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A working guide to international comparisons of health

Brief analytical summaries or syntheses #41 A working guide to international comparisons of health Summary This guide published by the Australian government highlights the types of questions to ask before comparing health systems in countries or presenting health data in an international context. The guide is intended to encourage users of international health-related data to consider the complexities before comparing countries, and to assist them in interpreting the results of these comparisons. It presents examples to highlight the types of questions to ask when using health data in an international context. Background It is common practice to compare health between countries. Such comparisons provide a broader perspective of health and health care. They enable researchers, policy makers and the general public to see how national experiences of health and health care compare on an international scale. These comparisons often attract much attention from the media, particularly if countries are ranked…

Health system performance comparison: an agenda for policy, information and research

Brief analytical summaries or syntheses #44 Health system performance comparison an agenda for policy, information and research Summary This WHO policy brief calls for more international comparisons of health system performance. It describes the methodology of international comparative studies, key domain comparators, and cites the benefits of international comparison in policy influence and as a source of evidence. Background This policy brief seeks to summarize the current “state of the art” of health system comparison, identifying data and methodological issues and exploring the current interface between evidence and practice. It also draws out the priorities for future work on performance comparison, in the development of measurement instruments, analytic methodology, and assessment of evidence on performance. It concludes by presenting key lessons and future priorities policy-makers should take into account. Analysis and results Comparing key domains of performance Population health measures often take a broad perspective, which captures the effect of…

International - Health system performance comparison: an agenda for policy, information and research

This WHO policy brief calls for more international comparisons of health system performance. It describes the methodology of international comparative studies, key domain comparators, and cites the benefits of international comparison in policy influence and as a source of evidence.

International - The Changing Role of Government in Financing Health Care: An International Perspective

This paper explores the changing role of governments in health care financing internationally. It reviews the economic literature to analyze policy decisions and performance results in financing incentives, risk pooling, hospital competition, performance-related pay, and wait times. The paper says there is little international evidence that revenue collection mechanisms alone can manage care costs.

International - International Variations in a Selected Number of Surgical Procedures

This OECD paper summarizes international data on rates of five surgical procedures (caesarean, hysterectomy, prostatectomy, hip replacement, and appendectomy). The paper examines trends over time and compares age- and sex-specific rates. It shows substantial international variations for most procedures, although some procedures show universal trends, such as appendectomies.

International - WHO issues roadmap to scale up international response to the Ebola outbreak in west Africa

Published on August 28, 2014, this WHO roadmap will serve as a framework for updating detailed operational plans. It maps hotspots, presents epidemiological data showing how the outbreak is evolving over time, and communicates what is known about the location of treatment facilities and laboratories, It covers the health dimensions of the international response.

International - Exploring international acute care models

This British report examines international acute service line models to gather information on potential care models for the UK National Health Service (NHS). Its insights include: the value of ‘risk tiers’ for maternity and pediatric services; the role of GPs in providing urgent care out-of-hours; and the importance of technology, especially for remote care delivery.

Canada - Quality of care: How the provinces fare internationally

For the first time, provincial and international health care systems can be compared in terms of quality of care. The Canadian Institute for Health Information(CIHI) found that the results of these comparisons are mixed, with no province being consistently the best or worst performer across the Organisation for Economic Co-operation and Development (OECD) quality of care indicators. CIHI provides snapshots of international comparisons for each province through a new interactive tool. A companion report, International Comparisons: A Focus on Quality of Care, contains essential information and context for interpreting Canada’s performance on various indicators and identifies potential quality improvement strategies.

International - Contribution of quality management systems for patient safety: international panorama

This systematic review, published in Pratiques et Organisation des Soins, aimed to identify the contribution of international quality management systems in patient safety.

International - Public Health Performance Strengthening at Districts. Rationale and Blueprint for Action

Published by the WHO, this paper documents the proceedings of a 2016 conference in Bellagio, Italy that convened an international group of 19 experts to discuss public health performance strengthening at district levels. Participants concluded that improving district public health practice is now a feasible priority for middle-income countries given the broad range of successful strategies tested in different international contexts.

International - International responses to austerity

Undertaken to support the report, “More than Money: closing the NHS quality gap”, this evidence scan provides information on austerity and health care from an international perspective. The scan uses a case study approach to examine health system policy responses to financial crises in six countries: Canada, Denmark, Ireland, the Netherlands, Portugal and Spain.

International -Training health professionals in shared decision making: Update of an international environmental scan

Updating a 2012 international environmental scan of training programs in shared decision making (SDM) for health professionals, this paper identified 94 new eligible programs, an increase of 174% in four years, bringing the total number of programs to 148. Of the new programs, 40 targeted licensed health professionals, 8 targeted pre-licensure trainees, and 27 targeted both groups.

International – The Base de connaissances francophone sur les inégalités sociales de santé now available on the Tribune sur les ISS’ website

This new tool allows researchers and policymakers to deepen their understanding of social inequalities in health. It helps to raise awareness, inform and educate stakeholders on many aspects of these inequalities. The “Base de connaissance francophone sur les inégalités sociales de santé” was produced by the Section des Amériques du Réseau francophone international pour la promotion de la santé (RÉFIPS), in collaboration with the Institut national de santé publique du Québec (INSPQ) and the Chaire Approches communautaires et inégalités de santé (Chaire CACIS).

International - International Portability of Health-Cost Coverage: Concepts and Experience

This World Bank paper published in July, 2011, analyzes the cost implications of health care mobility around the EU. It states that the need to ensure that migrants obtain comparable and continuous health coverage has to be balanced with the danger of imposing external costs or benefits on other EU members. The paper concludes there is a need for a system of compensation between national health funds based on changing net costs.

International - Delivering Universal Health Coverage: A Guide For Policymakers

Published in the UK, this review synthesizes the international research evidence on universal health coverage (UHC) and presents policy recommendations for politicians and policymakers. The review describes coverage, payment and implementation options, and notes that the redistribution of health benefits and financial burdens is a highly politicized process that often involves opponents from powerful interest groups.

International - Best practice. Medical training from an international perspective

Conducted by German researchers, this study compares approaches adopted in Germany, France, the UK and the Netherlands to address shortages of primary care physicians through the reform of medical education and training systems. The study highlights options for medical education and training in Germany while acknowledging ongoing reform activity.

International - Bupa health pulse 2011: international healthcare survey: Global trends, attitudes and influences

This survey is by the British company Bupa, one of the world’s largest private health care providers with over 10 million customers in 200 countries. Based on interviews with 13,373 adults, it explores people’s attitudes to and perceptions of health and healthcare in 12 countries around the world and examines factors that influence people’s behaviour with regard to their health.

International - New global initiative will engage 30 cities by 2030 to close the mental health gap

Mental Health Now is a global initiative to improve mental health treatment in cities. By 2030, it will engage 30 cities internationally to channel support to mental health projects in three areas: mobilizing youth leadership; expanding innovative programs; and improving the evidence base using city-level indicators.

International - Is There A Health-Care Problem in Western Societies

This working paper from the International Centre for Economic Research (ICER) discusses how today’s health policymakers are striving to reduce healthcare expenditures in ways compatible with universal access and social justice.

International - OECD urges countries to harmonise clinical trial regulations to boost medical research and save lives

This policy guidance from the OECD recognizes that increasingly complex and inconsistent clinical trial regulations are causing delays, raising costs and leading to a decline in the number of international trials conducted by academics for non-commercial purposes. In the European Union alone, the number of applications for clinical trials fell by 25% between 2007 and 2011. The OECD calls on its member governments to harmonise their clinical trial approval processes.

International - The Role of Private Non-Profit Healthcare Organizations in NHS Systems: Implications for the Portuguese Hospital Devolution Program

The national health systems of many countries are based on the principle of an integrated public sector payer-provider. However, in some systems private non-profit organizations (NPOs) continue to play a role. This paper compares the international position of NPOs in public health systems with Portugal’s ongoing program to devolve public hospitals to NPOs. Evidence on the Portuguese program suggests it improved efficiency and access without sacrificing quality.

Canada - Canada's International Health System Performance Over 50 years: Examining Potential Years of Life Lost

This report and accompanying web tool compare Canada's international performance in premature mortality — measured by potential years of life lost (PYLL) — with the performance of 17 other high-income countries in the Organisation for Economic Co-operation and Development (OECD) from 1960 to 2010. The report examines how Canada performed overall on PYLL, how Canadian men and women performed in relation to men and women internationally and how Canada performed on 4 specific causes of premature mortality (cancer, heart disease, stroke, and deaths due to external causes).

International - International Profiles of Health Care Systems, 2014

This publication presents overviews of the healthcare systems of Australia, Canada, Denmark, England, France, Germany, Italy, Japan, the Netherlands, New Zealand, Norway, Singapore, Sweden, Switzerland, and the US. Each overview covers insurance, financing, organization, care quality, cost containment, efficiency and integration, and use of information technology and evidence-based practice. Data is provided on key health system characteristics and performance indicators.

Australia - International trends and initiatives in primary health care

Recent trends in international health system reform have drawn attention to patient-centred approaches, integrated workforce models of care and eHealth. This Australian study identifies international initiatives in these areas and summarizes evaluations of these initiatives. Evidence is presented from countries comparable to Australia in terms of the organization, financing, and delivery of primary care.

International - Paying for Performance in Health Care. Implications for Health System Performance and Accountability

This book from the OECD presents an analysis of 10 international case studies of pay for performance (P4P) programs and highlights the potential impacts of P4P programs on health system performance in diverse settings. It provides critical insights into leveraging P4P experiences to improve system performance and accountability.

International - Waste Not, Want Not: The Efficiency of Health Expenditure in Emerging and Developing Economies

This International Monetary Fund (IMF) paper quantifies the inefficiency of public health expenditure and potential gains from improvements in emerging and developing economies. The authors present a model that provides country-specific estimates and controls for the socioeconomic determinants of health. Results suggest that African economies have the lowest efficiency. Even at current spending levels, life expectancy could be boosted five years by following best practices.

International - Report of the International Bioethics Committee of UNESCO (IBC) on social responsibility and health

After a descriptive part on the social determinants of health and constraints on health access, and a specific section devoted to the elaboration of the ethical and legal dimensions of the principle of social responsibility and health, the report presents a sample of possible concrete strategies and courses of action in order to translate the principle of social responsibility and health into specific policy applications, with a view to promote the highest attainable standard of health for all.

International - Measuring social protection for long-term care

The OECD released this report presenting the first international comparison of levels of social protection for long-term care (LTC) in 14 OECD countries. Focusing on five scenarios with different LTC needs and services, it quantifies the cost of care; the level of coverage by social protection systems and out-of-pocket costs; and the affordability of these costs.

Canada - Canadians continue to report longer wait times for care

A new international survey shows that Canadians continue to report some of the longest wait times for doctors, specialists and emergency department visits compared with citizens in peer countries. However, once they do get medical care, Canadians generally report experiences with their regular providers that are better than the international average. These and more insights come from How Canada Compares: Results From The Commonwealth Fund’s 2016 International Health Policy Survey of Adults in 11 Countries, released by the Canadian Institute for Health Information (CIHI) in partnership with the Canadian Institutes of Health Research.

International — A Theoretical Approach to Dual Practice Regulations in the Health Sector

Internationally, there is wide cross-country heterogeneity in government responses to dual practice in the health sector. This paper provides a uniform theoretical framework to analyze and compare some of the most common regulations. The authors of the paper focus on three interventions: banning dual practice, offering rewarding contracts to public physicians, and limiting dual practice. An ancillary objective of the paper is to investigate whether regulations that are optimal for developed countries are adequate for developing countries as well.

International- International perspectives on healthcare improvement

Healthcare providers around the world face similar challenges but adopt a wide array of approaches to tackle them. The website of the UK Health Foundation is currently featuring a range of articles on health care in different international contexts, along with comparative analyses with Britain.

International - Global leaders commit to act on antimicrobial resistance

Global leaders at the United Nations (UN) have agreed to mount a coordinated campaign to address the causes of antimicrobial resistance. The leaders pledged to develop stronger national systems to monitor and regulate the volume of antimicrobials used in humans, animals and crops, and to increase international cooperation and funding.

International - Measuring and comparing health care waiting times in OECD countries

Waiting times for elective treatments are an international concern. This study describes common measures of wait times from 12 OECD countries. It focuses on procedures, such as hip replacements, where lengthy waits are the norm, and analyzes different country policies to reduce waiting times. Solutions include increased spending and the introduction of targets and incentives.

International - International Survey Of Older Adults Finds Shortcomings In Access, Coordination, And Patient-Centered Care

The journal Health Affairs conducted a survey of the healthcare experiences of 15,617 older adults in 11 Western countries, including Canada. This report presents the survey findings, which show that the US lags behind in care access, quality, and affordability. Accessing primary care and avoiding the emergency department was more difficult in Canada than in other countries.

Canada — Accreditation Canada International Launches Global Health Care Services Standards

Accreditation Canada International is proud to announce the release of its Global Health Care Services Standards. The standards were developed to address the need for uniformity and standardization in the growing health tourism industry. Due to an increasing number of patients crossing borders to receive health care and concerns about the quality of care in these institutions, the need for international health services standards has never been greater.

International – International Journal of Integrated Care. Vol 11, Special 10th Anniversary Edition

In celebration of IJIC's 10th anniversary, the articles in this special edition examine the experiences, evidence and lessons from different countries (Switzerland, Sweden, England, Quebec) in the integration of care over the past decade.

International - Global Telehealth 2012 - Delivering Quality Healthcare Anywhere Through Telehealth – Selected Papers from Global Telehealth 2012 (GT2012)

This book contains selected contributions of papers deemed to have lasting value and which capture the international diversity and variations of scope of contemporary telehealth developments, in keeping with the theme of the conference.

International – Health in the Americas. 2012 Edition

In Health in the Americas 2012, the Pan American Sanitary Bureau presents and analyzes the data and information from every country in the Region of the Americas. In drafting the publication, it has used data from many domestic and international, as well as unofficial, sources, trying as much as possible to identify and eliminate any discrepancies.

International - International profiles of health care systems 2015

This publication presents overviews of the health care systems of Australia, Canada, China, Denmark, England, France, Germany, India, Israel, Italy, Japan, the Netherlands, New Zealand, Norway, Singapore, Sweden, Switzerland, and the United States. Each overview covers health insurance, public and private financing, health system organization and governance, health care quality and coordination, disparities, efficiency and integration, use of information technology and evidence-based practice, cost containment, and recent reforms and innovations.

International - Implementation Processes and Pay for Performance in Healthcare: A Systematic Review

Pay-for-performance (P4P) programs have been implemented to improve quality in numerous health systems. This systematic review examined 41 international studies to better understand implementation factors affecting the effectiveness of P4P. It found limited evidence from which to draw firm conclusions, but suggests that P4P programs should align with organizational priorities and undergo regular evaluation.

International - International Profiles of Health Care Systems: Australia, Canada, Denmark, England, France, Germany, Japan, Iceland, Italy, the Netherlands, New Zealand, Norway, Sweden, Switzerland, and the United States

This publication from the Commonwealth Fund provides overviews of healthcare systems in 15 countries, giving information on insurance, financing, organization, cost containment, efficiency, quality of care, health disparities, care coordination, and the use of information technology and evidence-based practice. Summary tables provide data on key health system characteristics and performance indicators.

International - Patient-Centred Healthcare Indicators Review

Published by the International Alliance of Patients’ Organizations (IAPO), this literature review identifies and assesses current initiatives to measuring the patient-centredness of organizations, countries, activities and stakeholders. It is part of a larger IAPO project to develop a robust set of patient-centred indicators.

International - Designing a results framework for achieving results: a how-to guide

Published by the World Bank, this booklet provides how-to guidance for designing results frameworks in the field of development. It discusses definitions, uses, requirements, formats, and challenges, and provides examples of frameworks at international, national and organizational levels.

International - A Comparative Analysis of Health Forecasting Methods

Concerns about health expenditure growth and its long-term sustainability have stimulated the development of health expenditure forecasting models in many OECD countries. This comparative analysis reviewed 25 models that were developed by, or used for, policy analysis by OECD member countries and other international organisations.

International - Systems thinking for health systems strengthening in LMICs: seizing the opportunity

This supplement from Health Policy and Planning provides an overview of the fundamental concepts of “systems thinking” within the context of global health care. Articles make a case for its relevance in strengthening health systems internationally, especially in lower middle-income countries.

International - Long-term care (LTC) protection for older persons: A review of coverage deficits in 46 countries

Published by the International Labour Organization (ILO), this report examines long-term care (LTC) services in 46 developing and developed countries that, together, make up 80% of the world’s population. The report provides data on gaps in access, coverage deficits, and the impact of insufficient funding. It calls for recognizing LTC as a right, and making it a priority in national policy agendas.

International - Financial sustainability and affordability of health care systems. Lessons from OECD countries

This presentation by Mark Pearson, head of the Health Division at the OECD, reviews how health spending has been affected during the economic crisis in various countries. It also makes some recommendations on how policy should react. The presentation was delivered at the International Conference of Social Security Actuaries and Statisticians that took place in Berlin from May 30 to June 1, 2012.

International - Case-based Payment Systems for Hospital Funding in Asia. An Investigation of Current Status and Future Directions

Published by the OECD, this book presents a study of payment systems based on Diagnosis Related Groups (DRGs) that focuses on hospital funding arrangements in the Asia-Pacific region. The book assembles international evidence regarding the impact on cost, quality and efficiency of introducing of a DRG-based hospital payment system.

International - Patient-Centred Healthcare Indicators Review

This review from the International Alliance of Patients’ Organizations (IAPO) is part of a project to develop indicators for healthcare service providers in order to measure how patient-centred they are. After assessing the literature measuring the patient-centredness of organizations, the review concludes that few reliable indicators currently exist.

International - Health in 2015: from MDGs to SDGs

This WHO report identifies the key drivers of progress in health under the United Nations Millennium Development Goals (MDGs). It lays out actions that countries and the international community should prioritize to achieve the new Sustainable Development Goals (SDGs), which come into effect on 1 January 2016.

International - Can rural health insurance improve equity in health care utilization? A comparison between China and Vietnam

Published in the International Journal for Equity in Health, this study aims to evaluate and compare equity in access to health care in the rural health insurance systems of China and Vietnam. The study finds that China has achieved high population coverage rate over a short period, while Vietnam’s health insurance system is more successful at reaching equity in health service utilization.

International - Sustainable Health Systems. Visions, Strategies, Critical Uncertainties and Scenarios

In 2012, the World Economic Forum worked with the McKinsey consultancy group to engage over 200 international health system leaders, policy-makers and experts in a global effort to provide a holistic long-term analysis of sustainable health systems. This report examines what health systems could look like in 2040.

International - International profiles of health care systems

This publication from the Commonwealth Fund presents overviews of health care systems in nine European countries, Japan, Australia, Canada, and the U.S. Each overview covers insurance, financing, organization, quality of care, health disparities, efficiency and integration, information technology usage, use of evidence-based practice, cost containment, and reform and innovation. Summary tables provide data on key characteristics and performance indicators.

International - Better Ways to Pay for Health Care

Published by the OECD, this briefing document looks at policies used internationally to improve healthcare quality, efficiency, and cost-effectiveness. Many policy efforts now align payer and provider incentives by using evidence-based clinical guidelines and outcomes to inform price setting, which could bolster a patient-centred focus to improve sustainable healthcare delivery and performance in the long-run.

International - The world health report - Health systems financing: the path to universal coverage

In this report, the World Health Organization maps out what countries can do to modify their financing systems so they can move more quickly towards this goal - universal coverage - and sustain the gains that have been achieved. The report builds on new research and lessons learnt from country experience. It provides an action agenda for countries at all stages of development and proposes ways that the international community can better support efforts in low income countries to achieve universal coverage and improve health outcomes.

International - Community participation in rural health: a scoping review

Community participation is often proposed as a strategy to engage communities in developing locally responsive healthcare. The aim of this study from BMC Health Services Research was to identify examples in the international literature of higher-level community participation in rural healthcare. The study found the existing literature to be uninformative and vague, with scant attention paid to rigorous outcome measures.

Medical Tourism: Treatments, Markets and Health System Implications: A scoping review

Brief analytical summaries or syntheses #28 Medical Tourism Treatments, Markets and Health System Implications A scoping review Summary This broad OECD review examines what is currently known about the flow of medical tourists between countries and discusses the interaction of the demand for, and supply of, medical tourism services. It highlights the different organisations and groups involved in the industry. It highlights treatment processes (quality, safety and risks) and system-level implications for countries of origin and destination (financial issues, equity and the impact on providers and professionals of medical tourism). Background The global growth in the flow of patients and health professionals as well as medical technology, capital funding and regulatory regimes across national borders has given rise to new patterns of consumption and production of healthcare services over recent decades. A significant new element of a growing trade in healthcare has involved the movement of patients across borders in…

International - OECD Health Statistics 2016

Produced by the OECD, this annual publication is the most comprehensive source of comparable statistics on health and health systems across the 34 OECD countries. It is an essential tool to carry out comparative analyses and draw lessons from international comparisons of diverse health systems.

International - An International Comparative Study of Financing Healthcare: The Case of Eight Developed Countries in 1990s- 2000s

In this discussion paper from the Institute for Economic Studies at Keio University in Japan, country-level health care expenditures in countries with social insurance programs (Japan, the Netherlands and France) and in countries with taxation models (the UK, Sweden, Denmark and Norway) are compared according to financial structures. It finds that healthcare expenditures have increased in centralized countries that have an authority to set insurance premiums or tax rates, regardless of population aging.

International Profiles of Health Care Systems

Brief analytical summaries or syntheses #32 International Profiles of Health Care Systems Summary This publication presents overviews of the health care systems of Australia, Canada, Denmark, England, France, Germany, Japan, Italy, the Netherlands, New Zealand, Norway, Sweden, Switzerland, and the U.S. Each overview covers health insurance, public and private financing, health system organization, quality of care, health disparities, efficiency and integration, use of health information technology, use of evidence-based practice, cost containment, and recent reforms and innovations. In addition, summary tables provide data on a number of key health system characteristics and performance indicators, including overall health care spending, hospital spending and utilization, health care access, patient safety, care coordination, chronic care management, disease prevention, capacity for quality improvement, and public views. Background The Commonwealth Fund is a private foundation that promotes a high performance health care system providing better access, improved quality, and greater efficiency. The Fund carries out…

Canada – Presentation from the International Health Observatory’s seminar now available on line

Since its creation in 2009, the International observatory on health and social services (OISSS) has hosted three international seminars, and has just made the presentations available on line. Also available are videos from the most recent seminar, held in December 2011, entitled How do health organizations succeed in increasing their performance? The OISSS’s mission is to analyze health and social service systems in various countries, provinces or regions, tracking developments, changes and trends in order to promote knowledge and align research and decision-making.

International - Knowledge to action for solving complex problems: insights from a review of nine international cases

This paper published by the Public Health Agency of Canada reports the results of a scan of systems approaches to knowledge to action (KTA) with the goal of identifying how to optimize their implementation and impact. Nine initiatives were selected and information was gathered on each to reveal guidelines for implementing KTA systems. These include nurturing relationships, co-production of knowledge and the creation of feedback loops.

International - Malnutrition Becoming the “New Normal” Across the Globe

The International Food Policy Research Institute (IFPRI) released its 2016 Global Nutrition Report, finding that malnutrition is increasing in every country in the world and is a leading global driver of disease. Forty-four percent of countries examined now experience very serious levels of both undernutrition and adult obesity.

International - Paying for “End-of-Life” Drugs in Australia, Germany, and the United Kingdom: Balancing Policy, Pragmatism, and Societal Values

This edition of Issues in International Health Policy analyses British, German, Australian and American policies on the coverage of costly life-extending medicines. For Europe and Australia, the challenge is to pay for medicines through publicly-funded systems without undermining core principles. In the U.S., the goal is to ensure the sustainability of Medicare and the private insurance market without restricting choice.

