discussion of “oecd health data”
DESCRIPTION
Discussion of “OECD Health Data”. major progress with SHA and indicators importance of Ministerial endorsement appreciating broader determinants of health and “what works” –versus – primacy of costs and “sustainable financing” caution re over reliance on SNA concepts. Michael Wolfson - PowerPoint PPT PresentationTRANSCRIPT
1 04/21/23 17:07 LifePaths
Discussion of “OECD Health Data”
major progress with SHA and indicators importance of Ministerial endorsement appreciating broader determinants of
health and “what works” –versus – primacy of costs and “sustainable financing”
caution re over reliance on SNA concepts
Michael Wolfson
Statistics Canada
2 04/21/23 17:07 LifePaths
Hospital and In-patient Curative-rehabilitative Expenditure
-
10
20
30
40
50
60
Australia Canada Denmark Germany Hungary Japan Poland Spain Switzerland Turkey
Hospital Expenditure Curative-rehabilitative (in-patient)
Source: “SHA-Based National Health Accounts in Thirteen OECD Countries: A Comparative Analysis” (OECD Health Working Papers No. 16)
% current exp. on health
previous uncertainty
3 04/21/23 17:07 LifePaths
0
200
400
600
800
1000
1200
1975 1980 1985 1990 1995 2000
Hospitals
Other Institutions
Physicians
Other Profesionals
Drugs
Per Capita Health Care Costs over Time by Use (Current $)
($1.3 billion aggregate drop)
*
(CIHI)
4 04/21/23 17:07 LifePaths
Inputs to Health
Services (Part 2)
Health Expenditure(Input volumes X prices)
Utilization of Services (Part 3)
Health Status
(Part 1) Social Welfare and Individual Utility
Non-medical Determinants (Part 8)
The Production of Health -Related Welfare
The Flow of Health Expenditure
Health Expenditure and Financing (Taxes, Insurance, Out-of-Pocket) (Part 4, 5)
Health Expenditure (Utilization volumes X prices)
A model for looking at data availability in OECD Health Data
Budgeting Decisions
Purchasing Decisions
Purchasing DecisionsDemographic (Part 9)
& Economic (Part 10)References
Overall social protection (Part 6)
Pharma Market (Part 7)
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The Evans and Stoddart “Plumbing Diagram”
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0
2
4
6
8
10
12
14
16
18
0 20 40 60 80 100 120
Mortality Rate(%, age 65-70)
Career Earnings and Deathfor 500,000 Canadian Men
Average Earnings (age 45-64, 1988 $000s)
top quintile
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One year mortality rate vs. % revascularized within 14 days, AMI patients in health regions with populations over 100,000, 4 provinces,
1995/96
0
5
10
15
20
25
30
0 5 10 15 20 25 30
Adjusted 1 year mortality rate (%)
% r
evas
cula
rize
d w
ith
in 1
4 d
ays
(Johansen et. al., Stats Can, 2001)
better
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(with virtually no differences in one year survival; but what about differences in health-related QoL?)
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Changes in Life Expectancy (LE) and Health-Adjusted Life Expectancy (HALE) by Cause
2.4
1
0
0.5
0.4
0.4
0.3
0.1
0
0.7
1.8
0.7
0.6
0.8
0.3
0.4
0.3
0
0
0.4
00.511.522.5
IHD
Lung cancer
Breast cancer
Stroke
COPD
Colorectal cancer
Diabetes
Melanoma
Osteoarthritis
Mental disorders
Men
Women
Source: Manuel et al, ICES and Health Canada, NPHS
HALELE
2.2
0.9
0.7
0.5
0.4
0.5
0.2
1
0.9
1.5
0.6
0.5
0.7
0.5
0.3
0.4
0.1
2.4
1.1
0 0.5 1 1.5 2 2.5
Men
Women
10 04/21/23 17:07 LifePaths
ONS, Atkinson, and Productivity mandate (from ONS National Statistician): “To advance methodologies for the measurement of
government output and productivity…” (OK) “in the context of the National Accounts” BUT: why not pose issue first in general, and then ask
whether SNA is an appropriate framework for this, and if not, what would be?
Caution: OECD should be careful about entering this domain