the OECD average.

Similarly, on average, 50 out of 100 000 adults are admitted to hospitals for uncontrolled diabetes each year.  Admission rates are particularly high in Austria, Hungary and Korea -- at over twice the OECD average.

These findings highlight the importance of strengthening prevention and management of chronic diseases and ensuring a sufficient supply of primary care providers.  Health at a Glance 2011 shows that the balance between general practitioners (GPs) and specialists has changed over the past decade, with the number of medical specialists increasing much more rapidly than GPs.  This imbalance can be explained partly by the growing gap in remuneration between GPs and specialists in several countries, including Canada, Finland, France and Ireland.

Preventing chronic diseases
Obesity is a key risk factor for many chronic conditions, with severely obese people dying up to 10 years earlier than those of normal weight.  Health at a Glance 2011 shows that obesity rates have doubled or even tripled in many countries since 1980.  In more than half of OECD countries, 50% or more of the population is now overweight, if not obese.  The obesity rate in the adult population is highest in the United States, rising from 15% in 1980 to 34% in 2008, and lowest in Japan and Korea, at 4%.

Rising obesity pushing up healthcare spending% of obese among adults

To tackle this epidemic, many OECD countries are now intensifying efforts to promote a culture of healthy eating and active living. Some have recently introduced taxes on foods high in fat or sugar – e.g. Denmark, Finland, France, and Hungary.  However, countries have yet to prove that these policies are sufficient, especially among the poorest in society who are most at risk of obesity. OECD work has shown that a comprehensive prevention strategy combining health promotion campaigns, government regulation and family doctor counselling would avoid hundreds of thousands of deaths from chronic diseases every year. It would cost from USD 10 to USD 30 per person, depending on the country.

Other highlights from Health at a Glance 2011
Health at a Glance 2011 also presents international comparisons of health expenditure and financing, and access to care. Highlights include:
In 2009, the country spending the most on health was, by far, the United States, devoting USD 7960 per capita, two and a half times the OECD average.  The next highest spending countries, Norway and Switzerland, spend only around two-thirds of the per capita level of the United States, but still spend more than 50% above the OECD average.
Despite public concerns about privatisation of health financing, the public sector continues to pay 72% of all health expenditure on average across OECD countries, a share that has not changed over the past 20 years. 
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