UK - Moving care to the community: an international perspective

The Royal College of Nursing prepared this policy briefing to set out the international thinking behind the acute to community shift and the types of policies and programmes implemented in various countries. The aim is to inform policies in the UK that might support the shift to community care. It highlights international trends and makes recommendations for commissioners, providers, governments, policy experts and clinicians.

UK - Reforming health care: why we need to learn from international experience

This paper provides an overview of system reform, using international examples, and highlights both how the health systems of countries at varying levels of economic development can benefit from adopting international good practice and the value of a truly global exchange on health system reform.

International - International Comparisons of Health Prices and Volumes: New Findings

This OECD brief looks at recent methodological advances in breaking down health and hospital spending into price and volume components and developing output-based measures to make pricing processes comparable across systems and countries. It shows that health-specific price levels play an important role in explaining differences in per capita healthcare volumes across OECD countries.

International - International Profiles of Health Care Systems, 2013

This publication presents overviews of health systems in Australia, Canada, Denmark, Great Britain, France, Germany, Japan, Italy, the Netherlands, New Zealand, Norway, Sweden, Switzerland, and the US. Each overview covers health insurance, public and private financing, system organization and governance, healthcare quality and coordination, efficiency and integration, information technology use and evidence-based practice, cost containment, and recent reforms and innovations.

International - Managerial attitudes and perceived barriers regarding evidence-based practice: An international survey

Evidence-based practice (EBP) in mainstream management is still in its infancy. To facilitate uptake, this research surveyed 2,789 management practitioners in Belgium, the Netherlands, the US, the UK and Australia. Findings indicate that most managers have positive attitudes towards EBP, but lack of time and a limited understanding of scientific research are perceived as major barriers to uptake and implementation.

International - Comparing Hospital and Health Prices and Volumes Internationally : Results of a Eurostat/OECD Project

This OECD Health Working Paper presents the results of a joint effort between the OECD and Eurostat in developing price comparisons for health goods and services. The main novel feature is the collection of comparable and output-based prices for hospital services. Health and hospital-specific price comparisons turn out to be quite different from the comparisons based on the input method and consequently lead to different conclusions about the volume of health services consumed per person. The new methodology became an integral part of the Eurostat/OECD Purchasing Power Parity comparison at the end of 2013.

International - Regulating quality and safety of health and social care. International experiences

This report provides an overview of regulatory strategies and actors that different systems employ to govern safety and quality in health and social care. The countries reviewed provide examples of systems that vary in the way that health and social care services are organised and financed.

International - Providing integrated care for older people with complex needs: lessons from seven international case studies

Synthesizing evidence from case study programs in seven countries (Canada, Australia, Holland, New Zealand, the UK and the US), this British report examines the delivery of integrated health and social care for older people with complex needs. The report identifies 10 lessons for policy-makers and service providers on how to improve care design and coordination.

International - The economics of patient safety. Strengthening a value-based approach to reducing patient harm at national level

Using WHO data to estimate the international health and economic costs of patient harm, this paper finds that one in 10 of the world’s patients are harmed by health care. After examining patient safety measures in 34 OECD nations, the authors conclude that organizational and local initiatives are vital, as is a culture conducive to safety.

International - Monitoring Progress towards Universal Health Coverage at Country and Global Levels: A Framework

This paper published by the World Bank and WHO proposes a framework for tracking the progress of countries towards universal health coverage that assesses equitable coverage of health services, as well as protection against financial risk. The global framework allows country-level data to be compared to international standardized indicators.

International - Global cancer burden rises to 14.1 million new cases in 2012: Marked increase in breast cancers must be addressed

The International Agency for Research on Cancer (IARC), the specialized cancer agency of the World Health Organization, recently released the latest data on cancer incidence, mortality, and prevalence worldwide. The new version of IARC’s online database, GLOBOCAN 2012, provides the most recent estimates for 28 types of cancer in 184 countries worldwide and offers a comprehensive overview of the global cancer burden.

International - G8 dementia summit concludes with international agreement to work together

On December 12, 2013, G8 countries agreed to collaborate on and invest in dementia research. They set the goal of identifying a cure or disease-modifying therapy by 2025. The declaration came at the end of the G8 dementia summit, held in London on 11 December 2013, that brought together G8 ministers, researchers, pharmaceutical companies and charities from around the world.

International - What do we know about the needs and challenges of health systems? A scoping review of the international literature

Classifying types of health system challenges studied by researchers, this scoping review analyzed 292 papers. It found that the most frequently researched areas were mental health, infectious diseases, and primary care. Frequently studied target populations included elderly people, minorities, those living in remote or poor places, and children. The most reported health system challenges concerned human resources, governance, and health service delivery.

International - A governance model for integrated primary/secondary care for the health-reforming first world - results of a systematic review

Internationally, key healthcare reform elements rely on improved integration of care between primary and secondary sectors. This systematic review synthesized 21 studies on elements of integrated primary/secondary healthcare. Elements included: joint planning; integrated information technology; shared clinical priorities; incentives; innovation; population focus; professional development; and patient and community engagement.

International - International practice settings, interventions and outcomes of nurse practitioners in geriatric care: A scoping review

This scoping review analyzes 23 systematic reviews and 56 studies from four countries to investigate outcomes of nurse practitioner (NP) care specific to older people. Examining NP care of geriatric patients in five clinical settings (primary, home, long-term, acute and transitional care), the review finds that NPs consistently produce equivalent or better outcomes compared to usual care or physician care alone.

Useful links

Association latine pour l’analyse des systèmes de santé Centre collaborateur de l'OMS du Québec pour la promotion de la sécurité et la prévention des traumatismes Centre collaborateur de l'OMS pour l'évaluation et la surveillance des impacts sur la santé de l'environnement et du milieu de travail Centre d'étude sur la pauvreté et l'exclusion Centre québécois collaborateur de l'OMS pour le développement des Villes et Villages en santé Commissaire à la santé et au bien-être du Québec Conseil national des Secrétaires municipaux à la Santé du Brésil Conseil national des Secrétaires d'État à la Santé du Brésil Institut national de santé publique du Québec Institut de la statistique du Québec Institut national d’excellence en santé et en services sociaux Ministère des Relations internationales et de la Francophonie Observatoire de l’administration publique (ENAP) Observatoire européen des systèmes et des politiques de santé Observatoire ibéro-américain des politiques et des systèmes de santé Observatoire…

International - OECD Health Statistics 2017

The OECD Health Database offers the most comprehensive source of comparable statistics on health and health systems across OECD countries. The most recent update of the database was released this past June 30. It is an essential tool to carry out comparative analyses and draw lessons from international comparisons of diverse health systems.

International - Mirror, Mirror 2017: International Comparison Reflects Flaws and Opportunities for Better U.S. Health Care

This Commonwealth Fund report compares health care system performance in Australia, Canada, France, Germany, the Netherlands, New Zealand, Norway, Sweden, Switzerland, the United Kingdom, and the United States. Seventy-two indicators were selected in five domains: Care Process, Access, Administrative Efficiency, Equity, and Health Care Outcomes. The U.S. ranked last on performance overall, and ranked last or near last on the Access, Administrative Efficiency, Equity, and Health Care Outcomes domains. The top-ranked countries overall were the U.K., Australia, and the Netherlands.

International – Development of predictive models in international health systems

Predictive models of health usage events, such as unplanned hospitalizations or entry into a care home, have been under development for a decade. A risk score is calculated for each individual, according to the probability that the event will occur. This article describes the different uses of this information for resource allocation, improvement of care pathways, remuneration and evaluations.

International - Investing in Health Infrastructure: How Decentralization Matters

A researcher from the Université de Montréal is a co-author on this joint Swiss-Québec paper published by Georgia State University. It examines the decentralization of infrastructure in health services. The paper presents international evidence on health service decentralization and infrastructure spending, and analyzes case studies and policy choices in the US, Canada, and Switzerland.

International - International Profiles of Health Care Systems

Produced by the Commonwealth Fund, this publication profiles healthcare systems in 19 countries (Australia, Canada, China, Denmark, England, France, Germany, India, Israel, Italy, Japan, the Netherlands, New Zealand, Norway, Singapore, Sweden, Switzerland, Taiwan and the US). System financing and coverage methods are described and country performance measures are presented along with information on providers and spending.

International - Conceptual Explorations on Person-centered Medicine 2010 - Special Issue

The Geneva Conference on Person-centered Medicine took place on May 29 and 30, 2008 and was aimed at presenting and discussing the experience on person-centered principles and procedures gained under the WPA IPPP as well as the conceptual bases of person-centered medicine, engaging interactively major international medical and health organizations, and identifying promising organizational steps for the further development of person-centered medical and health care. This special issue of the International Journal of Integrated Care focus on this issue.

International - Health System Performance Comparison: New Directions in Research and Policy

Published by the WHO, this special issue of Health Policy draws attention to the growing field of international comparison and performance assessment of health systems. The issue covers five broad areas related to methodological issues, highlights the strengths of current performance comparisons, and outlines the field’s future potential.

International - WONCA Rural Medical Education Guidebook launched

An international guidebook on rural medical education was launched at the 12th WONCA World Rural Health Conference in Brazil. Topics include teaching, learning and assessment in rural medical education; clinical research in rural settings; undergraduate student recruitment and selection; and advanced clinical skills training. WONCA is the World Organization of Family Doctors.

International - WHO/UNAIDS launch new standards to improve adolescent care

Existing health services often fail the world’s adolescents. The new WHO/UNAIDS standards recommend making services more “adolescent friendly”, providing free or low-cost consultations, and making medically accurate age-appropriate health information available. They also highlight the need for adolescents to be able to access services without necessarily having to make an appointment or requiring parental consent.

Canada - New study suggests that a family physician's decision to investigate symptoms suggestive of cancer could help explain international differences in cancer survival

This study by the International Cancer Benchmarking Partnership examined beliefs, behaviours and systems in primary care across six countries with similar healthcare systems, analysing responses from family physicians (FPs) on how they would manage patients presenting with symptoms suggestive of lung, colorectal or ovarian cancer. These responses were then correlated to one-year mortality rates from these cancers. Cancer Care Ontario researchers who participated in the study report that early investigation by FPs is reflected in mortality and that access to diagnostic tests by FPs may play a role in their decision to investigate symptoms.

International - Managing the Risk and Impact of Future Epidemics: Options for Public-Private Cooperation

Commissioned by the World Economic Forum, this briefing analyses the value of private-sector engagement in West Africa’s response to the recent Ebola crisis and captures lessons learned in the wide scope of partnerships and innovations developed at the time. The briefing considers models for public-private cooperation to best address possible future epidemics.

UK - Horizon 2035: International responses to big picture challenges

Published by the Centre for Workforce Intelligence, this report provides short, digestible analysis of international examples that might help to meet big picture challenges facing the health and care workforce challenges in England. Among the areas of interest are the retention of home care workers, the role of informal caregivers, the adoption of technology and the impact of 24/7 services. Changes or planned changes in Australia, Germany, Japan, the Netherlands, Sweden and the US are described.

International - More efforts needed to tackle rising obesity, says OECD

New OECD data and analysis reveal that obesity levels have continued to rise in most countries over the past five years, but more slowly than before. Obesity has been virtually stable in England, Italy, Korea, and the United States but has increased by 2 to 3% in Australia, Canada, France, Mexico, Spain, and Switzerland. One in five children is overweight, on average, in OECD countries, but rates are as high as one in three in countries like Greece, Italy, Slovenia and the US.

International - OECD outlines action for governments to tackle heavy cost of harmful drinking

Tackling Harmful Alcohol Use: Economics and Public Health Policy says that the increase of risky drinking behaviours is a worrying trend as it is associated with higher rates of traffic accidents and violence, as well as increased risk of acute and chronic health conditions. The report shows that several policies have the potential to reduce heavy drinking, regular or episodic, as well as alcohol dependence. Governments seeking to tackle binge drinking and other types of alcohol abuse can use a range of policies that have proven to be effective, including counselling heavy drinkers, stepping up enforcement of drinking-and-driving laws, as well as raising taxes, raising prices, and increasing the regulation of the marketing of alcoholic drinks.

International - How to reform western care payment systems according to physicians, policy makers, healthcare executives and researchers: a discrete choice experiment

Knowledge on how different groups of professional stakeholders trade off the merits and downsides of healthcare payment systems is limited. This study, published in BMC Health Services Research, asked physicians, policymakers, administrators and researchers from a number of countries, including Canada, to choose between different hypothetical payment profiles. It finds that value-based payments align better with stakeholders' overall objectives in most countries.

International - The 2015 Quality of Death Index. Ranking palliative care across the world

The 2015 Quality of Death Index, a measure of the quality of palliative care in 80 countries, shows that income levels are a strong indicator of the availability and quality of palliative care, with wealthy countries clustered at the top. The UK, Australia and New Zealand rank first, second and third, while Canada is in 11th place.

International - Health Data Governance. Privacy, Monitoring and Research

After examining health data governance in the 34 countries of the OECD, this paper identifies key data governance mechanisms to maximize benefits and minimize risks. The mechanisms include coordinated development of high-value, privacy-protective health information systems; legislation that permits privacy-protected data use; accreditation of health data processors; and transparent and fair project approval processes.

International - World Health Statistics reports on global health goals for 194 countries

The WHO's 2015 Report records progress towards health-related Millenium Goals in 194 countries. According to the report, a majority of surveyed countries have reduced maternal and child deaths and increased access to drinkable water. Global WHO targets for the prevention of HIV, malaria and tuberculosis remain on schedule. However, inequalities persist, and more must be done to ensure that vulnerable populations have access to health services.

International - Reframing professional boundaries in healthcare: A systematic review of facilitators and barriers to task reallocation from the domain of medicine to the nursing domain

Dutch researchers systematically reviewed task reallocation from physicians to nurse practitioners and attempted to analyse facilitators and barriers. They conclude that introducing nurse practitioners in health care requires organizational redesign and the reframing of professional boundaries. The study was published in Health Policy.

International - An Asian Flavour for Medicare Learning from Experiments in Japan, Korea, and Taiwan

This paper from the Macdonald-Laurier Institute looks to Asian countries as potential models for Canadian healthcare funding and delivery. The authors highlight these countries' willingness to learn from abroad, their frequent reviews of health policy, use of salaried hospital specialists, user fees and competition among private hospitals, along with well-developed long-term care systems.

International - New partnership to help countries close gaps in primary health care

On September 26, 2015, the Bill & Melinda Gates Foundation, the World Bank Group, and the WHO launched a collaboration to strengthen primary health care and advance progress toward Sustainable Development Goals. It will support countries to strengthen monitoring, tracking and sharing of key performance indicators for primary health care.

International - Child mortality rates plunge by more than half since 1990 but global MDG target missed by wide margin

This report by the WHO shows that global mortality rates for children under age 5 have dropped from 12.7 million deaths in 1990 to 5.9 million in 2015. The 53% drop in under-5 mortality misses by a wide margin the Millennium Development Goal (MDG) of a two-thirds reduction over the same time period.

International - Emergency Care Services: Trends, Drivers and Interventions to Manage the Demand

Emergency departments (EDs) often face high demand for their services. This report from the OECD summarizes trends in the volume of ED visits across 21 OECD countries. It describes the main drivers of visits, paying attention to both demand and supply side determinants. National approaches to improving emergency resources are presented.

International - Investment in human resources for health: impact on health outcomes and beyond

The three papers in this series include research, case studies and a review, and aim to expand the evidence base on the effects of investment in human resources for health. Topics are related to the health and socio-economic impact of health workforce investment on health outcomes, health service coverage, labour market conditions and sustainable development goals.

International - Global Strategy and Action Plan on Ageing and Health: consultation

Posted online, this initial draft of the WHO Global Strategy and Action Plan on Aging and Health is now open to input from individuals and institutions that will be incorporated into the next draft, to be discussed in Geneva, Switzerland on October 29 and 30, 2015. The draft zero proposes the following 5 strategic objectives: 1. Committing to foster healthy ageing in every country, 2. Aligning health systems to the needs of older populations, 3. Developing long-term care systems, 4. Creating age-friendly environments, and 5. Improving measuring, monitoring and understanding.

International – World report on ageing and health

With advances in medicine helping more people to live longer lives, the number of people over the age of 60 is expected to double by 2050 and will require radical societal change, according to a new report released by the World Health Organization. The Report highlights 3 key areas for action which will require a fundamental shift in the way society thinks about ageing and older people.

International - Universal health coverage programs that cover one-third of the world are transforming care for the poorest and most vulnerable: new World Bank Group report

This report from the World Bank Group was released at the United Nations General Assembly on September 25, 2015. It shows that more countries around the world are rolling out universal health coverage programs designed to expand access to health care and reduce the number of people impoverished by paying for the health care they need. The report looks at how policy makers in 24 countries are tackling five key challenges: covering people, expanding benefits, managing money, improving the supply of health care services and strengthening accountability.

International - World Health Statistics 2014. Large gains in life expectancy

The WHO's annual statistics report highlights recent trends in life expectancy and changing causes of premature death, rising levels of child obesity, as well as a progress report on the health-related Millennium Development Goals. Among the findings are that people everywhere are living longer, with global life expectancy for women born in 2012 at 73 and men at 68. Low-income countries have made the greatest progress. In high-income countries, progress has been in tackling non-communicable diseases.

International - Healthcare costs unsustainable in advanced economies without reform

The OECD finds in this report that most OECD countries regularly go over budget on health care. It cautions that funding future medical advances will be difficult without major reforms that will require health and finance ministries to work together. The OECD expects spending to increase from an average 6% of GDP today to 9% of GDP by 2030.

UK - Creating a Sustainable 21st Century Healthcare System

Produced by the International Longevity Centre-UK (ILC-UK), this report showcases international examples of health system innovation that could potentially save lives and money in the UK. The report suggests that a sustained focus on innovation and prevention that empowers health consumers while maximizing the potential of big data will deliver significant healthcare savings over the long term.

International - WHO calls for stronger focus on adolescent health

The WHO is calling for action after the release of a report showing depression as the top global cause of illness for boys and girls age 10 to 19. The top three causes of adolescent deaths globally are road traffic injuries, HIV/AIDS, and suicide.

UK - International Longevity Centre - UK investigates cancer’s cost to the UK economy

This report released by the International Longevity Centre-UK (ILC-UK) quantifies the cost of cancer to the British economy. The report presents research on the economic and societal impact of the disease in the UK. Over 50,000 people lose their lives to cancer annually in Britain at a cost to the economy of £585 million ($1.19 billion Cdn).

International - Substitution of physicians by nurses in primary care: a systematic review and meta-analysis

In many countries, the substitution of physicians by nurses has become common. This systematic review and meta-analysis by Swiss and Dutch researchers of 26 studies of doctor-nurse substitution suggests nurse-led care has a positive effect on patient satisfaction, hospital admission, and mortality.

International - Slow growth in health spending but Europe lags behind

Many European countries saw further reductions in health spending in 2013, according to OECD Health Statistics 2015. Health spending continued to shrink in Greece, Italy and Portugal in 2013. Most countries in the European Union reported real per capita health spending below the levels of 2009. Outside of Europe, health spending has been growing at around 2.5% per year since 2010.

International - Health system 2015 developments in former Soviet countries

This issue of Euro Health contains five articles on recent health system reforms in the 15 countries formerly part of the Soviet Union. Three articles on the post-Soviet countries discuss access to medicines, hospital sector challenges, and primary, inpatient and specialized care. Two other articles discuss Ukrainian health system reforms and barriers to universal coverage in Uzbekistan.

International - High performing hospitals: a qualitative systematic review of associated factors and practical strategies for improvement

Conducted by Australian and UK academics, this systematic review examines research methods used to identify high performing hospitals; the factors associated with high performance; and practical strategies for improvement. Assessment of 19 studies revealed four factors associated with high performing hospitals: positive organizational culture, effective leadership, expertise-driven practice, and interdisciplinary teamwork. Fifty-six practical improvement strategies are catalogued.

International - Global health workforce, finances remain low for mental health

Worldwide, nearly 1 in 10 people have a mental health disorder, but only 1% of the global health workforce is working in mental health. According to this WHO report, this brings huge inequalities in access to mental health services. The provision of mental health care by primary care physicians and nurses is key to progress.

International - New report shows that 400 million do not have access to essential health services

A report by the WHO says 400 million of the world's people still have no access to essential health services, including family planning, obstetrical care, child immunization, anti-retroviral therapy and tuberculosis treatment. The report, Tracking Universal Health Coverage, measures healthcare access and services to assess countries’ progress towards universal health coverage.

International - Activity-Based Funding of Hospitals and Its Impact on Mortality, Readmission, Discharge Destination, Severity of Illness, and Volume of Care: A Systematic Review and Meta-Analysis

Activity-based funding (ABF) of hospitals is a policy that re-shapes incentives across health systems. This review examined 65 studies from 10 countries to assess the impact of ABF on mortality measures, illness severity, volume of care, and readmission and discharge rates. Evidence suggests ABF is associated with increases in readmissions, with implications for system capacity and access.

International - Trends in health systems in the former Soviet countries

Based on health system reviews from the European Observatory on Health Systems and Policies, this 217-page book analyzes health system reform in 12 countries that were previously part of the Soviet Union. The book reviews the reorganization, financing, and provision of health services in Armenia, Azerbaijan, Belarus, Georgia, Kazakhstan, Kyrgyzstan, Moldova, Tajikistan, Turkmenistan, Ukraine and Uzbekistan. A large section is devoted to Russia.

International - Money talks - Paying physicians for performance

Pay-for-performance (P4P) systems that tie physician payment to care quality are popular among healthcare policy makers. This study assessed the effects on patients and physicians of two pay systems: traditional fee‐for‐service, and a blend of fee‐for‐service and P4P incentives. Patients treated under the blended system were shown to receive better treatment.

International - Guidance on priority setting in health care (GPS-Health): the inclusion of equity criteria not captured by cost-effectiveness analysis

Published in the journal Cost Effectiveness and Resource Allocation, this guidance, initiated by the WHO, offers a comprehensive map of equity criteria that are relevant to healthcare priority setting and should be considered in addition to cost-effectiveness analysis. It is especially targeted at decision makers who set priorities at national and sub-national levels.

International - What shapes patient's satisfaction in countries' health care systems?

Patient satisfaction is an important measure of healthcare quality. This study by Greek researchers developed a set of socio-economic and health provision indicators to study patient satisfaction and healthcare organization in 32 countries over a five-year period. Findings showed a positive association between patient satisfaction, public health expenditures, and the number of physicians and nurses.

International - The challenge of budgeting for healthcare programmes

This article argues that health system fiscal sustainability is a political issue and dismisses talk of unaffordable spending due to trends like aging and technology as either inaccurate or unhelpful. The author says public support for health care means that a business budgeting approach may not be appropriate for health systems.

International - Advancing the application of systems thinking in health

This series published by Health Research Policy and Systems aims to support the shift from abstract concepts to actual applications and experiences of systems thinking in health. It was coordinated by the WHO Alliance for Health Policy and Systems Research and focuses on low- and middle-income countries.

International - Health at a Glance: Asia/Pacific 2014. Measuring Progress towards Universal Health Coverage

Published by the OECD, this book presents indicators related to health status, access to care, quality of care and health financing, expenditure, and resources in 27 Asian and Pacific countries. Indicators are presented with charts, brief descriptive analyses and methodological context. An annex provides information on country health systems and local demography.

International - Self-management support interventions to reduce health care utilisation without compromising outcomes: a systematic review and meta-analysis

There is increasing interest in the role of self-management interventions to improve the management of long-term conditions in health service settings. This meta-analysis published in Biomed Central reviewed the literature on self-management support models to identify models that achieved the desired effect of reducing health resource utilization without leading to negative outcomes. Evidence on successful models was strongest in respiratory and cardiovascular diseases.

International - Governments must tackle regional variations in health care use, says OECD

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.

International - The impact of cost-containment policies on health expenditure : Evidence from recent OECD experiences

This article, published in the OECD Journal on Budgeting, assesses the most robust empirical evidence on the public spending effects of different health policy alternatives to contain excess cost growth in the system. Evidence indicates that there are various alternative policies to cost-containment in a government’s toolkit that can be combined to achieve cost control in the health system.

International - New data show child mortality rates falling faster than ever

Data released by the United Nations (UN) shows that under-five mortality rates have dropped by 49% between 1990 and 2013. The average annual reduction has accelerated – in some countries it has even tripled – but overall progress is still short of meeting the WHO global target of a two-thirds decrease in under-five mortality by 2015.

International - Taking care of innovation. The HRM innovation process in healthcare organizations

Employees are of crucial importance for the performance of healthcare organizations. This dissertation examines innovations in human resources management strategies in the health sector. It looks at the adoption, implementation and spread of innovations in both work design and employment practices.

International - Wage-setting in the Hospital Sector

This paper examines wage-setting mechanisms for health workers in hospitals across eight OECD countries. Based on a review of grey literature and expert interviews with officials, it finds that prior to the economic downturn, several countries had signalled a shift to more local and flexible wage setting but that fiscal pressures led to a re-centralization of wage-setting.

International - Exploring the relationship between governance mechanisms in healthcare and health workforce outcomes: a systematic review

This systematic review analyzes 113 studies on the relationship between health system governance and workforce outcomes. The authors identify six types of governance mechanism, none of which fully considers the impact on the workforce. The authors recommend strategies that build organizational trust through clarity and transparency and consider the workforce in all aspects of governance.

International - Instruments to assess integrated care: a systematic review

Although measurement instruments have been developed to assess integrated healthcare delivery, no validated instrument currently measures all aspects of integrated care. This review searched the literature to identify 23 integrated care measurement instruments. The authors found that no existing instrument covered all aspects of integrated care, and conclude by debating the desirability of such a measure.

International - How Was Life? shows long-term progress in key areas of well-being

Research published by a consortium of economic historians (CLIO-INFRA) in collaboration with the OECD finds that people’s well-being has generally progressed across a large part of the world. The study presents systematic evidence of trends in areas such as health, education, inequality, the environment and personal security over the past 200 years. With the exception of sub-Saharan Africa, countries have generally become more equal to each other in terms of well-being than in terms of per capita GDP.

Ireland - Varadkar announces international evaluation of Ireland’s cancer strategy

A team of international experts has been appointed by the Irish Health Minister to evaluate Ireland’s national cancer strategy and provide advice on its next phase. The evaluation process is the first step in developing a third national cancer strategy to run from 2016.

International - Pathways to progress: a multi-level approach to strengthening health systems

Produced by the UK Overseas Development Institute (ODI), this report draws lessons from five countries that are developing effective institutions and policies to promote health and social development. The report synthesizes findings from country case studies that focus on maternal and child health (Mozambique, Nepal and Rwanda), and neglected tropical diseases (Cambodia and Sierra Leone).

International - Tapering payments in hospitals : Experiences in OECD countries

Produced by the OECD, this study examines mechanisms that link unit prices to the volume of services produced. The study provides an overview of hospital payment methods in the 34 OECD countries and reviews studies on economies of scale in hospitals, which is the rationale behind tapering payments.

International - Innovations in Health Care System Reform in OECD Countries

The Innovation Journal published this special issue on innovations in healthcare system reform within the 34 countries of the OECD. The special issue features articles on innovative healthcare reform in Canada, Greece, Finland, the UK and Germany, along with an essay on new policy directions in Saskatchewan.

International - OECD launches interactive website on regional well-being

This is an interactive map covering the OECD's 34 member countries. It rates 362 sub-national regions with a relative score out of 10 in eight categories: income, health, safety, services, civic engagement, education, jobs and environment and reveals some large disparities.

International - Health spending starts to rise but remains weak in Europe, says OECD

Released on June 30, 2014, this latest OECD report shows that health spending has started to rise again after stagnating or even falling in many OECD countries during the financial crisis, but that the pace of growth remains well below pre-crisis rates, especially in Europe. Overall health spending accounted for 9.3% of GDP on average across OECD countries in 2012. Mexico has very strong growth in health spending, at 8.5%, as it works toward universal coverage and access to health care.

International - Implementing electronic health records in hospitals: a systematic literature review

Published in BMC Health Services Research, this study reviews the literature on EHR implementation in hospitals and identifies lessons for implementers. It presents a framework of 19 interventions that can help overcome typical problems in EHR implementation.

International - The future of health and long-term care spending

Analyzing data from the 34 nations in the OECD, this report develops country-specific public health and long-term care expenditure projections until 2060. The report identifies underlying determinants of health and long-term care spending, and extends its analysis to include the five BRICS countries (Brazil, Russia, India, China, and South Africa).

International - A roadmap for comparing readmission policies with application to Denmark, England and the United States

Reducing unnecessary hospital readmissions can improve quality and save costs. This paper by a group of European researchers reviews readmission policies in Denmark, England, Germany and the US Medicare system. It finds that readmission policies vary widely and develops a comparative roadmap to evaluate ways for countries to adopt each other’s policies.

International - Noncommunicable diseases prematurely take 16 million lives annually, WHO urges more action

Premature noncommmunicable disease (NCD) deaths can be significantly reduced through government policies reducing tobacco use, harmful use of alcohol, unhealthy diets and physical inactivity, and delivering universal health care. In the report entitled "Global status report on noncommunicable diseases 2014," WHO Director-General Dr Margaret Chan, states that an investment of just US$ 1-3 dollars per person per year would dramatically reduce illness and death from NCDs.

International - Better dementia care and a future cure require action today, says OECD

Nearly 50 million people are living with dementia worldwide, costing societies over half a trillion US dollars each year. This OECD report considers the current policy approach to tackling dementia socially and economically unsustainable, and calls on countries to take action now to improve the lives of people living with dementia and their carers, prioritise public research on dementia, and improve the incentives for private investment in dementia innovation. Incentives for collaboration may help.

International - Mental healthcare under-resourced in too many countries, says OECD

This OECD report calls on governments to step up efforts to improve mental health care. It finds that the social and economic costs of mental ill-health are rising: people with a severe mental disorder die up to 20 years earlier than the general population, as well as being six to seven times more likely to be unemployed. The OECD recommendations focus on improved access to primary care and psychological services, and better training and support for primary care providers in the provision of mental health care.

International - Overcoming vulnerabilities of health care systems

This paper investigates the vulnerabilities of healthcare systems to macroeconomic shocks in the five BRICS countries (Brazil, Russia, India, China, and South Africa) and the 34 countries of the OECD. It considers the institutional setting of healthcare systems and emphasizes the need to balance sustainability with adequate services.

International - Priority Setting for Universal Health Coverage

This special issue of Health Systems and Reform presents articles prepared for a conference held in Bangkok in January 2016 on the theme of priority setting for universal health coverage. The issue features commentaries from top global health leaders, articles on the challenges of prioritization and remarks by World Bank representatives on priorities for universal health coverage.

International - Understanding Variations in Hospital Length of Stay and Cost: Results of a Pilot Project

Published by the OECD, this comparative study of France, Ireland, Israel and Canada measures hospital length of stay and cost for a given condition to explore variations in efficiency. It shows that variations are more likely to exist at hospital level for cardiac surgery, and at the country level for hysterectomies and caesarean sections.

International - Future and potential spending on health 2015–40: development assistance for health, and government, prepaid private, and out-of-pocket health spending in 184 countries

Published in the Lancet, this study analyses all-sector government spending and health spending data in 184 countries from 1980–2015 to estimate government and health spending (government, out-of-pocket, and private) through the year 2040. The study expects global spending on health to increase from $9 trillion in 2014 to $24 trillion in 2040, and predicts that health spending will increase fastest in upper-income countries.

International - WHO launches global effort to halve medication-related errors in 5 years

The WHO has launched an initiative to reduce medication-associated harm in all countries by 50% over the next five years. The Global Patient Safety Challenge on Medication Safety lays out ways to improve how medicines are prescribed, distributed and consumed. The global cost of medication errors has been estimated at $42 billion US annually.

International - Sustainable access to innovative therapies - Online consultation

The OECD has initiated an online consultation with stakeholders on improving patient access to innovative medicines and ensuring a sustainable level of health spending. Reponses can be submitted in English or French by May 1, 2017.

International - The Effects of Pay-for-Performance Programs on Health, Health Care Use, and Processes of Care: A Systematic Review

Updating a prior review of the effects of pay-for-performance (P4P) programs on processes of care and patient outcomes in ambulatory and inpatient settings, this systematic review of 69 studies finds low-strength evidence suggesting that P4P programs in ambulatory settings may improve process-of-care outcomes over the short term. Many of the positive studies were conducted in the UK, where incentives were larger than in the US.

International - Using media to impact health policy-making: an integrative systematic review

Media interventions can play a role in influencing health policies. This systematic review of three qualitative studies, seven quantitative studies, and 11 case studies assesses the effects of planned media interventions, including social media, on the health policy process. The review concludes there is a lack of reliable evidence to guide decisions on the use of media interventions to influence policy-making.

International - Through the looking glass: A practical path to improving healthcare through transparency

Transparency in health care is considered important, but has failed to transform quality or costs. Often, progress has been symbolic and given rise to disputes between policymakers, providers and professionals. Awash with data, some systems are now finding it more difficult to work out what is going on. This study suggests there is considerable potential still waiting to be unlocked in the strategic use of health system data to achieve transparency.

International - World Health Statistics 2017

Published by the WHO, the annual World Health Statistics series compiles data from 194 countries on 35 indicators of health-related Sustainable Development Goals (SDG). The 2017 edition includes data on life expectancy and success stories from countries making progress towards health-related SDG targets.

International - Defining a staged-based process for economic and financial evaluations of mHealth programs

Mobile and wireless technology for health (mHealth) has the potential to improve health outcomes by addressing critical systems constraints. This paper aims to improve understanding among mHealth program managers and key stakeholders of how to select methodologies for economic and financial evaluation. It outlines a six-stage process for integrating economic and financial evaluation methods into the monitoring and evaluation of mHealth solutions.

International - Value in Healthcare. Laying the Foundation for Health System Transformation

Synthesizing the preliminary findings of the World Economic Forum’s Value in Healthcare project, this report focuses on concepts and definitions while developing a value-based health system framework and system transformation roadmap that emphasize public policy priorities. It advises tracking patient outcomes and associated costs across the cycle of care to develop customized interventions that improve value for specific populations.

International - Methods for designing interventions to change healthcare professionals’ behaviour: a systematic review

The objective of this review was to identify published methods for designing interventions to change healthcare professionals’ behaviour. After examining 15 previous studies, the review found agreement across four tasks that need to be completed when designing individual-level interventions: identifying barriers, selecting intervention components, using theory, and engaging end-users. Further analysis of tasks could facilitate the development of guidelines for designing interventions.

International - Measuring, Reporting, and Rewarding Quality of Care in 5 Nations: 5 Policy Levers to Enhance Hospital Quality Accountability

This study deals with accountability for the quality of hospital care in England, Germany, the Netherlands, Sweden and the US. It identifies five levers to enhance accountability: a central role for standards and incentives; a balance in system centralization to enable national comparisons and promote local innovation; a focus on outcomes transparency; the engagement of providers as proponents; and reporting that focuses on hospitals to ensure comparability and patient choice.

International - New approach needed to tackle rising drug prices

The proliferation of high-cost medicines and rising drug prices are increasing pressures on public health spending and calling into question the pharmaceutical industry’s pricing strategies. Governments need to work with the industry and regulators to define a new approach to the development and use of new health technologies that encourages innovation while also delivering more affordable and value for money treatments, according to a new OECD report.

International - The Effects of Pay-for-Performance Programs on Health, Health Care Use, and Processes of Care: A Systematic Review

This systematic review of 69 studies examines the effects of pay-for-performance (P4P) programs targeted at the physician, group, managerial, or institutional level on process-of-care and patient outcomes in ambulatory and inpatient settings. It finds that P4P programs may be associated with improved processes of care in ambulatory settings, but consistently positive associations with improved health outcomes have not been demonstrated in any setting.

International - Caring For Quality in Health. Lessons Learnt from 15 Reviews of Health Care Quality

Between 2012 and 2016, the OECD conducted a series of reviews looking at policies and institutions design to measure and improve healthcare quality in 15 OECD countries, primarily in Europe. The findings presented in this final synthesis report identify common challenges, responses, and leading edge practices to delivering value for money in health care.

International - Tackling Wasteful Spending on Health

Produced by the OECD, this report reviews strategies put in place by the 34 OECD member countries to limit ineffective healthcare spending and waste. Preventable clinical errors and low-value care are discussed, as are ways to obtain lower prices for medical goods. The report examines different countries' attempts to contain administrative costs and reduce errors.

International - Pay for performance in the inpatient sector: A review of 34 P4P programs in 14 OECD countries

Pay-for-performance (P4P) programs have been implemented in the hospital sector to improve quality of care. This paper provides an overview of 34 P4P programs in 14 member countries of the OECD. It notes that the impact of P4P remains unclear, as the programs analyzed are extremely heterogeneous in their aims, selection of indicators, and financial rewards.

International - Health at a Glance: Asia/Pacific 2016. Measuring Progress towards Universal Health Coverage

Published by the OECD, this book presents key indicators of health status and healthcare resources, financing, and quality across 27 Asia-Pacific countries. Each indicator is presented with charts illustrating variations across countries and over time, brief analyses highlighting major findings, and methodological information concerning limitations in data comparability.

International - Data portal tracks universal health coverage progress

The WHO has launched a new data portal tracking global progress towards universal health coverage that shows where countries need to improve access to health services. The portal features the latest data on access in 194 member countries, along with information about equity of access.

International - New report offers global resource on using the law to improve health

This WHO report looks at how health laws can make a crucial difference for public health. The report features case studies from around the world on how legislation has improved the health and safety of populations, providing a resource for countries to learn from each others’ experiences.

International - Access to healthcare for people facing multiple vulnerabilities in health in 31 cities in 12 countries

Reporting on urban health inequities in 12 countries (Belgium, France, Germany, Greece, Luxembourg, the Netherlands, Norway, Spain, Sweden, Switzerland, Turkey and the UK), this study is based on the medical data of 10,447 patients in 31 cities. Multiple barriers to accessing health care are described, including lack of health coverage, reported by 67.5% of patients, financial barriers (24.3%), and explicit denial of care (9.2%).

International - Number of people with depression increases

This WHO fact sheet identified depression as the leading cause of disability worldwide and decries the fact that fewer than half of those affected receive treatments known to be effective. Barriers to care include a lack of resources, lack of trained health-care providers, and social stigma associated with mental disorders.

Canada - International Comparisons at CIHI

This report from the Canadian Institute for Health Information (CIHI) presents various measures of how health care in Canada compares to that in other countries, and discusses CIHI's contribution to international data and knowledge production. The report highlights some key comparisons in clear graphic form: Canada spends 10% of its GDP on health, compared to the OECD average of 9%; Canada is above average in reducing premature mortality, especially among men; Canada is in the middle of the pack on combined measures of health status, determinants of health, quality of care, patient safety and access to care.

International - Cyclical VS Structural Effects on Health Care Expenditure Trends in OECD Countries

This paper explores common trends in the growth rate of health care expenditure since 1996 in a set of 22 countries of the Organisation for Economic Co-operation and Development (OECD). Authors conclude that structural changes in publicly financed health care have constrained the growth of care volumes (especially) and prices leading to a marked reduction in health care expenditure growth rates, beyond what could be expected based on cyclical economic fluctuations.

International - A systematic review of experiences of advanced practice nursing in general practice

In an effort to understand why advanced practice nurses (APNs) struggle to gain acceptance within healthcare, this Australian systematic review of 20 studies looks at the experience of patients and general practitioners (GPs) with APNs. It finds that GPs and patients continue to have concerns around responsibility, trust and accountability, and that GPs have particular trouble with a lack of clarity around APN scope of practice.

International - How do taxes on sugar-sweetened beverages affect health and health care costs?

The taxation of sugar-sweetened beverages (SSBs) is intended to reduce sugar intake, improve individual health and reduce healthcare costs. This review looking at the effectiveness of the approach finds no evidence directly linking taxes on SSBs to reductions in healthcare costs, despite positive results from modelling simulations. Numerous systematic reviews indicate associations between SSB consumption and unhealthy weight gains at all ages.

International - Future Health Index commissioned by Philips reveals significant gap between perception and reality of how global health systems are performing

This study released by global health technology firm Royal Philips has revealed a large gap between the perceptions of health professionals and the general population with regard to future health system performance. The study also finds that the most significant benefits of connected care technology are seen in diagnosis, home care, and chronic disease management.

International - Understanding effective approaches to promoting mental health and preventing mental illness

This paper from the London School of Economics (LSE) provides an overview of approaches to promoting mental health and preventing mental illness in the 34 countries of the OECD. While there is an extensive evidence base for effective interventions, the authors find the existence of prevention and promotion programs uneven both between countries and across the life course.

International - 7 000 newborns die every day, despite steady decrease in under-five mortality, new report says

This United Nations (UN) report reveals that although fewer children under age five are dying worldwide (5.6 million in 2016, compared with 9.9 million in 2000), newborn deaths increased from 41% to 46% during the same time period. In 2016, 7,000 babies died daily in their first 28 days of life.

International - Index of Access: A new innovative and dynamic tool for rural health service and workforce planning

This Australian study developed a tool to measure access to primary healthcare in rural areas. The Index of Access captures components of access and uses a floating catchment approach to define service areas and population accessibility levels, which enables the modelling of workforce supply variations. Increases in supply are modelled for a range of rural towns, with access scores informing subsequent health service and workforce planning decisions.

International - OECD Reviews of Public Health

Reporting on the public health systems of the 34 countries in the OECD, these Reviews of Public Health provide analysis and policy recommendations that highlight best practices and innovation. Topics include obesity, harmful alcohol use, health checks, preventive screening, public health emergencies, and more.

International - Health at a Glance 2017. OECD Indicators

This new edition of Health at a Glance presents the most recent comparable data on the health status of populations and health system performance in OECD countries. Where possible, it also reports data for partner countries (Brazil, China, Colombia, Costa Rica, India, Indonesia, Lithuania, Russian Federation and South Africa). This edition contains a range of new indicators, particularly on risk factors for health. It also places greater emphasis on time trend analysis.

International - Nurses in advanced roles in primary care. Policy levers for implementation

Many countries have introduced advanced roles for primary care nurses to improve access and care while reducing costs. This paper from the OECD provides an analysis of nursing reforms in 37 OECD countries. The paper notes three trends: the development of advanced practice nursing roles; the introduction of supplementary nursing roles; and increases in nursing education programs.

International - Indicators and Measurement Tools for Health Systems Integration: A Knowledge Synthesis

Conducted by Brazilian and western Canadian researchers, this knowledge synthesis identifies indicator domains and tools to measure progress towards integrated care. Establishing measurement domains, the researchers reviewed 7,133 studies and identified 114 tools to measure the integration of care across 16 domains. Few tools were found in the domains of performance measurement, information systems, organizational goal alignment and resource allocation.

International - New OECD data expose deep well-being divisions

New data on wellbeing released by the OECD shows deep divisions in the 34 OECD countries along fault lines of age, wealth, gender and education. A mere 10% of households in OECD countries own 52% of all wealth on average, while one in three people live without savings.

International - Healthy people, healthy planet. The role of health systems in promoting healthier lifestyles and a greener future

This document was produced by the OECD for the 2017 meeting of the G7 Ministers of Health. It provides an overview of policy actions health authorities can use to improve population health while decreasing pressure on the environment. The report encourages waste reduction, healthier food consumption, and cleaner energy generation in hospitals and nursing homes.

International - Centers of excellence in healthcare institutions: what they are and how to assemble them

Centres of excellence — specialized programs within healthcare institutions that supply concentrations of expertise and resources centred on particular medical areas — afford many advantages for healthcare providers and the populations they serve. This article presents insights from the US Willis-Knighton Health System’s experience operating centres of excellence and offers guidance to healthcare establishments wishing to replicate successful processes in their own programs.

International - Future trends in health care expenditure. A modelling framework for cross-country forecasts

In the 34 countries of the OECD, healthcare spending is outpacing economic growth. This OECD paper presents a modelling framework for cross-country forecasts of projected healthcare expenditure growth that identifies common healthcare spending drivers across countries. These include: population aging, technological progress, sector productivity and rising staff, infrastructure, and service and material costs.

International - WHO updates Essential Medicines List with new advice on use of antibiotics, and adds medicines for hepatitis C, HIV, tuberculosis and cancer

The WHO has updated its Essential Medicines List to include a total of 433 medicines, adding 55 medicines and describing new uses for nine products. Along with new medicines for hepatitis C, HIV, TB and cancer, the list now groups antibiotics into three categories (Access, Watch and Reserve) with recommendations on usage.

International - WHO launches new NCDs Progress Monitor

The WHO has released a progress monitor for noncommunicable diseases (NCDs) that charts actions by countries to set targets; implements policies to address four NCD risk factors (tobacco, poor diet, inactivity and alcohol abuse); and builds capacities to reduce and treat NCDs. The progress monitor provides data on 19 indicators.

International - The world is running out of antibiotics, WHO report confirms

A report by the WHO finds a serious lack of new antibiotics under development to combat the growing threat of antimicrobial resistance. Most new drugs are modifications of existing antibiotics and offer only a short-term solution. The report found few options for antibiotic-resistant infections, especially drug-resistant tuberculosis.

International - Together on the road to universal health coverage. A call to action

Universal health coverage (UHC) is central to achieving better health and wellbeing for people at all ages. It delivers health promotion, disease prevention and treatment, and ensures that patients are not driven into poverty because of high costs. This WHO publication provides a comprehensive overview of UHC and discusses policies, priorities, financing, health inequities, and human rights.

International - Community Hospitals in Selected High Income Countries: A Scoping Review of Approaches and Models

Seeking to understand the nature and scope of service provision in community hospitals, this UK review examined 75 studies from 10 high-income countries. It found that most community hospitals provide a diverse range of services catering to local needs, and that they collaborate with other local health care organizations on co-location of services, shared primary care workforces, and access to specialists.

International - Strategizing national health in the 21st century: a handbook

Released by the WHO, this handbook is designed as a resource providing up-to-date and practical guidance on national health planning. It establishes a set of best practices to support strategic plans for health and represents the wealth of experience accumulated by the WHO on national health policies, strategies and plans.

International - Public reporting on quality, waiting times and patient experience in 11 high-income countries

This article published in Health Policy maps current approaches to public reporting on waiting times, patient experience and aggregate measures of quality and safety in 11 high-income countries (Australia, Canada, England, France, Germany, Netherlands, New Zealand, Norway, Sweden, Switzerland and the United States). Using a questionnaire-based survey of key national informants, the authors found that the data most commonly made available to the public are on waiting times for hospital treatment, with Information on patient experience at hospital level also made available in many countries.

International - The Drivers of Public Health Spending: Integrating Policies and Institutions

This economic working paper from the OECD investigates the impact of policies and institutions on health expenditures for a large panel of OECD countries for the period 2000-2010. It uses a set of 20 policy and institutional indicators characterising supply-side, demand-side, and public management, coordination and financing features of health systems. The analysis helps to explain inter-country variations in health spending.

International - A review of pay-for-performance programs in the inpatient sector in OECD countries

Providing an overview of 30 pay-for-performance (P4P) programs in the inpatient sectors of 14 countries in the OECD, this German review finds that, although the institution of P4P is widespread, country programs and their impacts are very heterogeneous. Results of published evaluations of the 30 P4P programs ranged from no effect to moderately positive effects.

International - Health workers with right skills in right places needed

The number of doctors and nurses has reached record levels in the OECD. Countries should now reform their training and employment strategies to better respond to people’s changing health needs and also reduce their reliance on foreign-trained health workers from developing countries, according to a new OECD report. “Health Workforce Policies in OECD countries: Right Jobs, Right Skills, Right Places” says that in 2013, a total of 3.6 million doctors and 10.8 million nurses were employed in OECD countries, up from 2.9 million doctors and 8.3 million nurses in 2000.

International - Safer Healthcare. Strategies for the Real World

In this book, the authors argue that we need to see safety through the patient’s eyes, to consider how safety is managed in different contexts and to develop a wider strategic and practical vision in which patient safety is recast as the management of risk over time. The authors, Charles Vincent from the University of Oxford and René Amalberti from the HAS in France, conceived of the book as they looked at the considerable safety implications inherent in technological and organizational changes underway in health care.

International - A new OECD series to understand your country's health care system

The OECD will begin publishing a new series to provide two-page summaries on healthcare systems in different countries. Each country snapshot will focus on pertinent health and care issues, will feature fresh data and key statistics, and include brief policy recommendations.

International - WHO calls for global action on diabetes

The WHO released its first Global report on diabetes on April 7, 2016. It states that the number of adults living with diabetes worldwide has almost quadrupled since 1980, to 422 million, with prevalence rates in some European countries of up to 14%. The new report calls upon governments to ensure that people are able to make healthy choices and that health systems are able to diagnose, treat and care for people with diabetes. It encourages us all as individuals to eat healthily, be physically active, and avoid excessive weight gain.

International - Transformational change in healthcare: an examination of four case studies

Investigating examples of transformational change in the health care sector, this Australian study focuses on case studies from the US, the UK, and Australia that exemplify well communicated strategies, innovative redesign, extensive consultation, efficient performance management and high-quality leadership. Despite differences between the case studies, the overall characteristics of success were found to be similar.

International - World Health Statistics 2016

Dramatic gains in life expectancy have been made globally since 2000, but major inequalities persist within and among countries, according to this year’s “World Health Statistics: Monitoring Health for the SDGs”. The “World Health Statistics 2016” provides a comprehensive overview of the latest annual data in relation to the health-related targets in the SDGs, illustrating the scale of the challenge.

International - Ethical priority setting for universal health coverage: challenges in deciding upon fair distribution of health services

Priority setting is inevitable on any path towards universal health coverage as all countries experience a gap between their population’s health needs and what is economically feasible for government to provide. This Norwegian commentary asks if priority setting can ever be fair and ethically acceptable, and sets three criteria for governments: cost-effectiveness, giving priority to the worse-off, and financial risk protection.

International - An Aging World: 2015

Prepared by the US Census Bureau, this report covers the demographic, health and economic aspects of global population aging. Investigating the dynamics of global population aging, the report discusses health, mortality, and health care, along with work, pensions, and other economic factors affecting older people. The report examines aging trends in 182 countries, with an emphasis on differences among world regions.

International - Pharmaceutical Expenditure and Policies. Past Trends and Future Challenges

Across the 34 member countries of the OECD, pharmaceutical spending reached just over $1 trillion Cdn in 2013, accounting for about 20% of total health spending. This paper looks at recent trends in pharmaceutical spending across the OECD and examines drivers of recent spending trends, highlighting differences across therapeutic classes.

International - Public Spending Efficiency in the OECD. Benchmarking Health Care, Education and General Administration

This paper uses data envelopment analysis (DEA) to assess the efficiency of welfare spending in a 2012 sample of countries in the OECD that focuses on health care, secondary education and general public services. The paper finds wide dispersion in efficiency measures across OECD countries and provides possible quantified improvements for both output and input efficiency.

International - Interprofessional teamwork innovations for primary health care practices and practitioners: evidence from a comparison of reform in three countries

Investigating primary care interprofessional teamwork innovations in Australia, Canada and the US, this Australian review examined 12 studies to assess the impact and local context of reforms. Variations were associated with contextual factors such as the size, power dynamics, leadership, and physical environment of the practice. Unintended consequences included conflict between medical and nonmedical professional groups.

International - For-Profit Hospitals and Insurers in Universal Health Care Countries

This paper from the Fraser Institute seeks to correct the perception that private, for-profit institutions are incompatible with universal-access health care. It examines the presence of for-profit hospitals and for-profit health care insurers in the healthcare systems of six nations with universal healthcare systems: Australia, France, Germany, the Netherlands, Sweden, and Switzerland.

International - Systematic review of integrated models of health care delivered at the primary–secondary interface: how effective is it and what determines effectiveness?

Conducted in Australia, this review of 10 studies identifies characteristics of integrated primary-secondary care models that help deliver favourable clinical outcomes. Six common elements are identified: interdisciplinary teamwork, information exchange, shared guidelines, training, acceptability for patients, and viable funding. The authors note that integrated primary-secondary care’s actual impact on clinical outcomes is limited compared to usual care.

International - New Index Reveals Gap between Rhetoric and Reality on Universal Health Coverage

The World Bank has developed an index to assess countries’ progress towards universal health coverage (UHC) that measures the extent of service coverage and financial protection. Applied to 24 developing nations, the index gave the best score to Brazil (81/100), showing that, contrary to some other indices, developing countries are still working on UHC.

International - Do Healthcare Financing Privatisations Curb Total Healthcare Expenditures? Evidence from OECD Countries

Privatization has been advocated as a cure for rising healthcare expenditures, although it has not been proven whether they curb aggregate healthcare expenditures. Using data from the OECD, this Belgian paper quantitatively analyzes this question. Results from 21 OECD member countries show that private funding leads to small cost savings in total healthcare expenditures.

International - Health at a glance 2015

This new edition of Health at a Glance presents the most recent comparable data on the performance of health systems in OECD countries and, where possible, partner countries. As always, it presents indicators of health and health system performance and focuses on the pharmaceutical sector, health workforce migration and the quality of health care.

International - Comparing the Health Care Systems of High-Performing Asian Countries

The newly industrialized and high-income economies of East Asia perform well on a wide range of health system indicators. This paper examines and compares similarities and differences in healthcare financing and provision in Singapore, Malaysia, Taiwan and South Korea.

International - Geographic Imbalances in Doctor Supply and Policy Responses

Doctors are distributed unequally across urban and rural areas in virtually all of the 34 OECD countries. This paper examines what drives physicians to choose an urban practice location and assesses policy responses in 15 OECD countries.

International - Which country has the world's best healthcare system?

Comparing health outcomes and value for money, this article from the UK’s Guardian newspaper examines health systems in France, Ireland, Sweden, China, USA, Japan, Spain, Italy, Germany, Russia, Australia and the UK. It finds that the UK has the best healthcare system overall, but notes that it also has the worst cancer outcomes of any rich country.

International - A New Resource for Exploring Health Care around the World

This website presents profiles of healthcare systems in 18 countries in Europe, North America, and Asia, along with Australia. Readers can compare health system organization and insurance, financing, quality, coordination, efficiency, integration, information technology use, evidence-based practice, cost containment and recent reforms and innovations.

International - How High-Need Patients Experience the Health Care System in Nine Countries

Conducted by a US health foundation, this analysis investigates healthcare use, quality, and experience among high-need patients in nine countries (Australia, Canada, France, Germany, the Netherlands, Norway, Sweden, Switzerland, and the US). It finds that high-need patients use more healthcare than others, and experience more bureaucracy and financial barriers to care. Disparities are particularly pronounced in the US.

International - Spending cuts on health care in countries badly affected by the economic crisis impede access to care

This report, published by INSEE in France, examines the impact of the economic crisis begun in 2008, which caused a reversal in health spending trends that, in the 30 years before the crisis, grew fairly consistently in most European countries. The report finds that in some countries, measures implemented after the crisis have reduced access to care, and especially to medicines. Although life expectancy has not declined, life expectancy in good health has declined in Greece and Italy.

International - Are better health outcomes related to social expenditure? A cross-national empirical analysis of social expenditure and population health measures

Studies have shown that social spending and the ratio of social to health spending are associated with better health outcomes. This paper builds on this finding by incorporating other factors — social capital and income inequality — into its assessment at the cross-national level. It finds that public social expenditure by government seems to have a particularly strong relationship with population health outcomes.

International - Health care coverage in OECD countries in 2012

This paper describes health coverage in the 34 OECD countries. It includes information on health coverage, benefits, cost-sharing requirements and voluntary health insurance. Combining qualitative information collected through a survey of OECD countries, and spending data collected through health accounts for 2012, the paper provides valuable, timely information on OECD healthcare coverage.

International - How to do better health reform: a snapshot of change and improvement initiatives in the health systems of 30 countries

This article discusses a book entitled "Healthcare Reform, Quality and Safety: Perspectives, Participants, Partnerships and Prospects in 30 Countries" that analyses the impact of reform initiatives on the quality and safety of care in low, middle, and high-income countries. Reforms in less well-off countries include boosting equity, providing infrastructure, and reducing mortality. Richer countries largely focus on developing new information technology systems and innovative funding models.

International - WHO urges global action to curtail consumption and health impacts of sugary drinks

Taxing sugary drinks can lower consumption and reduce obesity, type 2 diabetes and tooth decay, says a new WHO report. Fiscal policies that lead to at least a 20% increase in the retail price of sugary drinks would result in proportional reductions in consumption of such products, according to the report titled “Fiscal policies for Diet and Prevention of Noncommunicable Diseases (NCDs)”.

International - Visibility: The New Value Proposition for Health Systems

One of the main challenges facing healthcare systems is patient safety: medical errors are now the third leading cause of death in North America. This report from the World Health Innovation Network (WHIN) proposes a new direction to improve patient safety and performance.

International - How OECD health systems define the range of good and services to be financed collectively

Universal health coverage has been achieved in nearly all the 35 countries of the OECD. This paper describes how countries delineate the range of benefits covered, including the role of health technology assessment and criteria informing the decision-making process. The paper also looks at the boundaries of healthcare coverage and services for which coverage varies widely.

International - Why human resources policies and practices are critical to improving the patient experience

This US paper argues that human resources (HR) policies, procedures and programs are key to improving patient experience by supporting an organization’s vision and culture. As the organization achieves a better understanding of how to best serve patients, HR can build patient care improvement into every aspect of the organization. The author also describes how competency-based performance reviews, compensation and retention strategies should reflect patient-centred values.

International - Building a Framework. The makings of a lean health care transformation

Written by a US hospital administrator, this article describes a framework for successfully instituting Lean management techniques in hospitals, arguing that the sector has too often applied Lean tools without the behaviors and principles required for improvements. The article discusses the roles of the "model cell" (the incubator within the organization for Lean techniques); the central improvement office; and management and administrative systems.

International - From theory to action: developments in value frameworks to inform the allocation of health care resources

Processes for assessing value involve many factors (methods, behaviours, contexts) that make up value frameworks. This Dutch article explores the value frameworks commonly used to inform the allocation of health care resources. It also investigates proposed frameworks to determine whether these are better suited to the needs of decision makers.

International - The Effects of Competition on Medical Service Provision

This paper explores how physician competition affects medical service provision. Results revealed that introducing competition reduced both over-provision and under-provision, dependent on patient and payment characteristics.

International - Waiting time policies in the health sector

Examining wait time policies in the 34 OECD countries, this study compares policies in the UK with those in Scandinavia, Portugal, the Netherlands and New Zealand. It discusses the prioritization policies of the UK National Health Service (NHS) and assesses inequalities in waiting times by socioeconomic status across the OECD.

International - Countries start to act on noncommunicable diseases but need to speed up efforts to meet global commitments

This report by the WHO highlights the need to intensify national action to meet global targets that have been adopted on four noncommunicable diseases (NCDs): heart disease, cancer, diabetes, and lung diseases. Globally, these 4 noncommunicable diseases (NCDs) represent the largest cause of death in people aged under 70 years, posing a major threat to sustainable development.

International - Universal health coverage: moving towards better health. Action framework for the Western Pacific Region

Published by the WHO for countries of the Western Pacific Region, this framework supports national road maps for universal health coverage. The framework prioritizes 15 relevant planning domains, which it categorizes using five attributes of high-performance health systems: quality, efficiency, equity, accountability, and sustainability and resilience.

International - The involvement of medical doctors in hospital governance and implications for quality management: a quick scan in 19 and an in depth study in 7 OECD countries

Drawing on the Health Care Quality Indicator program of the OECD, this study looks at doctors in hospital management in 19 OECD countries and examines the phenomenon in more depth in seven OECD countries. It determines that doctor involvement in hospital management is positively associated with the advanced implementation of quality management systems.

International - WHO releases country estimates on air pollution exposure and health impact

A new WHO air quality model confirms that 92% of the world’s population lives in places where air quality levels exceed WHO limits. Information is presented via interactive maps, highlighting areas within countries that exceed WHO limits.

International - Working for Health and Growth. Investing in the health workforce

The Commission on Health Employment and Economic Growth was established by the UN in March, 2016, to encourage the creation of millions of new jobs in the health and social care sectors worldwide. It is hoped that this might offset a projected shortfall of 18 million health workers worldwide by 2030. This preliminary report presents recommendations for investment in the global health workforce.

International - eHealth Advances in Support of People with Complex Care Needs: Case Examples from Canada, Scotland and the US

Advances in eHealth offer better care and support for people with complex care needs. This article presents case studies from Ontario, Scotland, and the state of Colorado to identify how these jurisdictions are using eHealth to address multi-morbidity. A SWOT (strengths, weaknesses, opportunities, threats) analysis is presented for each case, and thoughts on eHealth's future in complex care are presented.

International - The Organisation of Out-Of-Hours Primary Care in OECD Countries

Out-of-hours (OoH) services provide urgent primary care when primary care physician offices are closed. Based on a policy survey covering 27 OECD countries, this working paper reviews existing OoH service models and the challenges of delivering OoH primary care. The paper pays particular attention to policies that improve OoH access and quality.

International - World Health Statistics 2012

This edition of the WHO’s annual compilation of health-related data for its 194 Member States includes a summary of the progress made towards achieving the health-related Millennium Development Goals and highlights the topics of noncommunicable diseases, universal health coverage and civil registration coverage.

International - Assessing barriers to health insurance and threats to equity in comparative perspective: The Health Insurance Access Database

Methods used for international comparisons of health systems often conflate system characteristics. This paper from BMC Heath Services Research proposes a database containing explicit standardized indicators to capture service policy changes over time in the health system regulation of public and private insurance.

International - Performance-related pay in the public sector : a review of theory and evidence

The objective of this paper from the World Bank is to provide a review of the theoretical and empirical literature on performance-related pay in the public sector with the aim of distilling useful lessons for policy-makers in developing countries. It finds that the majority of studies find a positive effect from performance-related pay, especially in fields such as education and health care where outputs are more readily observable.

International - Building China’s Regional Municipal Healthcare Performance Evaluation System: A Tuscan Perspective

China has yet to build a healthcare performance evaluation system (PES) to optimize resources on a regional basis. This paper looks at the potential for applying the model developed in Tuscany in China, including commissioning a third party agency to evaluate the performance of regional hospitals and community health service centers.

International - Comparative Performance of Private and Public Healthcare Systems in Low- and Middle-Income Countries: A Systematic Review

This paper published in PLoS Medicine provides a systematic review of research studies investigating the performance of private and public sector delivery of health services in low- and middle-income countries.

International - Selected articles from Universal Coverage: Can We Guarantee Health for All?

This supplement to BMC Public Health contains proceedings from this meeting held October 3 and 4, 2011 in Malaysia. Universal coverage is explored in many different countries and from different perspectives.

International - Growth in health spending grinds to a halt

Growth in health spending slowed or fell in real terms in 2010 in almost all OECD countries, reversing a long-term trend of rapid increases, according to OECD Health Data 2012. Overall health spending grew by nearly 5% per year in real terms in OECD countries over the period 2000-2009, but this was followed by zero growth in 2010. Preliminary figures for a limited number of countries suggest little or no growth in 2011. The halt in total health spending in 2010 was driven by a fall of 0.5% in public spending for health, following an increase of over 5% per year in 2008 and 2009.

International - Consumers Are Ready to Adopt Mobile Health Faster than the Health Industry is Prepared to Adapt, Finds PwC Study on Global mHealth Adoption

This report, conducted by the Economist Intelligence Unit (EIU) for PwC, examines the current state and potential of mHealth (the provision of healthcare or health-related information through the use of mobile devices) and the barriers to adoption and opportunities for companies seeking growth in the mHealth market. The report includes findings of two surveys conducted by the EIU: one of consumers and one of physicians and government and private payers in 10 markets, including Brazil, China, Denmark, Germany, India, South Africa, Spain, Turkey, the UK and the US.

International - Health systems and the financial crisis

This issue of Eurohealth examines health system responses to the financial crisis in the Czech Republic, Estonia, Greece and Ireland. It also looks at chronic care in Denmark, health insurance competition in The Netherlands and Pharmaceutical reforms in Portugal.

Australia - A working guide to international comparisons of health

This guide published by the Australian government highlights the types of questions to ask before comparing health systems in countries and when presenting health data in an international context.

International - Provider-payment assessment tool in development

WHO, along with the World Bank and the Joint Learning Network for Universal Coverage (JLN), is developing a diagnostic and assessment guide to support countries making reforms to mechanisms for paying health-service providers. This initiative is part the global effort to achieve universal coverage, which was the theme of the 2010 world health report. The new tool will enable the assessment of provider-payment mechanisms in the wider context of health-system performance, and focus on avoiding unintended consequences from making reforms. Its development will take a year, and will include field tests in selected countries.

International - Impact of electronic medical record on physician practice in office settings: a systematic review

Published in BMC Medical Informatics & Decision Making, this systematic review examines the impact of electronic medical records (EMRs) on physicians’ offices and the factors that influence successful EMR adoption. Reviewing studies cited in Medline and CINAHL databases between 2000 and 2009, the authors conclude that EMR impact in physicians’ offices remains limited due to the absence of support for clinical uses and technology and cost issues.

International - Healthcare financing in OECD countries beyond the public-private split

This working paper from ECONSTAR develops and applies a trichotomous concept for healthcare funding that distinguishes taxes, contributions, and private sources in OECD countries. Most studies of trends in healthcare financing focus on a dichotomous concept discerning public from private funding sources.

International - Reform, Competition, and Policy in Hospital Markets

This OECD report examines competitive policies, cost controls, and efficiency reforms in hospital markets in the U.S., the Netherlands, and the U.K. since the 1980s. The report concludes that the evidence supports the idea that competition improves quality in hospital markets when policies are set and/or overseen by administrative and regulatory bodies.

International - Paying for performance to improve the delivery of health interventions in low- and middle-income countries (Review)

This study published in The Cochrane Library assesses current evidence on the impact of payment for performance on health care and health outcomes in low- and middle-income countries. The authors conducted a literature review, analyzed the grey literature and consulted experts in the field.

International – Real Reform in Health Systems. Special Issue. Journal of Health Politics, Policy and Law

Health care reform seems to be fundamental to the coherence and the future of the welfare state. This volume’s collection of essays and research papers looks at some options that may strengthen our ability to bring about important and necessary transformations.

International - Health: the high cost of diabetes

Across OECD countries some 83 million people suffer from diabetes. On current trends, that will rise to almost 100 million by 2030. Speaking at the European Diabetes Leadership Forum in Copenhagen, OECD Deputy Director General Yves Leterme said, “Preventing and treating diabetes and its complications costs about €90 billion annually in Europe alone.

Time for Transformative Change: A review of 2004 Health Accord

Brief analytical summaries or syntheses #40 Time for Transformative Change A review of 2004 Health Accord Summary Canada is no longer seen as a model of innovation in health care delivery and financing, says this report from the Standing Senate Committee on Social Affairs, Science and Technology. The committee’s review revealed that real systematic transformation of health care systems across the country had not yet occurred, despite more than a decade of government commitments and increasing investments. The committee made 46 recommendations it believes will truly transform the way health care professionals do business and will achieve lasting reform. Background On January 31, 2011, the Minister of Health requested that the Standing Senate Committee on Social Affairs, Science and Technology initiate the second parliamentary review of the 10-Year Plan to Strengthen Health Care (10-Year Plan), an agreement reached by First Ministers on September 16, 2004 that focuses on federal/provincial/territorial (F/P/T)…

International - DISMEVAL Developing and validating disease management evaluation methods for European healthcare systems: Final report

This RAND Corporation technical report documents the overall findings of the work carried out within the DISMEVAL project that reviewed current approaches to chronic care and explored the policy context for chronic disease management in European countries. It also sought to test and validate different evaluation methods using data from disease management interventions in six countries.

International - Can competition reduce quality?

This paper from Portugal’s University of Minho studies competition’s effects on quality in markets such as health care when competition among provider is based on both price and quality. The paper argues that because providers are motivated and risk-averse and because, for given quality levels, fiercer competition results in lower profits due to lower prices, providers will respond by lowering their quality in order to recover some of the lost profits.

International - Health at a Glance: Asia/Pacific 2012

Produced by the OECD, this second edition of Health at a Glance: Asia/Pacific looks at health in 27 Asia/Pacific countries. It presents key indicators covering health status and health determinants along with many aspects of healthcare systems, including utilization of resources, expenditure and financing, and quality of care.

International - A Survey of Primary Care Doctors in Ten Countries Shows Progress in Use of Health Information Technology

A survey of primary care physicians in 10 countries by the Commonwealth Fund has found progress in the use of electronic medical records (EMRs). Adoption has particularly accelerated in the US, although America still lags behind several countries where EMR use is near-universal. Physicians in every nation surveyed reported challenges with communication and care coordination.

International - Public social spending rising in most OECD countries

The OECD reports that public social spending has jumped from 17% to an average 22% of GDP in its 34 member countries. Rising spending-to-GDP ratios are due to the decline of GDP in many countries along with increased expenditures on social programs such as unemployment benefits.

Designing a results framework for achieving results: a how-to guide

Brief analytical summaries or syntheses #52 Designing a results framework for achieving results a how-to guide Summary Published by the World Bank, this booklet provides how-to guidance for designing results frameworks in the field of development. It discusses definitions, uses, requirements, formats, and challenges, and provides examples of frameworks at international, national and organizational levels. Background Results-based management is a key tool for development effectiveness. Recent years have witnessed a trend in explicitly specifying the results (outcomes and impacts) of both broader country strategies and more specific programs and projects. Internationally agreed principles have underpinned this push for results, most notably with the adoption of the United Nations Millennium Declaration (2000), which established the Millennium Development Goals with targets and indicators to provide the basis for measuring progress and the effectiveness of aid. Analysis and results This publication provides how-to guidance for developing results frameworks by discussing the following The…

International - Classifying OECD healthcare systems: A deductive approach

This paper from Germany’s Leibniz Centre for Economics (ZBW) classifies healthcare systems in countries within the OECD. It divides systems in five categories: the National Health Service, the National Health Insurance, the Social Health Insurance, the Etatist Social Health Insurance, and the Private Health System. Findings are discussed with respect to likely trends for the future.

International - Government Spending and Central-Local Relations in Thailand’s Health Sector

Thailand has seen impressive improvements in health outcomes and the expansion of health coverage over the past two decades. Produced by the World Bank, this discussion paper highlights three remaining key challenges: inequalities in utilization and spending, mounting cost pressures, and fragmentation of financing between central and local government.

International - From efficacy to equity: Literature review of decision criteria for resource allocation and healthcare decision making

This systematic review published in July 2012 in Cost Effectiveness and Resource Allocation identifies criteria reported in the literature on healthcare decision-making. Among the most frequently mentioned criteria were equity, efficacy, safety, need, strength of evidence, and patient-reported outcomes.

International - Income-Related Inequalities in Health Service Utilisation in 19 OECD Countries, 2008-2009

This July 2012 paper from the OECD iLibrary examines income-related inequalities in healthcare service utilization within 18 member countries of the OECD. It extends a 2004 analysis, adding new results for cancer screening and doctor and dentist visits. The effects of health system financing arrangements on income-related inequalities are explored.

International - Physicians in private practice: reasons for being a social franchise member

This paper from Health Research Policy and Systems examines what motivates physicians in private practice to join a social franchise network. The study finds that franchise membership has a positive effect on client volumes, earnings, and access to cheaper, higher quality medications for patients.

International - Preventive care and healthy ageing: a global perspective

Published by the Economist Intelligence Unit, this report investigates the challenges and pressures that ageing populations put on healthcare systems and economies worldwide. Case studies of eight countries (Brazil, China, India, Japan, Russia, South Africa, the UK and the US) are included.

International - Large-System Transformation in Health Care: A Realist Review

Published by the Milbank Quarterly, this review examines policy focused on patient- and family-centered care, primary healthcare renewal, quality improvement, and surgical wait lists in the province of Saskatchewan. The review analyzes transformation initiatives and the role of government, and outlines evaluation options.

International - Primary care: an increasingly important contributor to effectiveness, equity, and efficiency of health services. SESPAS report 2012

This draft report released by the Spanish journal Gaceta Sanitaria was undertaken for Spain’s public health body, the Sociedad Española de Salud Pública y Administración Sanitaria (SESPAS). The English-language report identifies key features within national health systems that work to produce patient-focused primary care polices with wider health care benefits.

International - World urged to follow Thai healthcare scheme

Inspired by Thailand's universal health care scheme, the WHO is planning to encourage a similar model worldwide for other lower-income countries, according to a January 25, 2012, report by Asia News Network (ANN). Thailand launched its scheme in 2002, when national income was just US $1,900 (60,000 baht) per head. Its health plan now covers 75% of the Thai population.

International - Young Researchers for Health 2010. Health systems research: towards universal health coverage

The 2010 competition, organized under the auspices of the First Global Symposium on Health Systems Research in partnership with the Global Forum for Health Research and The Lancet, continues the principle of encouraging the next generation of researchers to consider the range and complexity of issues involved in research for health. Authors were charged to give a personal perspective on one of the four sub-themes of the symposium: political economy of universal coverage, health system financing, scale-up of health services or knowledge translation.

International - Telemedicine. Opportunities and developments in Member States

This second volume of the Global Observatory for eHealth series examines trends in the uptake of telemedicine, from the well established to newly emerging telemedicine applications. With an emphasis on the needs of developing countries, it looks to the future with an analysis of the strategic actions required to support and strengthen telemedicine in countries.

International - Analysing Health Systems to Make Them Stronger

The framework presented here is developed for the analysis of any Health System at national, intermediate or local level. Ten elements or functions are identified as essential and constitutive of any HS: 1) goals & outcomes; 2) values & principles; 3) service delivery; 4) the population; 5) the context 6) leadership & governance; and 7-10) the organisation of resources (finances, human resources, infrastructure & supplies, knowledge & information).

International - Action for Global Health launches online tool to track EU support for health in developing countries

Action for Global Health has launched an "Action Tracker" - an online tool that tracks the contributions that EU Member States make to improve health in developing countries.

International - How Health Insurance Design Affects Access to Care and Costs, By Income, In Eleven Countries

This survey examines the insurance-related experiences of adults in Australia, Canada, France, Germany, the Netherlands, New Zealand, Norway, Sweden, Switzerland, the United States, and the United Kingdom.

International - Improved Quality and Access to Health Data Essential to Global Health

The World Economic Forum recently launches an ambitious project to advance global health through improved data collection and management. The Global Health Data Charter recognizes that accurate health data is essential for effective and efficient health management. The Charter aims to enable individuals and patients, health professionals and policy-makers to make more informed decisions through secure access to comprehensive, quality data.

International — Effects of global financial crisis on funding for health development in nineteen countries of the WHO African Region

The objectives of this article are to present the findings of a quick survey conducted among countries of the WHO African Region to monitor the effects of global financial crisis on funding for health development; and to discuss the way forward.

International — Governance in the health sector: a strategy for measuring determinants and performance

Many different strategies have been proposed to improve the delivery of health care services, from capacity building to establishing new payment mechanisms. Recent attention has also asked whether improvements in the way health care services are governed could make a difference. These approaches ask which factors -- such as rules and institutions -- influence the behaviour of the system in ways that are associated with better performance and outcomes. The paper concludes by proposing specific measures of governance determinants and performance and describes the instruments available to collect and interpret them.

International - Health: Improving health care efficiency is key to curbing spiraling costs

Governments must make their health care systems more efficient if they are to maintain quality of care without putting further stress on public finances, according to a new OECD report. In Health Care Systems: Efficiency and Policy Settings, the OECD warns that cash-strapped governments no longer have the option of boosting spending to improve health outcomes, as they have done over the past several decades.

International - Can user charges make health care more efficient?

This article by Sarah Thomson, Thomas Foubister and Elias Mossialos explain why charging patients for health services we want them to use, makes little economic sense.

International - International Profiles of Health Care Systems

This publication presents overviews of the health care systems of 13 countries - Australia, Canada, Denmark, England, France, Germany, Italy, the Netherlands, New Zealand, Norway, Sweden, Switzerland, and the United States. Each country summary provides information on insurance coverage and benefits, health system financing, delivery system organization, quality assurance mechanisms, efforts to improve efficiency and control costs, and recent innovations and reforms.

OECD - International Migration of Health Workers

This Policy Brief provides new insights on recent migration trends for doctors and nurses up to 2008, and discusses the main causes and consequences for destination and origin countries. It presents possible policy responses stressing the importance of international co-operation to address the worldwide scarcity of health workers.

International - Value for Money in Health Spending

This publication examines current efforts to improve health care efficiency, including tools that show promise in helping health systems provide the best care for their money, such as pay for performance, co-ordination of care, health technology assessment and clinical guidelines, pharmaceutical reimbursement and risk-sharing agreements and information and communication technology.

International - Improving Value in Health Care. Measuring Quality

This report gives new evidence on patient safety across OECD countries, and shows that large variations in quality of care remain for cancer, stroke, heart attacks, and services provided by family doctors. It addresses the various ways countries can improve measuring quality; the need for a balance between privacy concerns and transparency on quality and safety and how links can be made between quality indicators and policies to improve the performance of physicians, hospitals and the health care system as a whole.

International - Sharing the Burden. Could risk-sharing change the way we pay for healthcare?

Risk-sharing is a relatively new concept in the field of healthcare policy. As such, it is subject to confusion and misunderstanding, not only in terms of terminology but also in terms of substance. This paper will examine and compare risk-sharing schemes in the following five countries: Australia, Germany, Italy, the United Kingdom, and the United States.

International - Nurses’ Reports on Hospital Care in Five Countries

A new study of more than 43,000 nurses practicing in more than 700 hospitals in five countries indicates that fundamental problems in the design of work are widespread in hospitals in Europe and North America. Its findings further suggest that major workforce management problems in hospitals must be corrected to ensure acceptable quality of care and an adequate nurse workforce for the future.

International — Quality of Private and Public Ambulatory Health Care in Low and Middle Income Countries: Systematic Review of Comparative Studies

In developing countries, the private sector provides a substantial proportion of primary health care to low income groups for communicable and non-communicable diseases. These providers are therefore central to improving health outcomes. We need to know how their services compare to those of the public sector to inform policy options. The authors of this study summarised reliable research comparing the quality of formal private versus public ambulatory health care in low and middle income countries.

Governance in the health sector: a strategy for measuring determinants and performance

Brief analytical summaries or syntheses #22 Governance in the health sector a strategy for measuring determinants and performance Summary Governance in the health sector a strategy for measuring determiMany different strategies have been proposed to improve the delivery of health care services, from capacity building to establishing new payment mechanisms. Recent attention has also looked at whether improvements in the way health care services are governed could make a difference. These approaches ask which factors, such as rules and institutions, influence the behaviour of the system, its performance and outcomes. The paper proposes specific measures of governance determinants and performance and describes the instruments available to collect and interpret them. Background While the term “governance” is increasingly being used to draw attention to a number of factors that affect the quality, effectiveness and reach of social services, no consensus has emerged on definitions, frameworks and, in particular, how it applies…

International - Educating a New Generation of Doctors to Improve the Health of Populations in Low- and Middle-Income Countries

This article from PLoS Medicine looks at the mismatch in many low and middle-income countries between professional education and the realities of local health service delivery. The study calls for a transformative scale-up of national medical education programs, saying that new paradigms and practices are fundamental to improving health systems’ ability to respond to population needs.

International - Medical Tourism: Treatments, Markets and Health System Implications: A scoping review

This OECD review details what is currently known about the flow of medical tourists between countries and discusses the interaction of the demand for, and supply of, medical tourism services. It highlights the different organisations and groups involved in the industry. Treatment processes and system-level implications for countries of origin and destination (financial issues, equity and the impact on providers and professionals of medical tourism) are highlighted.

International - Towards Improved Measurement of Financial Protection in Health

This article published in the September edition of PloS Medicine discusses the health system’s failure to offer citizens adequate financial protection. The authors attribute this failure to insufficient financial risk pooling and prepayment mechanisms. According to the authors, broader metrics are required to better inform policy development.

International - Better Health. A Shared Challenge for Hospitals and Primary Health Care

This report from HOPE (European Hospital and Healthcare Federation) discusses the findings of this year’s congress, HOPE Agora 2011, held in Turku, Finland on June 20 and 21, 2011. Findings are presented on the congress’s central themes: rational reforms, locally implemented patterns, role changes for health professionals, and home care.

International - Improving Estimates of Exports and Imports of Health Services and Goods under the SHA Framework

This document constitutes the final report of this OECD project that responds to increasing demand for statistics on the trade in health care goods and services. This report provides clear concepts, definitions and guidelines for the production of reliable, timely and comparable estimates of imports and exports of health services and goods within a standard health accounting framework.

International - Rising Health Care Costs Could Weigh On The G-20's Sovereign Creditworthiness, Says S&P Report

The Standard & Poor’s Rating Service report "Mounting Medical Care Spending Could Be Harmful To The G-20's Credit Health" provides a hypothetical scenario analysis for the period 2010 to 2050. It find that countries with high social protections and rapidly worsening demographic profiles have little room to maneuver in managing their health care spending and face a deterioration in public finances. Health care represents the majority of the total increase in age-related spending in many G-20 countries and the authors recommend that countries undertake reforms soon, before the demographic profile of the electorate makes such changes ever more difficult.

International - Assessing the contribution of prescribing in primary care by nurses and professionals allied to medicine: a systematic review of literature

Legislation enabling nurses and allied heath professionals to prescribe medications exists in some countries, and others are considering introducing such legislation. Questions remain as to the contribution this type of legislation makes to the care of patients in primary care and the evidence base on which clinicians, commissioners of services and policy makers can consider this innovation. This study, published in BMC Health Services Research provides a review of the literature on non-medical prescribing in primary care, looking at its impact on health care quality.

International - New 2011 Survey of Patients with Complex Care Needs in Eleven Countries Finds That Care Is Often Poorly Coordinated

In high-income countries, patients with complex care needs account for a disproportionate share of health spending. This Commonwealth Fund survey focuses on patients with high care needs in 11 countries. It finds that U.S. patients are most likely to struggle with care coordination and forego needed care because of costs.

International - Strengthening primary care: recent reforms and achievements in Australia, England and the Netherlands

This paper published by the Commonwealth Fund examines recent primary care reforms in Australia, England and the Netherlands. It details quality improvement strategies, strategies for improving access, mid-level primary care organizations and payment reforms that have contributed to enhancing the quality and accessibility of primary care.

International - The Impact of Pay Increases on Nurses' Labour Market: A Review of Evidence from four OECD Countries

This OECD report published in August 2011 reviews the impact of pay increases on nursing labour market indicators in member states. It presents background data, summarizes evidence on pay and labour market behaviour, and provides case studies highlighting labour market challenges in the U.K., New Zealand, Finland, and the Czech Republic. The report uses a variety of indicators to illustrate the economic impact of pay increases and concludes with key points for policy makers.

International — Spending for seniors to double or more by 2050, says OECD

Spending on long-term care in OECD countries is set to double, even triple, by 2050, driven by ageing populations. Governments need to make their long-term care policies more affordable and provide better support for family careers and professionals, according to a new OECD report. “Help Wanted? Providing and paying for long-term care” says that half of all people who need long-term care are over 80 years old. And the share of the population in this age group in OECD countries will reach nearly one in ten by 2050, up sharply from one in 25 in 2010. This percentage will reach 17% in Japan and 15% in Germany by 2050.

International — Many countries hit by health threats from both infectious and chronic diseases

An increasing number of countries are facing a double burden of disease as the prevalence of risk factors for chronic diseases such as diabetes, heart diseases and cancers increase and many countries still struggle to reduce maternal and child deaths caused by infectious diseases, for the Millennium Development Goals, according to the World Health Statistics 2011 released by the WHO recently.

International — Nurse prescribing of medicines in Western European and Anglo-Saxon countries: a systematic review of the literature

The aim of this review was twofold: firstly, to gain insight into the scientific and professional literature describing the extent to and the ways in which nurse prescribing has been realised or is being introduced in Western European and Anglo-Saxon countries; secondly, to identify possible mechanisms underlying the introduction and organisation of nurse prescribing on the basis of Abbott's theory on the division of professional labour.

International — New world report shows more than 1 billion people with disabilities face substantial barriers in their daily lives

WHO and the World Bank today revealed new global estimates that more than one billion people experience some form of disability. They urged governments to step up efforts to enable access to mainstream services and to invest in specialized programmes to unlock the vast potential of people with disabilities. The first-ever World report on disability provides the first global estimates of persons with disabilities in 40 years and an overview of the status of disability in the world. The report stresses that few countries have adequate mechanisms in place to respond to the needs of people with disabilities. Barriers include stigma and discrimination, lack of adequate health care and rehabilitation services; and inaccessible transport, buildings and information and communication technologies.

International — Comparing the USA, UK and 17 Western countries’ efficiency and effectiveness in reducing mortality

The objective of this study was to test the hypothesis that the USA healthcare system was superior to the NHS and 17 other Western countries in reducing feasible mortality rates over the period 1979–2005. In cost-effective terms, i.e. economic input versus clinical output, the USA healthcare system was one of the least cost-effective in reducing mortality rates whereas the UK was one of the most cost-effective over the period.

International - Chronic Disease Management Matrix 2010. Results of a survey in ten European countries

Although the greatest threat to population health today comes from chronic diseases such as cancer, COPD, cardiovascular disease and depression, there has been little institutional response to these threats from national healthcare systems. This European survey conducted in 2010 assesses the situation in 10 countries, first establishing criteria for relevant Chronic Disease Management Programs (DMPs), and then investigating health systems’ implementation of DMPs on a national, regional or local basis.

International — The Relative Efficiency of Public and Private Health Care

A health care system is efficient when an increase in spending results in significant improvements in the health of a population. The authors of this paper test the relative efficiency of public and private health care spending in reducing infant and child mortality using cross-national data for 163 countries.

UK — Integration in action: four international case studies

This report explores how to strengthen integration between services in order to improve health outcomes, patient experience of care and value for money from available resources. It describes work to improve integration in four international organisations: 1. a government-funded network to improve access to and quality of Medicaid services in North Carolina, United States (US) 2. an independent practice association in upstate New York, US 3. a Dutch organisation providing support to general practitioners (GPs) to deliver integrated care for diabetes and other chronic conditions, 4. a Scottish health and social care partnership.

International - Performance-based financing as a health system reform: mapping the key dimensions for monitoring and evaluation

This paper published in BMC Health Services Research aims to develop a framework for assessing the interactions between performance-based financing and health systems, focusing on low and middle income countries.

International - Cooperation between general practitioners and pharmacists : a systematic review

Conducted by French researchers studying cooperation between general practitioners (GPs) and pharmacists, this systematic review found that cooperation significantly improved the management of patients’ cardio-metabolic problems (hypertension and hypercholesterolemia). Sixteen of 22 studies showed that patients benefitted from pharmacist involvement in prescriptions for chronic conditions.

International - Health Landscape in Six Regions Reveals Rapid Progress Made and Daunting Challenges from Hundreds of Diseases, Injuries, Risk Factors

These reports from the World Bank Group explore changes in the leading causes of premature mortality and disability in different parts of the world and compare the performance of countries in a range of health outcomes. Individually, they document how each region is working to reduce health loss from most communicable, newborn, nutritional, and maternal conditions and what new challenges lie ahead.

International - How to recruit and retain health workers in rural and remote areas in developing countries

In response to the ongoing challenge to recruit and retain health workers in rural and poorer areas, this paper proposes the application of Discrete Choice Experiments (DCEs) to allow for measurement of health workers' preferences and quantitatively predict uptake given a set of job characteristics.

International - Promoting universal financial protection: evidence from seven low- and middle-income countries on factors facilitating or hindering progress

Universal health coverage (UHC) is a global health policy priority, but there remains limited evidence on UHC reforms in low- and middle-income countries. Published in Health Research Policy and Systems, the case studies accomplished as part of this study highlight the importance of increasing pre-payment funding through tax funding.

International - ICTs and the Health Sector: Towards Smarter Health and Wellness Models

A whole new world of possibilities in using mobiles and the Internet to address healthcare challenges has opened up. A key hurdle is, however, the big data challenge, dealing with the exponentially accelerating accumulation of patient data – all of which must be mined, stored securely and accurately, and converted to meaningful information at the point of care.

International - A Comparative Analysis of Hospital Care Payments in Five Countries

This report from the Belgian Health Care Knowledge Centre examines how hospitals and medical specialists paid in a selection of countries. It looks at the intended and unintended consequences of a case prospective hospital payment system. It also examines how incentives for improving quality and for stimulating integrated care systems are introduced in hospital payment systems.

International - Series of five papers on integrated primary health care

In this this policy issue review, the Primary Health Care Research and Information Service examine policies that have an impact on the integration of care at the macro, meso and micro levels.

International - Resources, attitudes and culture: an understanding of the factors that influence the functioning of accountability mechanisms in primary health care settings

Webs of accountability relationships exist within every health system. There is a need to strike a balance between achieving accountability upwards within the health system while at the same time allowing for the local level innovation that could improve quality of care and patient responsiveness. Published in BMC Health Services Research, this literature review examines factors that influence the functioning of accountability mechanisms.

International – Financing public health expenditures in five federations: Australia, Belgium, Spain, the United States and Switzerland

This project report published by CIRANO aims, through an examination of how public health expenditures are financed in these five federal systems, to contribute to the debate on the financing of the health system.

International - We must take better care of the elderly, say OECD and the European Commission

The number of people over 80 will double by 2050 rising from 3.9% of the population to 9.1% in 2050 across OECD countries and from 4.7% to 11.3% across 27 EU members. Estimates are that up to half of them will need help to cope with their daily needs. Yet even today governments are struggling to deliver high-quality care to elderly people with reduced physical and mental abilities, says a new OECD/EC report, A good life in old age?. Most countries have legislation to prevent abuse, including encouraging public disclosure of specific cases, complaint mechanisms and an ombudsman to deal with concerns. However very few countries systematically measure whether long-term care is safe, effective, and meets the needs of care recipients.

International - Do political or economic factors drive healthcare financing privatisations? Empirical evidence from OECD countries

This Dutch paper analyzes political and economic factors that trigger or hinder healthcare financing privatizations in 23 member-countries of the OECD. The authors find evidence to support a “crises induced reform” hypothesis: economic recession, large-scale unemployment, and high interest rates on government debt combine to trigger privatization.

International - Health spending continues to stagnate, says OECD

After falling sharply in 2010, health spending remained flat across OECD countries in 2011 as the economic crisis continued to have an impact, particularly in those European countries hardest hit by the crisis, according to OECD Health Data 2013. While health spending grew on average by close to 5% year-on-year from 2000 to 2009, this has since been followed by a sluggish growth of around 0.5% in 2010 and 2011. Current expenditure on health (i.e., excluding capital expenditure) grew by 0.7% in both years. Preliminary figures for some countries suggest a continuation of this trend in 2012.

International - Toward systematic reviews to understand the determinants of wait time management success to help decision-makers and managers better manage wait times

This systematic review, published in Implementation Science, examines factors influencing the implementation and sustainability of wait time management strategies at the organizational level. Specific factors for successful implementation were consultation with front-line actors and common standards and guidelines, and at the organizational level, financial incentives and dedicated staffing. The authors consider that more research is needed to understand the sustainability of wait time management strategies.

International - Health systems in times of global economic crisis: an update of the situation in the WHO European Region. Report

This report was produced from a follow-up, held in April 2013, to an original meeting in 2009 on health and the financial crisis. The meeting reviewed the impact of the economic crisis on health and health systems, and focused on three themes: reinforcing equity, solidarity and universal coverage; and coping mechanisms, with a focus on efficiency and health system resilience. Policy recommendations were prepared for consideration by member states.

International - Assessing Quality in Cross-Country Comparisons of Health Systems and Policies: Towards a Set of Generic Quality Criteria

There is a growing body of cross-country comparisons in health systems and policy research. This paper from the RAND Corporation reviews methods of cross-country comparison to identify quality issues and assess generic quality criteria. The authors identify criteria such as the appropriate use of theory, design and research rigour, as well as attention to complexity.

International - Health Workforce Planning in OECD Countries. A Review of 26 Projection Models from 18 Countries

This OECD Health Working Paper reviews the main characteristics and results from 26 health workforce projection models. It focuses mainly on physician models, but also includes some nurse models, and examines supply-side and demand-side considerations included in the models.

International - The world health report 2013: research for universal health coverage

Everyone should have access to the health services they need without being forced into poverty when paying for them. The World health report 2013 "Research for universal health coverage" argues that universal health coverage – with full access to high-quality services for prevention, treatment and financial risk protection – cannot be achieved without the evidence provided by scientific research.

International - Managing Hospital Volumes. Germany and Experiences from OECD Countries

Published by the OECD, this paper offers a comparative perspective on Germany’s hospital sector, viewing the structure, financing and volume management of German hospitals against hospital organization in other OECD countries. The paper notes that Germany has weaker controls over hospital budgets and a more open-ended approach to financing.

International - Improving detection and treatment would cut cancer death rates significantly, says OECD

The report by the OECD was prepared with the support of the European Commission and builds on earlier WHO research. It finds that earlier detection and better treatment for cancer would cut death rates from the disease by around a third, saving the lives of nearly a million people in the developed world every year. Improving care standards, cutting waiting times and spending resources more effectively are key steps to save many lives.

International - Global battle against cancer won’t be won with treatment alone. Effective prevention measures urgently needed to prevent cancer crisis

The WHO's World Cancer Report 2014 shows that the cancer burden is growing at an alarming pace. The estimated 14 million new cases per year in 2012 will grow to 22 million annually within 20 years. With spiralling costs of treatment, prevention, especially by reducing exposure and risk behaviours, along with early detection must be emphasized.

International - The more I know, the less I sleep - Global perspectives on clinical governance

Produced by the Canadian branch of KPMG, this report on clinical governance examines leading practices by the world’s best-regarded providers and thought leaders. The report highlights the importance of organizational culture, optimized and standardized practices, accountable staff, and systematic, real-time measurement.

International - New UN report identifies unmet need for palliative care worldwide

Only 1 in 10 people who need medical care to relieve the pain, symptoms and stress of serious illness is currently receiving it, according to a new United Nations report, which calls on countries to include palliative care as an essential component to their health systems. The “Global Atlas of palliative care at the end of life,” published jointly by the UN World Health Organization (WHO) and the Worldwide Palliative Care Alliance (WPCA), is the first tool to map the need for, and availability of, palliative care globally as well as to identify the barriers to this important element of patient and family care.

International - Health Spending Continues to Stagnate in Many OECD Countries

The global economic crisis, which began in 2008, has had a dramatic effect on health spending across the 34 countries of the OECD. This report describes the most recent trends in health spending and shows that health expenditures experienced close to zero growth across a majority of OECD countries in 2013.

International - Risky Behaviors Constitute Growing Threats to Global Health

Published by the World Bank, this report warns that risky behaviours constitute a growing threat to the world’s health. The report looks at choices that lead to five risky behaviours (smoking, illicit drug and alcohol abuse, unhealthy diet, and risky sex) and uses empirical evidence to examine the success of intervention mechanisms.

International - Incentives for telehealthcare deployment that support integrated care: a comparative analysis across eight European countries

This Spanish study investigated 31 telehealth initiatives across eight European countries to identify factors that promoted the use of telehealth applications to support integrated care. The study found a trend towards greater uptake in the presence of outcomes-based and bundled payment schemes, but sees a need to design more effective incentive models.

International - Major brake in health spending growth as governments cut budgets in the crisis, says OECD

Total health spending has fallen in one of three OECD countries between 2009 and 2011, with those hardest hit by the crisis most affected. This is a sharp reversal from the strong growth in the years prior to the crisis, according to a new OECD report. Health at a Glance 2013 says that this makes it all the more important that countries make their healthcare systems more productive, efficient and affordable.

International - Patient-based Funding: A literature review of experiences in other countries

The objective of this report from INESSS is to examine and describe other countries' experience with replacing global budgeting by activity-based funding (ABF). It details the steps involved, determines the prerequisites and conditions necessary, and points out the obstacles that need to be overcome to permit the successful implementation of ABF in Québec.

International - Measuring and Comparing Health Care Waiting Times in OECD Countries

Waiting times for elective non-emergency treatments are a key health policy concern. This study provides comparative data on waiting times from twelve OECD countries. It presents trends in waiting times over the past decade, focusing on such common elective procedures as cataract surgery and hip and knee replacement.

International - 2nd International Conference on Age-Friendly Cities: Videos of Plenary Sessions now available online

The Conference brought together 700 elected officials, municipal administrators, professionals, practionners, researchers, decision makers and elders from 46 different countries to share their knowledge and experiences on age-friendly cities and communities.

International - A Universal Truth: No Health without a Workforce. Third Global Forum on Human Resources for Health Report

This report from the Global Health Workforce Alliance and the WHO consolidate the latest information available on human resources for health. It also examines how the global community can attain, sustain and accelerate progress on universal health coverage.

International - New Way to Finance Health in World's Less Developed Nations. Results-Based Financing can get 20 percent more health care with same funds

The World Bank reports that results-based financing for health projects enables low-income countries to achieve improvements in care provision. Countries and major donors are now moving to results-based financing in programs that provide funding to maternal and child health, malaria, tuberculosis and HIV/AIDS.

International - The Role of Fiscal Policies in Health Promotion

This paper provides a review of the theoretical arguments and empirical evidence on the key factors that governments must address when considering the adoption of fiscal measures for health promotion. The main focus is on taxes on health-related commodities.

International - Getting better: improving health system outcomes in Europe and Central Asia

Instead of catching up with their Western neighbours, many countries in Eastern and Central Europe have been falling behind. This report from the World Bank identifies three key agendas for achieving more rapid convergence with the world's best-performing health systems. First is to strengthen public health and primary care interventions to help achieve the 'cardiovascular revolution' that has taken place in the west in recent decades. Second is to improve healthcare financing and the use of resources. The third agenda relates to broader institutional arrangements.

International - Countries in the Americas prioritize universal access to health services

Held at the beginning of October 2013, the 52nd meeting of the Pan-American Health Organization (PAHO) approved a five-year plan highlighting the importance of universal health coverage to social, environmental and economic indicators related to health. The PAHO meeting issued a statement saying universal coverage is essential for eradicating disease and ending health inequities in the Americas.

International - Universal Healthcare on the rise in Latin America

World Bank studies highlight the successes of nine Latin American countries in expanding health coverage. The nine countries have applied strategies from explicitly defined benefits packages to reforms of public health services provision to ensure that quality coverage reaches previously excluded populations.

International - Machines that go ‘ping’: medical technology and health expenditures in OECD countries

While rising national healthcare expenditures are widely documented, the quantification of underlying cost drivers has proven difficult. This paper looks at data on approved medical devices and confirms the substantial cost-increasing effect of medical technology, which accounts for 50% of historical spending.

International - Pay-For-Performance Incentives in Low- And Middle-Income Country Health Programs

This study from the US National Bureau of Economic Research surveys experience with performance pay in developing country health programs. It focuses on four key conceptual issues: what, who, and how to reward, and the unintended consequences of performance incentives. The paper highlights the fact that the use of performance pay has outpaced growth in evidence about its effects.

International – Strengthening Health Information Infrastructure for Health Care Quality Governance

This OECD report examines the progress made by OECD countries in developing national health information infrastructures. The report focuses on the linkage of health data and the utilization of electronic health records, and finds substantial differences between OECD countries.

International - Performance Assessment in Primary Health Care: A Systematic Literature Review

This CEFAGE working paper by researchers at the University of Algarve in Portugal provides a systematic literature review of studies devoted to the performance assessment of primary healthcare providers.

International - Conceptualizing performance of nursing care as a prerequisite for better measurement: a systematic and interpretive review

Despite the critical role of nursing care in healthcare delivery, nursing's contribution is rarely quantified. This study, undertaken by researchers at the Université de Montréal and published in BMC Nursing, develops a framework to measure nursing performance.

International – WHO statistics show narrowing health gap between countries with best and worst health status

The world has made dramatic progress in improving health in the poorest countries and narrowing the gaps between countries with the best and worst health status in the past two decades, according to the World Health Statistics 2013. The WHO annual statistics report highlights how efforts to meet the Millennium Development Goals (MDGs) have reduced health gaps between the most-advantaged and least-advantaged countries.

International - Waiting Time Policies in the Health Sector. What Works?

This book describes healthcare system wait-list policies in 14 OECD countries. It looks at discrepancies between countries in wait times for medical specialties, reviews best practices and different policy approaches, and discusses government use of sanctions against providers with long wait times.

International - A systematic approach to the planning, implementation, monitoring, and evaluation of integrated health services

Published by BMC Health Services Research, this study develops a systematic country-specific approach to the development of integrated health services. It applies principles from existing monitoring and evaluation frameworks to country-specific health challenges, which integration is meant to improve, and includes recommendations about improvements to health information systems and data usage.

International - World Bank Group President Urges Countries to Deliver Universal Health Coverage to Help End Poverty

According to worldwide estimates, out-of-pocket health spending forces 100 million people into extreme poverty every year and inflicts severe financial hardship on another 150 million people. At the World Health Assembly held on May 21, 2013, Jim Yong Kim, President of the World Bank Group, called on countries to ensure universal access to quality, affordable health services.

The Netherlands - The Dutch Healthcare System in International Perspective

This article by a Dutch academic discusses aspects of the Netherlands' healthcare system of managed competition from an economic perspective that highlights both the system’s merits and the major challenges posed by its adoption. The article goes on to compare the outcomes achieved with those of different countries and suggest improvements to the Dutch system.

Canada - Measuring What Matters: The Cost vs. Values of Health Care

This white paper on Canada’s healthcare system from the Ivey International Centre for Health Innovation considers five key questions about stakeholder values and their alignment with funding, reimbursement, measures, and incentives. It also assesses whether Canada’s health care values and performance outcomes compare well over time to other OECD nations.

Canada - Building better health care: Policy opportunities for Ontario

The province of Ontario’s healthcare performance is uncompetitive among international peers, many of which spend less to achieve better outcomes. This paper urges Ontario to confront its main healthcare cost drivers (technology, drugs, increased service utilization and physician compensation), and recommends abolishing the tax subsidy for employer health insurance benefits.

UK - Focus on: international comparisons of healthcare quality - what can the UK learn?

This study compares British healthcare quality in four sectors (primary care, acute care, cancer care and mental health) with equivalent care in 12 countries: Australia, Belgium, Canada, France, Germany, Ireland, Italy, the Netherlands, New Zealand, Spain, Sweden and the US. Analysis reveals that the UK ranks last or second last on 16 of 27 quality indicators used in the study.

Canada - Where you live matters: Canadian views on health care quality Results from the 2013 Commonwealth Fund International Health Policy Survey of the General Public

This final bulletin in the Health Council of Canada's Canadian Health Care Matters series presents Canadians’ views on and experiences with health care, based on the 2013 Commonwealth Fund Survey. It focuses on differences between provinces, comparisons among the 11 OECD countries participating in the survey, and changes in Canada’s performance over the past decade. Large variations between provinces in patient experiences, not only around wait times and coordination of care, but also in other areas including out-of-pocket expenses, patient safety, and preventive care, were identified.

Canada - Procurement Can Drive Innovation and Better Care in Canada's Health System

According to the Conference Board of Canada, procurement strategies used internationally in health systems could improve Canadians’ access to innovative technologies and better care without increasing costs. In this report, the Conference Board highlights procurement practices used outside Canada to introduce cost-effective, quality-conscious innovations into public health systems.

Canada - Call for projects: Québec-Maharashta Cooperation

In 2009, the first call for proposals of cooperation between Quebec and the Indian state of Maharashtra was launched. This call for projects aimed to implement the Joint Declaration on Cooperation between the Government of Quebec and the Government of Maharashtra, signed in 2006 by the Quebec premier of the time and his Marathi counterpart. The ministère des Relations internationales, de la Francophonie et du Commerce extérieur (MRIFCE) has since supported projects between partners in Quebec and Marathi in areas as diverse as research and innovation, the environment, the sharing of expertise in health, literature, art, etc.. This call for proposals aims to encourage the continuation of such collaborations. Parties with an interest in undertaking a project with partners from Maharashtra are invited to submit a proposal by April 8, 2014.

New Zealand - Trends in Service Design and New Models of Care. A Review

This report prepared by the National Health Board provides a high-level overview of how pressures on health systems worldwide are influencing the current and future configuration of health services. The report outlines the ways in which health systems internationally are considering their responses to the challenges they face.

Ireland - Health Care Quality Indicators in the Irish Health System

Utilizing an IT system called HIPE to capture information on all hospital stays in Ireland’s public hospitals, this preliminary government report is an important step in the development of an Irish national reporting system on health quality. The system will report at national and regional levels and will enable international comparison on selected health indicators.

Australia - Nurse Practitioners and Physician Assistants: Adapting models of care to changing demographics

Australia recently introduced nurse practitioner and physician assistant roles in response to changes in use patterns and shortages of workers. This paper from the Australian University of Technology looks at the international history of the two job designations and at growing needs arising from Australia’s changing demographics and aging population.

UK — Health is Global: an outcomes framework for global health 2011-15

The UK’s Global Health Outcomes Framework will focus the UK Government’s efforts to drive forward the global health agenda by 2015. It defines twelve global health outcomes in three overarching areas for action: global health security, international development and trade.

Australia - Patient Safety in Primary Health Care. Discussion Paper and Consultation

The Australian Commission on Safety and Quality in Health Care is seeking to clarify its understanding of patient safety issues in primary health care, including identifying key priorities and solutions both nationally and internationally that could be applied to the Australian primary health care context. A draft discussion paper on Patient Safety in Primary Health Care has been developed for public consultation. The findings of this consultation process will be used to inform the Commission's consideration of activities it could undertake or support to strengthen patient safety in primary health care in Australia.

Canada - A Better Prescription: Advice for a National Strategy on Pharmaceutical Policy in Canada

Building on published research and international frameworks, this article proposes that the pharmaceutical policies of federal, provincial, and territorial governments be coordinated around a core health-focused goal. It strongly suggests policy action on four core objectives: universal access to necessary medicines; appropriate prescribing and use of medicines; value for money spent on medicines; and patient safety.

International - Comparing Price Levels of Hospital Services across Countries: Results of Pilot Study

This paper presents a new set of comparative prices for hospital services in a selection of OECD countries. The data is novel in that it reflects quasi-prices (negotiated or administrative prices or tariffs) of the output of hospital services. Traditionally, prices of outputs have been compared with prices of inputs, such as wage rates of medical personnel. The new methodology moves away from the input perspective towards an output perspective. This should allow productivity differences between countries to be captured. It also paves the way for more meaningful comparisons of the volume of health services provided to consumers in the different countries. One of the key findings of the pilot study is that the price level of hospital services in the United States is more than 60 % above that of the average price level of 12 countries included in thestudy. Price levels turn out to be significantly below average…

International — How health systems make available information on service providers: experience in seven countries

This report reviews information systems that report on the quality or performance of providers of healthcare in seven countries (Denmark, England, Germany, Italy, the Netherlands, Sweden and the United States) to inform the use and further development of quality information systems in the English NHS.

The Republic Of Ireland - A Review of Practice Development in Nursing and Midwifery in the Republic Of Ireland and the Development of a Strategic Framework

Practice development is a term that has been used to describe particular approaches to supporting and promoting change in health care. The purpose of the review was to identify how practice development activity in Ireland compares with the international evidence and from the information gained, develop a strategic framework for practice development in Ireland.

UK - Open innovation in health. A guide to transforming healthcare through collaboration

Published by Nesta, this guide explores international examples of open innovation in the field of health and examines the ways that companies, governments, researchers and citizens are collaborating to improve the innovation process. The guide analyzes 18 types of open innovation initiative, illustrated with examples from around the world, and identifies open innovation approaches across the innovation cycle.

Canada - Value for Money from Health Insurance Systems in Canada and the OECD

This paper compares the economic performance of Canada’s health insurance system against the health insurance systems of 27 other countries that are members of the Organisation for Economic Co-operation and Development (OECD). Economic performance is defined by the availability of medical resources and the output of medical services, as well as the associated level of national health spending as a percentage of GDP. The value for money produced by a country’s health insurance system is defined relative to the economic performance of the health insurance systems of its international peers.

International - Framework for assessing, improving and enhancing health service planning

This report aims to contribute to policy learning across countries from the diversity of healthcare planning approaches in Europe and elsewhere through developing and validating a framework for assessing, improving and enhancing healthcare planning. It identifies a set of criteria within three broad themes: "Vision", "Governance" and "Intelligence", which were then tested empirically through an in-depth analysis of four countries, using a case study approach: Germany, Austria, Canada (Ontario) and New Zealand.

International - Health at a Glance: Asia/Pacific 2010

This first edition of Health at a Glance: Asia/Pacific presents a set of key indicators of health status, the determinants of health, health care resources and utilisation, and health care expenditure and financing across 27 Asia/Pacific countries and economies in the Asia/Pacific region. Drawing on a wide range of data sources, it builds on the format used in previous editions of Health at a Glance: OECD Indicators, and gives readers a better understanding of the factors that affect the health of populations and the performance of health systems.

Belgium – Implementation of Hospital at Home: Orientations for Belgium

This scientific report from KCE analyses the effectiveness and the safety of different international models of hospital at home (HAH). It explores practical considerations regarding the coordination of the care plan, patient and family empowerment, as well as workforce, financing, information technology and other supports required to implement HAH in Belgium.

Nurses in advanced roles: a description and evaluation of experiences in 12 developed countries

Brief analytical summaries or syntheses #1 Nurses in advanced roles a description and evaluation of experiences in 12 developed countries Summary This health working paper from the OECD Directorate for Employment, Labour and Social Affairs looks at the development of advanced practice nurses in 12 countries Australia, Belgium, Canada, Cyprus, Czech Republic, Finland, France, Ireland, Japan, Poland, United Kingdom and United States. Many countries are seeking to improve healthcare delivery by reviewing the roles of health professionals, including nurses. Developing new and more advanced roles for nurses could improve access to care in situations of limited or diminishing supply of doctors. The redefinition of roles might also contain costs by delegating some of the tasks currently accomplished by expensive doctors to nurses, especially in primary care. The paper also assesses how the reorganization of work impacts the quality of patient care. Background Advanced nursing roles vary significantly between countries. The…

World Health Report 2010
Health systems financing: The path to universal coverage

Brief analytical summaries or syntheses #10 World Health Report 2010 Health systems financing The path to universal coverage Summary The 2010 World Health Report presents practical guidance on ways to finance health care. It describes different options for changing healthcare financing systems in order to move towards universal coverage and maintain gains that have been achieved to date. The report draws on evidence and lessons from a number of different countries. Background Promoting and protecting health is essential to human welfare and sustained economic and social development. This was recognized more than 30 years ago by the Alma-Ata Declaration signatories, who noted that Health for All would contribute both to a better quality of life and also to global peace and security. In this context, timely access to health services is critical. This cannot be achieved, except for a small minority of the population, without a well-functioning health financing system.…

The impact of global processes on health systems in Europe

Brief analytical summaries or syntheses #11 The impact of global processes on health systems in Europe Summary The relationship between globalization and health systems is a complex one, where both positive and negative influences are reported. This unsystematic literature review explores the impact of globalization on European health systems and emphasizes the need for national policy-makers and leaders to consider global processes when designing national health systems. Background The world is changing rapidly with increasing life expectancies and improving child survival rates. Globalization has contributed to economic growth. In addition to global economic integration, globalization entails the mobility of capital, goods, services and labour, and can be said to be part of an ideological process justifying neo-liberal economic policies. Globalization is also a dynamic process of global interconnectedness influenced by a number of driving and constraining forces such as technological developments, political influences, economic pressures, changing ideas, and greater awareness…

National health expenditure trends in Canada, 1975 to 2010

Brief analytical summaries or syntheses #12 National health expenditure trends in Canada, 1975 to 2010 Summary Healthcare spending in Canada is expected to reach $191.6 billion this year, an estimated increase of $9.5 billion, or 5.2%, over 2009 spending, according to figures recently published by the Canadian Institute for Health Information (CIHI). This represents an increase of $216 per Canadian, bringing total health expenditure per capita to an estimated $5,614 this year. After adjusting for inflation and population growth, spending on health care is expected to grow by 1.4% in 2010, the lowest annual growth in 13 years. Background Both the public and private sectors finance Canada’s health system. Public sector funding includes payments by governments at the federal, provincial/territorial and municipal levels and by workers’ compensation boards and other social security schemes. Private sector funding consists primarily of health expenditures by households and private insurance firms. The CIHI tracks…

International - Payment and economic evaluation of integrated care

Austria, France, the UK, the Netherlands and Germany have all experimented with models of integrated care, implementing disease management programs (DMPs) supported by payment schemes with financial incentives. This paper assesses these payment schemes and explores the cost variability, economies of scale and scope of different DMPs. Larger DMPs are found to do better.

Canada - Building on Canada's Strengths in Regenerative Medicine

This report summarizes a workshop convened by the Council of Canadian Academies in Toronto on October 13 and 14, 2016 to review current strengths and weaknesses in regenerative medicine in Canada. Overall, the workshop report confirms that Canadian regenerative medical research is both of high quality and highly cited. National networks are recognized as enabling Canada to maintain its status as an international leader in the field.

Canada - Québec's health care commissioner releases its 2014 report on the performance of the health and social services system

Published on May 13, this report is based on analysis of a wide range of data from multiple sources at provincial, national, and international levels. Quebec performs very well with regard to wait times to see a specialist, obtain specialized testing, as well as for hospital readmissions, but performs less well on continuity and coordination between specialists and family physicians. Quebec comes dead last in the use of information technology by physicians, access to a regular doctor, and follow-up care.

International - Health Spending Growth at Zero. Which Countries, Which Sectors Are Most Affected?

Health spending slowed markedly or fell in many OECD countries recently after years of continuous growth, according to OECD Health Data 2012. As a result of the global economic crisis which began in 2008, a zero rate of growth in health expenditure was recorded on average in 2010, and preliminary estimates for 2011 suggest that low or negative growth in health spending continued in many of the countries for which data are available. This paper analyses in detail the recent slowdown in health expenditure, looking at which countries and which sectors of spending have been most affected.

Canada - How do Quebec primary care physicians rate the health system?

The Commissaire à la santé et au bien-être du Québec collaborated with the Commonwealth Fund and the Canadian Health Council to present survey data on the Quebec health care system. The 2012 survey collected information from primary care physicians in Quebec and compared it to other Canadian and international jurisdictions. Quebec physicians have a rather negative perception of the health system and more than half indicate deterioration in the quality of care over the last three years.

Reforming health sector resource allocation and financing in Ireland

Brief analytical summaries or syntheses #4 Reforming health sector resource allocation and financing in Ireland Summary This report from the Expert Group on Resource Allocation and Financing in the Health Sector examines how the health system can be changed to support core objectives of the health reform program. The report presents 34 recommendations grouped under seven guiding principles. Background Like most other developed countries, Ireland is grappling with the challenges of providing health care for it's population at a cost it can afford. This report shows how these challenges are set in a context of a growing and aging population; rising individual expectations in relation to healthcare provision; rising incidence of chronic disease; greater provision of first-line care in the community; the need for people to be involved in the management of their own health alongside health professionals. The response to these issues across developed countries has been to develop…

Portugal - Health system review

Since the 2008 economic crisis, health sector reform in Portugal has been guided by financing agreements between the Portuguese Government and international lending institutions. While measures mainly focus on containing costs and improving efficiency to ensure financial sustainability, this review says significant health inequalities persist and quality and accessibility of care is likely to be negatively affected by continuing budget cuts.

International — Mortality Amenable To Health Care in 31 OECD Countries: Estimates and Methodological Issues

This study assesses the potential of the concept of “mortality amenable to health care” as an indicator of outcome for health care systems. It presents estimates of the mortality amenable to health care in 31 OECD countries for the period 1997-2007. It measures the sensitivity of this indicator to the list of death causes considered to be “amenable to care” by comparing results obtained from two leading lists. It then presents the advantages of this indicator over indicators of general mortality, as well as its limitations.

Canada - How do Canadian primary care physicians rate the health system? Survey results from the 2012 Commonwealth Fund International Health Policy Survey of Primary Care Doctors

In this issue of Canadian Health Care Matters, the Health Council of Canada examines survey results that shed light on the potential for improvement in several key areas: access to primary health care, coordination among health care providers, the uptake of information technology in primary care, and initiatives to drive practice improvement.

The evolution of healthcare managers’ role: a comparison France/United Kingdom

Brief analytical summaries or syntheses #54 The evolution of healthcare managers’ role a comparison France/United Kingdom Summary This study on nurses’ job satisfaction from the University of Lyon compares the expanding role of healthcare managers in France and the UK. It concludes that the evolution of the healthcare manager role has negative consequences for workplace relations and staff retention in both countries, and suggests research into new modes of leadership. Background Nursing shortages are a problem in all countries (Hayes et al., 2010; Lu et al., 2005). More than 70% of expenses at the UK National Health Service (NHS) go to human resources. Optimal use of the workforce is therefore a key issue. Job satisfaction is recognized in the international nursing literature as being related to turnover rate, staff retention and intention to leave (Hayes et. al., 2010; Lu et. al., 2005; Caers et al., 2008 ; Van Saane, 2003…

Health in the Americas. 2012 edition

Brief analytical summaries or syntheses #53 Health in the Americas. 2012 edition Summary In Health in the Americas 2012, the Pan American Sanitary Bureau presents and analyzes health data and information from every country in the Region of the Americas. In drafting the publication, it has used data from many domestic and international, as well as unofficial, sources, trying as much as possible to identify and eliminate any discrepancies. Background Chapter 1 A Century of Public Health in the Americas In the last 110 years, Latin America and the Caribbean have experienced great transformations, from the independence of the Caribbean countries to the construction of modern states, from authoritarian regimes and dictatorships to democracy and the rule of law, and from cycles of economic growth and high productivity to financial crises, economic slow-downs, and massive foreign debt. The Region also has achieved a notable increase in life expectancy and a…

Northern Ireland - Ministers announce initiative to exploit economic opportunities in health

On January 20, 2013, the Irish government announced the creation of the Task and Finish Group (TAGF) to exploit economic opportunities from the health sector. The group will be made up of international business experts and will draw up proposals for consideration by the Minister of Health and the Minister of Enterprise.

International - Sub national Health Spending and Soft Budget Constraints in OECD Countries

Government spending on health has grown as a percent of GDP over the last 40 years in industrialized countries. Widespread decentralization of healthcare systems has often accompanied this increase in spending. The authors of this paper explore the effect of soft budget constraints on sub national health spending in a sample of OECD countries. The authors of the study find countries where sub national governments rely primarily on central government financing and enjoy large borrowing autonomy have higher healthcare spending than those with more restrictions on sub national government borrowing.

Canada - Quality of Healthcare in Canada: A Chartbook

The Canadian Health Services Research Foundation has released Canada’s first-ever chartbook on healthcare quality. Providing both domestic and international data, the chartbook reports on six key domains of quality: the effectiveness of the healthcare sector; access to healthcare services; the capacity of systems to deliver appropriate services; the safety of care delivered; the degree to which healthcare in Canada is patient-centred; and equity in healthcare outcomes and delivery.

USA - mHealth in China and the United States: How Mobile Technology is Transforming Health Care in the World’s Two Largest Economies

Rising costs, unequal access and aging populations are increasing pressure on many countries’ healthcare systems. This article suggests that policy-makers look to the US and China, where mobile health technology, or mHealth, is boosting productivity, encouraging better data collection and analysis, and helping providers improve affordability, access and treatment. The authors suggest a number of ideas to speed the international adoption of mHealth.

Sweden - Saint Göran: A Competitive Hospital in a Universal System

Publically funded but run by a private company, Saint Göran is a Stockholm hospital that regularly stands out in Sweden and internationally on important performance indicators such as emergency room wait times, cost effective management, and patient and staff satisfaction. This article by Quebec researchers analyzes Saint Göran in depth to see what lessons can be drawn for Canadian hospitals.

Canada - McGuinty Government Helps Recruit More Doctors

Ontario is improving access to health care with two new programs that will help communities that have traditionally had the hardest time recruiting doctors. The province is introducing: 1. The Northern and Rural Recruitment and Retention Initiative, which will provide grants to doctors and new doctor graduates who agree to practise in a northern or highly rural community. 2. The Postgraduate Return of Service Program, in which international medical graduates agree to practise for five years in any Ontario community, except the Toronto area and Ottawa, in exchange for postgraduate training opportunities. Previously, these doctors were restricted to practising in rural and northern communities for five years, following graduation.

Canada - Improving Canada’s primary healthcare: benefits and opportunities

These three reports summarize the current state of primary healthcare in Canada, investigate best international practices and provide concrete recommendations on how Canada can redefine its priorities in order to strengthen the system. Commissioned by CHSRF and the Canadian Working Group for Primary Healthcare Improvement, the three reports will be used to guide activities in developing a pan-Canadian strategy for using evidence to improve the design and delivery of primary healthcare.

UK - International benchmarking of healthcare quality: A review of the literature

The report focuses on the three quality domains identified as important by the NHS Next Stage Review High Quality Care for All, namely effectiveness of care, patient safety and patient experience.

Australia: Review of Health Technology Assessment in Australia

A new report released recently by the Minister for Health and Ageing, Nicola Roxon, and the Minister for Finance and Deregulation, Lindsay Tanner, recommends improvements to the way new health products, procedures and services are assessed for public funding, in line with international best practice.

International - Overview of a formal scoping review on health system report cards

There is an extensive body of literature on health system quality reporting that has yet to be characterized. Scoping is a novel methodology for systematically assessing the breadth of a body of literature in a particular research area. The objectives of this study were to showcase the scoping review methodology in the review of health system quality reporting, and to report on the extent of the literature in this area.

Europe - Public health in Europe during the austerity years

Released by the UK International Longevity Centre (ILC-UK), this report explores the relationship between European governments’ economic austerity policies and public health across Europe. Using cross-national data and evidence from individual countries, the report charts the evolution of austerity across the continent since the financial crisis of 2008, describes subsequent changes to health systems and health outcomes, and identifies channels through which austerity impacts on health.

Canada – Survey-based patient experience measurement: from concepts to best practices

This publication reports on the literature regarding the measurement of patient experience through surveys. Among other things, it presents the key underlying concepts used to measure patient experience as well as the various Québec, Canadian and international initiatives that have attempted to do so.

International - Meeting the Demand for Results and Accountability: A Call for Action on Health Data from Eight Global Health Agencies

The eight agencies working in global health (Bill & Melinda Gates Foundation, GAVI, Global Fund to Fight AIDS, Tuberculosis & Malaria, UNAIDS, UNFPA, UNICEF, World Bank, World Health Organization) agree that it is critical to strengthen the five key data sources and capacity for analysis, synthesis, validation, and use of health data in countries. This should enable countries to better monitor and evaluate their own progress and performance and, secondarily, allow them to respond to the increased emphasis on results and accountability. The eight agencies propose four global actions to support these country goals.

International - The effectiveness of research implementation strategies for promoting evidence-informed policy and management decisions in healthcare: a systematic review

Conducted by Malaysian researchers, this systematic review of 21 articles evaluates the effectiveness of research implementation strategies for promoting evidence-informed policy and management decisions in health care. It finds that workshops, ongoing technical assistance, and distribution of instructional digital materials may improve knowledge and skills around evidence-informed decision-making. The authors conceptualize interrelated factors associated with effective strategies to implement research findings.

Contact information

Observatoire international de la santé et des services sociaux (OISSS) Ministère de la Santé et des Services sociaux du Québec 1005, chemin Sainte-Foy, 1er étage Québec (Québec) Canada G1S 4N4 (418) 266-8740 If you have any question about the OISSS, you can contact Émilie Larochelle Sara Veilleux

Canada - Project Management and Practitioners in the Health Sector: From the Quebec Healthcare System Perspective to PM Literature Review

Authored by Quebec researchers, this article reviews 40 years of literature (1979-2017) on project management (PM) in both the health sector internationally and Quebec’s provincial healthcare system. The article describes the importance ascribed to health sector project management but finds a lack of emphasis on PM as a lever for healthcare service improvement. Most health sector PM research is not published by mainstream PM journals.

International - Growing health spending puts pressure on government budgets, according to OECD Health Data 2010

In all OECD countries, total spending on healthcare is rising faster than economic growth, pushing the average ratio of health spending to GDP from 7.8% in 2000 to 9.0% in 2008. Factors raising health spending - technological change, population expectations and population ageing - will continue to drive cost higher in the future.

USA - U.S. Health in International Perspective: Shorter Lives, Poorer Health

Published by the National Academies Press, this book examines the experience of health in the US, a wealthy nation whose population live shorter lives and experience more injuries and illnesses than people in all other high-income countries. The book results from a panel convened by the Institutes of Medicine (IOM) to investigate issues surrounding the “American health disadvantage.”

International - Implementing Health Financing Reform. Lessons from countries in transition

This book analyses health financing reforms in central and Eastern Europe, the Caucasus, and central Asia. Reforms are analysed first from a functional perspective, focusing on revenue collection, pooling, purchasing and benefit entitlements. Subsequent chapters analyse particular financing reform topics including: financing of capital costs; links between reforms and the wider public finance system; financing of public health services; voluntary health insurance; informal payments; and accountability in financing institutions.

Australia - Barriers to accessing primary health care: comparing Australian experiences internationally

This study describes Australia’s barriers to primary care compared with experiences from 10 other developed countries. In 2013, 27% of Australian adults experienced difficulties with after-hours access to primary care and 16% went without any health care in the previous year due to affordability and cost concerns. These barriers were more common in Australia than in seven of 10 comparator countries.

International - Systematic review: Effects, design choices, and context of pay-for-performance in health care

Pay-for-performance (P4P) is one of the primary tools used to support healthcare delivery reform. This paper summarizes evidence, obtained from studies published between January 1990 and July 2009, concerning P4P effects, as well as evidence on the impact of design choices and contextual mediators on these effects. Effect domains include clinical effectiveness, access and equity, coordination and continuity, patient-centeredness, and cost-effectiveness.

Europe - Projecting future health care expenditure at European level: drivers, methodology and main result

To assess correctly the demography-related risks facing public finances in the EU over the next couple of decades and establish adequate policy responses to the demographic, social and economic developments, it is essential to devise a reliable method to estimate future health care expenditure. To tackle this issue, the European Commission and the Economic Policy Committee projected future public health care expenditure in all EU Member States over the period 2007-2060. A unique internationally comparable database has been established and a model built allowing to project health care spending in a common, coherent framework of macroeconomic variables.

Canada — Hospital Payment Mechanisms: An Overview and Options for Canada

Through a review of international experiences with hospital funding, this paper aims to present a synthesis of evidence governing hospital funding. It discusses the relevance of other countries’ experiences to Canada’s federalist system, and it identifies key issues facing publicly funded hospitals from the funder’s perspective and policy options for decision-makers and Canadians.

International - On the estimation of hospital cost: the approach

There has been a huge interest during the last decade for modelling hospital cost. Now that there is a fare amount of clarity achieved in estimating cost functions of hospitals, it is time to take stock of the existing methodologies. This article attempts to bring to light the issues and methodology related to cost estimation in health care provision, keeping in mind the increasing interest towards health insurance in developing countries through a brief review of the past studies.

International – Health care systems in Sweden and China: Legal and formal organisational aspects

This article aims to describe and compare health care in Sweden and China with regard to legislation, organisation, and finance.

International - Towards Measuring the Volume Output of Education and Health Services: A Handbook

An increasing number of countries is now working towards output-based measures of the volume of education and health services. The present document summarises country practices and provides methodological guidance for output-based approaches in the measurement of health and education services.

International - Economic Transition and Health Care Reform: The Experience of Europe and Central Asia

This paper exploits the staggered adoption of major concurrent health reforms in countries in Europe and Central Asia after 1990 to estimate their impact on public health expenditure, utilization, and avoidable deaths. While the health systems all derived from the same paradigm under central planning, they have since introduced changes to policies regarding cost-sharing, provider payment, financing, and the rationalization of hospital infrastructure.

International - Retaining health workers in remote and rural areas

This special theme issue of the Bulletin of the World Health Organization focuses on retention of health workers in rural and remote areas. The key messages illustrated by papers in this issue are as follow: there is no single-bullet solution to this problem. Effective retention tactics must respond to both the needs of the population and the expectations of health workers; monitoring and evaluation should be built into the design and implementation of rural retention interventions; context matters and external factors influence to a great extent (greatly) the success or failure of rural retention strategies.

International - Health Systems Institutional Characteristics: A Survey of 29 OECD Countries

In 2008, the OECD launched a survey to collect information on the characteristics of member countries' health systems. This paper presents the information provided by 29 of these countries in 2009. It describes country-specific arrangements to organise the population coverage against health risks and the financing of health spending. It depicts the organisation of health care delivery, focusing on the public/private mix of health care provision, provider payment schemes, user choice and competition among providers, as well as the regulation of health care supply and prices. Finally, this document provides information on governance and resource allocation in health systems (decentralisation in decision making, nature of budget constraints and priority setting).

Canada - Euro-Canada Health Consumer Index 2010

This is the third annual Euro-Canada Health Consumer Index (ECHCI). The ECHCI is an international comparison of healthcare system performance in 34 countries. All 27 European Union member states are examined, along with Norway, Switzerland, Croatia, FYR Macedonia, Iceland, Albania and Canada. For the third straight year, the Netherlands finishes in first place in the ECHCI, earning 857 out of 1,000 possible points.

International - Multinational Comparisons of Health Systems Data, 2008

This updated Commonwealth Fund chart book uses data collected by the Organization for Economic Cooperation and Development to compare the health care systems and performance across several industrialized countries.

International - Effective Ways to Realise Policy Reforms in Health Systems

Sometimes it is argued that the timing of a proposal; the way in which a reform is presented; the discussions with stakeholders; and a multitude of other factors, are more important in determining whether or not it receives public and legislative approval than the content of the reform in itself. The OECD has a crosscutting project on these issues, entitled Making Reform Happen. Several OECD directorates are considering the factors lying behind successful implementation of reforms in their different policy areas, including tax, environment, agriculture, trade, competition, education, health, pensions, product markets and labour markets. This paper is a contribution to the wider OECD project. It is based on evidence from the countries which have seen their health systems reviewed by the OECD in recent years, and on a selected review of the literature.

International - Accountable care organisations (ACOs) in the United States and England: testing, evaluating and learning what works

In the US, accountable care organizations (ACOs) are health providers responsible for the comprehensive care of a given population over a specified period of time. This study describes different types of ACO and presents early evidence on their performance. The authors then discuss the implications of ACO development for integrated care initiatives in England.

Australia - Expanding healthcare quality and patient safety reporting across Queensland’s health system

Prepared for the government of the Australian state of Queensland, this paper discusses the benefits of increasing healthcare quality and safety reporting across the state’s health system. Using Australian and international comparators, it provides evidence that expanded reporting will positively affect health outcomes, professional practice, system administration and cost-effectiveness. The paper proposes extending common reporting measures to Queensland's network of private hospitals.

International - Health Care Systems: Efficiency and Institutions

This paper presents a set of indicators to assess health care system performance. It also presents new comparative data on health care policies and institutions for OECD countries. This set of indicators allows the empirical characterisation of health care systems and the identification of groups of countries sharing similar health institutions. It also helps to uncover strengths and weaknesses of each country’s health care system and assessing the scope for improving value-for-money.

International - The Challenge of Financing Health Care in the Current Crisis: An Analysis based on the OECD Data

The ratio of health expenditure to GDP, which in macroeconomic terms is an indicator which summarises the financing needs of a national health system, is likely to rise in countries for which the GDP falls. Over the past four decades, in most countries health expenditure has risen at a faster rate than GDP, leading to a rise in the expenditure ratio. Fluctuations in this ratio can come about through fluctuations in either of its components. In some cases, notably in the USA, GDP variation is the main origin of changes in the ratio, but in the majority of countries health expenditure variation is more important. The experience of countries which did reduce health expenditure after previous recessions suggests that such reductions are short-lived, and demand for health services results over time in a revival of health expenditure growth.

International - World Health Statistics 2010

The World Health Statistics series is WHO’s annual compilation of health-related data for its 193 Member States, and includes a summary of the progress made towards achieving the health-related Millennium Development Goals (MDGs) and associated targets. Taken together, these indicators provide a comprehensive summary of the status of national health and health systems in the following nine areas: mortality and burden of disease; cause-specific mortality and morbidity; selected infectious diseases; health service coverage; risk factors; health workforce, infrastructure and essential medicines; health expenditure; health inequities; and demographic and socioeconomic statistics.

International - Nurses in Advanced Roles: A Description and Evaluation of Experiences in 12 Developed Countries

Many countries are seeking to improve health care delivery by reviewing the roles of health professionals, including nurses. Developing new and more advanced roles for nurses could improve access to care in the face of a limited or diminishing supply of doctors. It might also contain costs by delegating tasks away from more expensive doctors. This paper reviews the development of advanced practice nurses in 12 countries (Australia, Belgium, Canada, Cyprus, Czech Republic, Finland, France, Ireland, Japan, Poland, United Kingdom and United States), with a particular focus on their roles in primary care. It also reviews the evaluations of impacts on patient care and cost.

Finland - Counties as the organisers of health and social services is a good solution

The Ministry of Social Affairs and Health in Finland has released results of an international assessment panel's evaluation of Finnish reforms. The panel considers that counties provide a better level than municipalities at which to place responsibility for integrated health and social services, and therefore considers recent reforms to be functional. The panel points to factors that will be important in reform implementation, including resources to enable counties to develop capacities, strong information systems, and state guidance for organizing and evaluating services.

Belgium - Conceptual Framework for the Reform of the Belgian Hospital Payment System

Commissioned by Belgium's government, this report on the reform of acute hospital payment systems includes an analysis of the current Belgian system along with a literature review, stakeholder survey, and international case studies. The report devises a conceptual framework for reform that accounts for differences between hospital systems in Belgium's French- and Flemish-speaking regions.

UK - A Framework for Exploring the Policy Implications of UK Medical Tourism and International Patient Flows

This paper from the journal Social Policy and Administration addresses four key issues surrounding the contemporary British experience of ‘medical tourism.’ Researchers from the University of Birmingham examine the real-world practice of medical tourism along with its conceptual framework, and explore important research gaps and policy considerations for the future.

UK - Outpatient services and primary care: scoping review, substudies and international comparisons

Evidence from this scoping review suggests that substantial parts of care given in UK outpatient clinics could be transferred to primary care. The research supports General Practitioner (GP) visits as an alternative to outpatient follow-up appointments, and a greater role in the care of chronic conditions, and performance of minor surgeries. The findings are in keeping with recent surveys of public sentiment in Britain.

Canada - Reforming Canadian Primary Care – Don't Stop Half-Way

Strong primary care is a fundamental underpinning of high-performing health systems. Sadly, primary care infrastructure and performance in Canada lag behind many of our international peers. Although substantial reforms have been implemented over the past decade, progress has been uneven, and no province has all the essential system elements in place. Continued investment is both needed and affordable, according to this paper.

International - Peer Review in Slovenia: Long-term care – the problem of sustainable financing

Slovenia is preparing a major reform of its fragmented long-term care (LTC) system and is introducing long-term care insurance. A Peer Review held in Ljubljana on November 18 and 19, 2014, brought 12 Member States and stakeholders together to discuss how to ensure adequate and sustainable financing of LTC. This report, published by the European Commission, presents results of the meeting.

Ireland - The Potential Role of Pay-for-Performance in Irish Health Care

Published in December 2011 by Ireland’s Economic and Social Research Institute, this paper is one of 12 in a special series that adopts an evidence-based approach to tackling issues in Ireland’s current economic crisis. This paper examines international evidence on pay for performance (P4P) schemes to inform policymakers on the potential for implementing P4P in the Irish healthcare system.

Europe – Is migration the solution to staff shortages in the health care sector?

La migration : la solution aux pénuries de personnel dans le secteur des soins et de la santé ? The King Baudouin Foundation seeks to develop a clear framework on migration and integration in Belgium. This report discusses, in particular, the international recruitment of health workers to meet the growing needs in this sector. The report looks closely at the phenomenon of foreign-born health care workers, identifies how many are currently in Belgium, their country of origin, how they arrived at their jobs, and the impact of their departure on their country of origin.

International - The Economic Impact of Non-communicable Disease in China and India: Estimates, Projections, and Comparisons

This paper from Harvard University provides estimates of the economic impact of non-communicable diseases (NCDs) in China and India for the period 2012-2030. It presents results for the five top NCDs (cardiovascular disease, cancer, chronic respiratory disease, diabetes, and mental health) using estimates derived from modelling the effects of NCDs on labour supply and capital accumulation.

Responding to the challenge of financial sustainability in Estonia’s health system : one year on

Brief analytical summaries or syntheses #29 Responding to the challenge of financial sustainability in Estonia’s health system one year on Summary This WHO follow-up report looks at changes in Estonian health care financing one year after a comprehensive WHO analysis. It reviews developments in four areas where policy recommendations had been made. Background Health system financial sustainability has always been a central health policy issue, but the recent financial crisis has forced it to the top of the policy agenda the world over. With the aim of supporting a financially sustainable, high-performing health system, this report assesses health financing policy in Estonia. It looks at how well placed current financing policy is to enable goal attainment in the medium-to-long term (to 2030) and identifies ways to strengthen financing policy. The report is the result of a year-long process of stakeholder consultations and expert analysis initiated by the Ministry of Social…

UK - Towards a new age: The future of the UK welfare state

Published by the International Longevity Centre (ILC) and available online, this 170-page book collects essays by multiple authors on the effects of population aging on Britain’s welfare state. The book considers the societal challenges posed by demographic change and proposes health, pension, housing, and labour market reforms to preserve welfare state policies and encourage social participation by older Britons.

International - Monitoring Universal Health Coverage

Published by PLOS Medicine, this book collects 13 country case studies and five technical reviews that monitor global progress towards Universal Health Coverage (UHC). The case studies discuss the featured countries’ progress towards UHC, while the technical reviews address issues related to UHC and the measurement of financial protection, service coverage, efficacy and equity.

The Netherlands - Health System in Transition, 2016

Produced by the WHO, this review looks at the current state of health care in the Netherlands. While the country has some of Europe's highest per capita health expenditures, costs are slowing considerably following of the introduction of managed system competition and universal social health insurance. Out-of-pocket payments are low from an international perspective, and healthcare quality remains high.

Canada - Mental Health Commission of Canada Releases Summary of Report on Support to Emerging Adults

On February 23, 2015, the Mental Health Commission of Canada released the executive summary of its forthcoming report on how to promote a more seamless continuum of services for emerging adults. Developed in partnership with a research team from the Children’s Hospital of Eastern Ontario (CHEO), the report will detail the current state of policies and practices in the area of youth transitioning from child and youth to adult mental health and addiction services. It will also present best practices and policies from the Canadian and international experience.

Canada - Physician supply increasing twice as quickly as Canadian population. Physician payments also on the rise; fewer doctors migrating

The 2010 edition of CIHI’s annual report, Supply, Distribution and Migration of Canadian Physicians, shows that over the past five years, growth in the number of physicians in Canada has consistently outpaced population growth. It also shows a significant increase in the number of medical graduates, both from Canadian universities and abroad, and an 18% increase in the number of international medical graduates practising in Canada over the last five years.

Improving estimates of exports and imports of health services and goods under the SHA framework

Brief analytical summaries or syntheses #31 Improving estimates of exports and imports of health services and goods under the SHA framework Summary This document is the final report of an OECD project that responds to increasing demand for statistics on the trade in health care goods and services. The report provides clear concepts, definitions and guidelines for the production of reliable, timely and comparable estimates of imports and exports of health services and goods within a standard health accounting framework. Background Trade in health services, and its best-known component, medical tourism, has attracted a great deal of media attention in recent years. This creates the impression that a large part of the population is regularly seeking health care abroad or buying pharmaceuticals over the internet from foreign providers. The apparent growth in such imports and exports has been fuelled by a number of factors. Technological advances in information systems and…

UK - Can NHS hospitals do more with less?

This report by the Nuffield Trust looks at hospital efficiency in the U.K.’s National Health Service (NHS) and proposes sustainable improvements to support ongoing health care reform. An accompanying policy analysis reviews the evidence on methods used internationally by hospitals to increase efficiency.

Australia - Regionally-based needs assessment in Australian primary health care

This expert review from Australia’s Primary Health Care Research & Information Service looks at international and domestic models that may inform approaches to needs assessment in the Australian primary health care sector. The main purpose of needs assessments in primary health care is to reallocate funds in a more equitable and efficient manner.

France - What role does population aging play in increasing healthcare costs?

This article, published in the French journal Medicine/Science, provides an overview of the economic literature that has sought to isolate and quantify the respective effects of aging and non-demographic determinants on the dynamics of health spending. The authors conclude that changes in morbidity have so far had favourable impacts on healthcare budgets; they state that it is the pattern of aging that will be of most importance to future health expenditures.

France - The relationship between costs and quality of care : a profitable alliance for hospitals?

Investigating the relationship between cost reduction and quality of care, this review considers whether the two objectives are contradictory or can be resolved to the benefit of hospitals and health systems overall. Its findings show that no international consensus has yet developed because the impact of quality of care on costs is still difficult to quantify.

International - Urgent action needed to tackle rising inequality and social divisions, says OECD

Society at a Glance 2014, published by the OECD, examines social spending since the economic crisis began in 2008 and finds that Income inequality and social divisions could worsen and become entrenched unless governments act quickly to boost support for the most vulnerable in society. It warns against further across-the-board cuts in social transfers. The number of people living in households without any income from work has doubled in Greece, Ireland and Spain, and risen by 20% or more in Estonia, Italy, Latvia, Portugal, Slovenia and the United States.

Australia - Telehealth in primary health care settings within Australia and internationally

This Policy Issue Review from Australia’s Primary Health Care Research and Information Service (PHC RIS) examines the evidence on telehealth models in Australia, Europe, and North America. It focuses on real-time video consultations involving patients, primary health care providers and specialists.

UK - Under Pressure: What The Commonwealth Fund’s 2015 International Survey Of General Practitioners Means For The UK

In 2015, the US-based Commonwealth Fund surveyed 12,049 primary care physicians across 11 countries, including 1,001 general practitioners (GPs) from the UK. This British report looks at the survey’s results for the UK, focusing on GP satisfaction (lower than in other countries); care coordination (generally poor); and the use of electronic medical records (used daily by 98% of GPs).

Canada - Aspiring to a new standard of healthcare for Canada

This paper maintains that Canadian healthcare can be transformed using health information technology and highlights international examples of relevant programs. The paper explores the impact of existing incentive programs in Canada’s provinces and presents a three-stage model for better care.

Outlook on Québec

This section of the Observatory’s website offers a unique outlook on Québec’s expertise in the field of health care and social services and aims at promoting and disseminating this information on the international scene. It also presents key websites providing information on Quebec’s health and social services system.

Italy - Cost-containment policies and hospital efficiency: evidence from a panel of Italian hospitals

This paper from Italy’s Centre for Economic and International Studies evaluates how cost-control policies like hospital mergers and regional bailouts have affected Italian hospital efficiencies. The longitudinal study samples hospitals over the period from 1999 to 2007.

Canada - Select Cost Sharing in Universal Health Care Countries

A prominent feature of Canada’s public healthcare system is the absence of any charge at the point of consumption. This article by the Fraser Institute argues against this “first-dollar” coverage, citing international evidence that it encourages the consumption of services whose costs exceed associated benefits. The article also cites evidence that cost sharing does not result in adverse health outcomes.

Canada – Quebec: 2013 Health and social services system performance report

This report from Quebec’s Commissaire à la santé et au bien-être analyzes the performance of the province’s health and social services system on an interregional, interprovincial and international basis. The analysis is based on the framework for assessing the Commissioner’s performance and reflects a major update of the indicators employed that enables connections to be made between the different dimensions of performance.

Canada - Outlook on Québec

This section of the Observatory's website offers a unique outlook on Québec's expertise in the field of health care and social services and aims to promote and disseminate this information internationally. A first presentation, based on work undertaken by the INESSS and its partners on the conditions required to establish practice guidelines in the social services sector, is available online. A second presentation, Why does a good idea like integrated services take so much time to implement ?, is also available.

USA - U.S. Health-Care System Faces Obstacles to Improving Health Care Value

The Boston Consulting Group assessed international progress in adopting value-based health care, and found the US trailing other countries. The assessment evaluates national health systems according to support at a national level for things like common national standards and IT infrastructure and the engagement of clinicians and policymakers. It also considers the quality of a country’s disease registries.

USA - Explaining High Health Care Spending in the United States: An International Comparison of Supply, Utilization, Prices, and Quality

This analysis uses data from the Organization for Economic Cooperation and Development and other sources to compare health care spending, supply, utilization, prices, and quality in 13 industrialized countries: Australia, Canada, Denmark, France, Germany, Japan, the Netherlands, New Zealand, Norway, Sweden, Switzerland, the United Kingdom, and the United States. The U.S. spends far more on health care than any other country.

Europe - Person-centred care in Europe: a cross-country comparison of health system performance, strategies and structures

Published by the Picker Institute, an international charity based in England, this policy briefing compares patient or person-centred care within healthcare systems in the UK, Germany, Italy, Spain and the Netherlands. The briefing considers health system performance, strategies and structures, along with the cost-effectiveness of national person-centred care schemes.

UK - NHS finances: the challenge all political parties need to face

Britain’s troubled National Health Service (NHS) is sure to feature prominently in the country’s next election, scheduled for 2015. This briefing analyzes health funding issues raised by British political parties and describes various actors’ policy stances. It looks at NHS funding by the current government, makes projections, and provides international comparisons of spending on health services.

Europe - Promoting Health, Preventing Disease: The economic case

Available for download, this book by British and French authors provides an economic perspective on health promotion and chronic disease prevention, and gives a rationale for assessing the economic case for action. It provides a review of the international evidence base for public health interventions that addresses effectiveness, implementation costs, impacts on health expenditures, and wider economic consequences.

UK - New support to export UK healthcare management expertise

The export of British healthcare management expertise is gaining a boost from the recent establishment of the UK International Healthcare Management Association (UKIHMA), a new professional society that helps members win healthcare management contracts overseas. UKIHMA currently provides market intelligence, practical support and advice to over 30 UK health sector organizations.

Canada - The Utilization of Nurse Practitioners and Physician Assistants: A Research Synthesis

This research synthesis prepared for the Michael Smith Foundation for Health Research provides a comprehensive international review and synthesis of the research literature pertaining to nurse practitioners and physician assistants, including information regarding their current and potential organization, financing, funding and regulation in BC.

Vietnam - Public Health Insurance in Vietnam towards Universal Coverage: Identifying the challenges, issues, and problems in its design and organizational practices

Vietnam is attempting to achieve universal health insurance coverage by 2014. This study from Japan’s Osaka School of International Public Policy provides an overview of Vietnam’s push towards universal coverage based on official documents, research reports, and high-level policy access. The study says distorted incentives and a lack of financial stability are hindering progress.

UK - Securing the future of general practice: new models of primary care

This report from the Nuffield Trust and The King’s Fund examines the new GP organisations forming to allow care provision at greater scale. It reviews UK and international models of primary care, focusing on those that could increase capacity and help primary care meet the pressures it faces. It emphasizes the need to enable GPs to test out new and imaginative approaches.

UK - United Kingdom: Health system review. Health Systems in Transition, 2015

Conducted by the WHO, this analysis of the UK health system looks at the autonomous branches of the National Health Service (NHS) in the UK’s four parts (England, Northern Ireland, Scotland and Wales). The review notes that all four NHS branches function well compared to international peers and continue to demonstrate improvements in major health indicators despite increased financial constraint.

USA - Four years on: A status report on Obamacare implementation

This article presents a detailed history of Obamacare, and explores its rationale, mechanisms and early effects on the proportion of people with health insurance and on healthcare costs. It was published in the Chronique internationale de l'IRES.

USA - Investing in Global Health Systems: Sustaining Gains, Transforming Lives

This Institute of Medicine (IOM) report looks at how health system improvements can increase health, reduce poverty, and make donor investment in health sustainable in the world’s poorest countries. The report outlines a broad donor strategy that can make effective use of the US comparative advantage in science and technology to improve health internationally.

Canada - Learning From the Best: Benchmarking Canada’s Health System

Canada’s health system has mixed results in comparison with its peers in the Organisation for Economic Co-operation and Development (OECD), according to a new report released recently by the Canadian Institute for Health Information (CIHI). Learning From the Best: Benchmarking Canada’s Health System examines Canadians’ health status, non-medical determinants of health, quality of care and access to care. It is based on international results that appear in the OECD’s Health at a Glance 2011, also being released recently, which provides the latest statistics and indicators for comparing health systems across 34 member countries.

Europe - A European Flavour for Medicare. Learning from experiments in Switzerland and Sweden

This paper published by the MacDonald-Laurier Institute compares Canada’s healthcare system with Sweden and Switzerland, two countries in the middle of the public/private spectrum whose health systems rank high internationally. The paper also describes how the UK government in the 1990s sold Britons on market reforms to the National Health Service (NHS).

Turkey — Turkey’s health system has a high level of preparedness for crises, says report: Experience gained can help other countries

On 24 May 2011, a new WHO report “Assessment of Health Systems' Crisis Preparedness in Turkey” was launched in Ankara by Professor Recep Akdağ the Minister of Health of Turkey during a press conference. Turkey has a high level of political commitment to crisis preparedness and its health system has developed extensive capacity to respond to any type of health emergency at national and international level.

Canada - Ontario ranks among the best in Canada and internationally when it comes to certain measures of the coordination of care and communication between older patients and their health care providers

Ontario patients aged 55 and older often experience top-rated coordination of their health care, as well as communication with their health care providers, compared to people in other provinces and in other countries, according to Experiencing Integrated Care, the latest report from Health Quality Ontario (HQO), the provincial advisor on health care quality.

Canada - Should Canada's Hospitals Open Their Doors to Medical Tourists? Health Care in Canada: An Economic Growth Engine

This Conference Board briefing describes the current state of medical tourism in Canada and internationally and looks at potential advantages and risks for Canada's hospitals and healthcare system. It also presents thoughts on ways to ensure that it would make a positive contribution were it developed further.

The Netherlands - The Buurtzorg Nederland (home care provider) model Observations for the United Kingdom (UK)

Founded in the Netherlands in 2006, Buurtzorg is a home care system that has garnered international acclaim for being entirely nurse-led and cost effective. This British article considers the successes of the Buurtzorg program while identifying challenges it has encountered and highlighting differences in context that would need to be addressed if the UK were to adopt a similar system.

Brazil - Case study on working time organization and its effects in the health services sector

Published by the International Labour Office (ILO), this paper explores working time organization (work scheduling and time at work) in Brazil’s health services sector. The paper explores working time arrangements for different types of health workers and identifies areas where improvements would better meet the needs of workers and organizations.

Canada - Mergers and integrated care: the Quebec experience

This study, published in the International Journal of Integrated Care, examines mergers undertaken in Quebec in the name of promoting system integration. The authors review studies on mergers and integrated care projects in the Quebec healthcare system, and show that mergers cannot facilitate integrated care unless they are desired and represent for all of the actors involved an appropriate way to deal with service organisation problems.

UK — GP Commissioning in the NHS in England: Ten suggestions from the United States

Nuffield Trust Viewpoints provide a platform for UK and international health leaders to explore, debate and discuss critical health care reform issues. In the first of the series, a leading scholar from the US sets out what the NHS in England could learn from the US experience of doctor-led commissioning.

Financial sustainability and affordability of health care systems. Lessons from OECD countries

Brief analytical summaries or syntheses #46 Financial sustainability and affordability of health care systems. Lessons from OECD countries Summary This presentation by Mark Pearson, head of the Health Division at the OECD, reviews how health spending has been affected during the economic crisis in various countries. the author makes some recommendations on how policy should react. The presentation was delivered at the International Conference of Social Security Actuaries and Statisticians that took place in Berlin from May 30 to June 1, 2012. Background The problem facing many European health systems is one of fiscal unsustainability. Claims that health spending is good value for money compared to many other things that people purchase are beside the point. Fiscal sustainability needs to be restored in the short term and once this is done, there will still remain the longer-term challenge of ensuring economic sustainability, which requires a different agenda of policies –…

Canada - The Inconvenient Truths about Canadian Health Care

This briefing from the Conference Board of Canada says Canada’s health system has slipped to 10th place internationally and is in urgent need of transformation. The briefing identifies key issues in Canadian healthcare and outlines priorities for reform, saying the country must abandon an obsolete model.

Managed competition in the Netherlands: an example for others?

Brief analytical summaries or syntheses #21 Managed competition in the Netherlands an example for others ? Summary The introduction of managed competition in the Netherlands in 2006 fundamentally changed the roles of patients, insurers, providers and the government. This article, included in the last issue of Eurohealth, discusses the challenges presented by the introduction of managed competition in the Netherlands. Background After almost two decades of preparation, major health system reforms were introduced in the Netherlands in 2006. These brought important new structures and regulatory mechanisms to the Dutch health system, including managed competition among actors in health care. The basic aims of the reform were to contain rising health expenditures by increasing health system efficiency (i.e. higher quality at lower costs) through the introduction of managed competition; reduce system inequities related to age, income and health status (under the new system everybody is insured under the same conditions and…

International — Description of Alternative Approaches to Measure and Place a Value on Hospital Products in Seven OECD Countries

This paper provides a description of the classification systems used to measure hospital services in selected OECD countries: Australia, Canada, England, France, Germany, Norway, and the United States. Three classifications are relevant: those on diagnoses; on procedures; and on products. In addition, methods used to measure the cost of hospital services are reviewed.

Canada - Does the health contribution spare the poor?

The Groupe de Recherche en Économie et Développement International published this Working Paper to examine the impact on the poor of Quebec's health contribution in its two forms: the initial fixed contribution, and the more progressive revised contribution plan. The authors find that the fixed contribution increased poverty, while the progressive version leaves the incidence of poverty unchanged.

International — A New Look at OECD Health Care Systems: Typology, Efficiency and Policies

This year’s issue of Going for Growth features a chapter on health care (Chapter 6), a key contributor to individual well-being and an important driver of long-term economic growth. The OECD has assembled new cross-country comparative data on health policies and health care system efficiency, which show that there is room in all countries surveyed to improve the effectiveness of their public health care spending.

USA - Mirror, Mirror on the Wall, 2014 Update: How the U.S. Health Care System Compares Internationally

In this latest update of the Commonwealth Fund's comparative assessment of healthcare systems, the US once again comes first in expense and last or near last in access, efficiency and equity. The UK ranks first on most measures, despite coming in 10th out of 11 countries in terms of healthy lives.

A new look at OECD health care systems: Typology, efficiency and policies

Brief analytical summaries or syntheses #19 A new look at OECD health care systems Typology, efficiency and policies Summary This 2011 edition of the OECD’s Economic Policy Reforms features a chapter on health care (Chapter 6), a key contributor to individual wellbeing and an important driver of long-term economic growth. The OECD has assembled a new cross-country comparative data on health policies and health care system efficiency, which shows that there is room in all countries surveyed to improve the effectiveness of their public health care spending. Background Rising health care spending is putting pressure on government budgets. Governments will have to make their health systems more efficient if they are to maintain quality without putting further stress on public finances. The OECD has assembled new comparative data on health policies and health care system efficiency for its member countries. These show that all countries surveyed can improve the effectiveness…

UK - A guide to quality improvement methods

Developed by the Healthcare Quality Improvement Partnership (HQIP), this guide introduces 12 quality-improvement methods based on a review of the international literature. It describes when and how the methods should be used and presents case examples and tools to assist implementation. Methods include clinical audits, performance benchmarking, and process mapping.

UK - Universal healthcare without the NHS: towards a patient-centred health system

Service (NHS) is one of the developed world’s worst public health systems, with outcomes far behind systems in other comparable countries. Calling for its abolishment, the book draws on international evidence to develop a vision for a British universal healthcare system based on patient freedom of choice, competition, and pluralism.

Ireland - Health system responses to financial pressures in Ireland: policy options in an international context

This report from the WHO reviews policy options open to Ireland’s government as it responds to the financial crisis’ impact on the health system. The report analyzes the system’s major pressures and reviews policy levers, focusing on changes to health coverage and more efficient health services.

Australia - Primary health care reform discussion paper released

Australia’s health ministry has released a paper on ways to better support community-dwelling patients with complex and chronic diseases. Options discussed include enrolling patients under a single provider who coordinates multi-disciplinary care; setting payments for care of chronic disease as a defined package of care; and adopting international best practices.

Sweden – Health System Review

Brief analytical summaries or syntheses #43 Sweden – Health System Review Summary Published by the European Observatory on Health Systems and Policies, this report regards Sweden’s health system in detail. It describes the institutional framework, process, content, and implementation of Swedish health policies, highlighting challenges and areas that require further analysis. Background Sweden is a monarchy with a parliamentary form of government. The size of the population is about 9.4 million inhabitants and more than 80% of the population lives in urban areas. The GDP per capita, measured as purchasing power parity (PPP, current international US$), amounted to Swedish krona (SEK) 37 775 (€4200) in 2010. Life expectancy in Sweden is among the highest in the world. Diseases of the circulatory system are the leading cause of mortality, accounting for about 40% of all deaths in 2009. The second largest cause of death is cancer. There are three independent government…

Israel - Excellent primary health care, but hospitals must improve

Israel has world class-primary care services and should now focus efforts on bringing its hospitals up to the same high international standards, according to the OECD Reviews of Health Care Quality: Israel. While most OECD countries grapple with rising healthcare costs, Israel has maintained tight control – limiting health spending to about 8% of GDP, the eighth lowest across OECD countries – and still offers universal coverage and high-quality primary health care services.

USA - The U.S. health care system achieves a score of 64 out of 100 in the third National Scorecard on U.S. Health System Performance

The new U.S. National Scorecard updates assessments of population health and health care quality and access. Across 42 performance indicators, the U.S. achieved a score of 64 out of a possible 100 when comparing national rates with international benchmarks. The Scorecard concludes that the American health system continues to fall short, especially considering how much the country spends on health.

The U.S. Health System in Perspective:A Comparison of Twelve Industrialized Nations

Brief analytical summaries or syntheses #26 The U.S. Health System in Perspective A Comparison of Twelve Industrialized Nations Summary This paper analyzes 2010 OECD health data for Australia, Canada, Denmark, France, Germany, Netherlands, New Zealand, Norway, Sweden, Switzerland, the United Kingdom, and the United States. Health care spending in the U.S. towers over the other countries and findings suggest opportunities for cross-national learning to improve health system performance. Background Findings from this cross-national comparison of health care systems can inform public policy, highlight areas where nations could improve, and yield benchmarks for high performance. The Organization for Economic Cooperation and Development (OECD) annually tracks and reports on more than 1,200 health-system measures across 34 industrialized countries, ranging from population health status and non-medical determinants of health, to health care resources and utilization. Since 1998, The Commonwealth Fund has sponsored an analysis of cross-national health systems based on OECD health data…

International - WHO calls for coordinated action to reduce suicides worldwide

This WHO report on suicide calls on countries to reduce access to means of suicide. Pesticide poisoning, hanging and firearms are among the most common methods of suicide globally. Another key to reducing deaths by suicide is a commitment by national governments to the establishment and implementation of a coordinated plan of action. Currently, only 28 countries are known to have national suicide prevention strategies.

Brazil - Horizontal equity in health care utilization in Brazil, 1998–2008

This study published in the International Journal for Equity in Health assesses Brazilian trends in achieving equity in the utilization of healthcare services from 1998 to 2008, a period of major economic and social change in Brazil. The study finds that government policies have made healthcare utilization increasingly equitable.

Japan - The Impact of Marginal Tax Reforms on the Supply of Health Related Services in Japan

This paper from the International University of Japan presents a computable general equilibrium (CGE) framework to examine the effect of Japan’s marginal tax reforms on the supply side of the health sector.

Australia - Funding Indigenous organisations: improving governance performance through innovations in public finance management in remote Australia

Commissioned by the Australian government, this report explores how funding modalities can improve governance performance and service delivery outcomes in Australia’s remote Indigenous communities. The report considers current public finance arrangements, examines domestic and international case studies of different funding modalities, and proposes alternative funding approaches.

Japan - Health Care Lessons from Japan

This paper from Canada’s Fraser Institute is part of a series examining the way health services are funded and delivered internationally. The paper focuses on Japan’s healthcare system, identified as providing superior access and superior outcomes with fewer resources. Japan’s system outperforms Canada’s with regard to infant mortality, cancer survival and in-hospital mortality.

Denmark - Good hospitals but primary health care must improve

The Danish central government and regions are leading international efforts to reform hospital systems, improving quality and safety by gathering specialists into major hospitals and closing smaller ones. The country should now focus on modernising its primary care sector to deal with the rising demands of chronic disease and a leaner hospital sector, according to the OECD’s Health Care Quality Review of Denmark.

INT - Non-communicable Diseases (NCDs) to Cost $47 trillion by 2030, New Study Released recently

This report from the World Economic Forum analyses the overall costs of NCDs to the global economy. Findings show that the estimated cumulative output loss over the next 20 years represents approximately 4% of annual global GDP. The report includes mental illness, which is usually left off the list of top NCDs but accounts for one-third of the total spend. This assessment of the developmental and financial impact of these diseases comes as the United Nations convenes the High-Level Meeting on NCDs in New York on September 19 and 20. Heads of State and government assembled to address the prevention and control of NCDs worldwide.

International — Health: spending continues to outpace economic growth in most OECD countries

Health spending continues to rise faster than economic growth in most OECD countries, maintaining a trend observed since the 1970s. Health spending reached 9.5% of GDP on average in 2009, the most recent year for which figures are available, up from 8.8% in 2008, according to OECD Health Data 2011.

Lunch hour conferences 2013

22_mai_2013.pdf Towards greater equity and better results in mental health in Québec perspective of the Commissaire à la santé et au bien-être regarding improvements in the performance of the health and social services system. March 13, 2013 By Jacques E. Girard, Deputy Commissioner for Assessment and Analysis The CSBE’s 2012 Report on the Performance Appraisal of the Health and Social Services System includes 5 major recommendations and 15 specific actions to improve the performance of the health and social services system in this sector, with the aim of consolidating knowledge gained in recent years and better responding to the needs of persons with mental disorders, in particular, with regard to front-line services. Following an outline of the key findings, the presentation will highlight the need to re-examine the allocation of mental health resources for an optimal supply of services, with an emphasis on continuity, collaborative health care and the provision…

China — Roadblocks to health reform in China

Two years after China launched a sweeping US$130-billion health care reform plan, the country faces huge obstacles to progress in what’s been described as the world’s largest health care experiment. The plan centres on quickly reforming hospital management while delivering universal access to primary health care through national insurance schemes. But roadblocks have arisen, according to new research presented at the annual world congress of the International Health Economics Association in Toronto, Ontario (July 10–13).

Canada - Triple Aim in Canada: developing capacity to lead to better health, care and cost

Many health systems strive for Triple Aim — better population health, improved patient care, and lower costs. This paper describes the participation of nine Canadian teams in an international Triple Aim improvement community offering support for design, implementation, assessment and sustainability through a program of webinars and activities. An evaluation of the Canadian cohort examines their progress in building Triple Aim infrastructure across healthcare settings.

International - Health, austerity and economic crisis: assessing the short-term impact in OECD countries

This paper looks at the impact of economic crisis on health and health care. It summarises findings from the published literature on the effects of economic crisis that took place over the past few decades and also describes recent health policy reforms, focusing on those countries where the economic crisis has hit hardest. Finally, this paper analyses the empirical relationship between unemployment and health care use, quality and health outcomes, using data from OECD Health Statistics. In doing so, it investigates whether the effects of unemployment on health outcomes have been extenuated by austerity measures.

UK - Payment by Results: how can payment systems help to deliver better care?

Based on a review of the British National Health Service’s use of payment by results (PbR), this report by the Kings Fund identifies lessons from international payment systems, draws conclusions on the continuing suitability of PbR, and presents options for its reform.

USA - The U.S. Health System in Perspective: A Comparison of Twelve Industrialized Nations

This paper in the July 2011 issue of the Commonwealth Fund publication Issues in International Health Policy analyzes 2010 OECD health data for Australia, Canada, Denmark, France, Germany, Netherlands, New Zealand, Norway, Sweden, Switzerland, the United Kingdom, and the United States. Health care spending in the U.S. towers over the other countries and findings suggest opportunities for cross-national learning to improve health system performance.

UK - Reformers and wreckers

Great Britain’s Reform Research Trust produced this report on public service reform. It presents evidence from eight international case studies showing that workforce reform is essential to improving public services and reducing costs. Key outcomes of workplace reform are identified and policy recommendations are made.

Japan - Japan: universal health care at 50 years

A world leader in several health metrics, Japan this year marked the 50th anniversary of its universal healthcare system. To consider the country’s achievements, The Lancet has published a series on Japan’s health system in its August 2011 edition. Theme papers and comments by Japanese academics and international collaborators document the evolution of health care in Japan.

Canada - Reducing Wait Times for Health Care: What Canada Can Learn from Theory and International Experience

From the Fraser Institute, this new book on Canadian healthcare wait times assesses wait list policy issues such as health effects, costs and labour market consequences. The authors argue that Canada’s current policies will not improve timely healthcare provision.

Australia - Healthcare in Focus 2014: How does NSW compare?

Prepared by the Bureau of Health Information (BHI), this report compares the performance of the healthcare system in the Australian state of New South Wales (NSW) with the other six Australian states and 10 countries including Canada. Using patient survey data and 120 performance measures, the report finds that performance in NSW is ahead of other parts of Australia and is in the middle of the pack internationally.

The Netherlands - The Dutch health care performance report: seven years of health care performance assessment in the Netherlands

This study of the Dutch Health Care Performance Report reflects on important lessons learned after seven years of performance assessment in The Netherlands. These include the importance of repeated measurement, the importance of a central role for the patients' perspective in performance assessment and the value of international benchmarking.