【经合组织（OECD）】2023年健康报告_234页_15mb

Summary of Health at a Glance 2023

Core Content

Health at a Glance 2023 is a comprehensive report by the OECD that compares key indicators of population health and health system performance across 38 OECD member countries, along with accession candidates and key partner countries such as Argentina, Brazil, and China. The report provides insights into health status, risk factors, access, quality of care, and health system resources, with a special focus on digital health transformation.

Main Viewpoints

• Health System Financial Pressure: Health spending as a share of GDP rose to 9.7% in 2021 but fell to 9.2% in 2022 due to reduced pandemic-related spending and inflation. On average, health spending per person was USD 5000, with significant variation between countries.

• Pandemic Impact on Health: The pandemic has left lasting effects on population health. Life expectancy dropped by 0.7 years on average between 2019 and 2021, and mental health issues remain elevated, with depression symptoms being at least 20% higher than pre-pandemic levels in many countries.

• Health Status and Mortality: Chronic diseases, including circulatory diseases and cancer, remain leading causes of death. In 2021, circulatory diseases caused over 25% of deaths, and cancer caused 20%. Premature deaths due to ambient air pollution still average 29 per 100,000 people.

• Risk Factors for Health: Unhealthy lifestyles and environments continue to be major contributors to mortality. Obesity rates are rising, with 54% of adults overweight or obese. Smoking and vaping remain prevalent, with 16% of adults smoking daily and vaping increasing in many countries. Alcohol consumption and physical inactivity also pose significant risks.

• Access to Healthcare: Despite universal health coverage, financial barriers and waiting times persist. The least well-off are three times more likely to delay or not seek care. Waiting times for common procedures like hip and knee replacements have improved post-pandemic but are still higher than pre-pandemic levels. Teleconsultations have increased, improving access in remote areas.

• Quality of Care: There has been an improvement in patient safety and clinical effectiveness, particularly in safe prescribing and avoidable hospital admissions. However, challenges remain, such as the perception of unsafe working conditions among healthcare staff and the need for more people-centered care.

• Health Expenditure and Financing: Health expenditure has remained relatively stable, but funding sources and allocation vary. Prevention spending increased during the pandemic but is not sustained as a long-term investment. Capital expenditure in the health sector is crucial for system resilience, especially in light of emerging health threats.

• Health Workforce: The health and social care workforce is growing, but shortages are becoming more acute due to population aging. In 2021, 18% of the population was aged 65 and over. Wages for health workers have stagnated or declined in some countries, while others have seen significant increases.

• Pharmaceutical Sector: Pharmaceutical expenditure and consumption are key areas of focus. Generics and biosimilars are increasingly used, and there is a growing need for investment in pharmaceutical research and development.

• Ageing and Long-term Care: As populations age, the demand for long-term care services is increasing. However, many countries lack sufficient infrastructure and workforce to meet this demand. Informal carers and the availability of quality long-term care settings are critical for supporting aging populations.

Key Information

• Digital Health: Digital health is a major theme in this edition. While most OECD countries have online health portals, only 42% allow the public to access and interact with all their health data. Interoperability of health data is limited in many countries due to lack of clinical standards and vendor certification.

• Data Sources: The data is sourced from official national statistics and other international organizations such as Eurostat and the World Health Organization. Readers are encouraged to consult the OECD Health Statistics database for detailed data and documentation.

• Methodology: The report uses a conceptual framework that considers health system performance in relation to broader determinants of health, including economic, social, and environmental factors. The report highlights both national variations and the importance of policy coherence and data comparability.

• Country Comparisons: The report includes detailed country comparisons across various health indicators. It emphasizes the need for policy insights based on these comparisons to address specific health challenges and improve system performance.

• Limitations: Data comparability is affected by differences in methodology and definitions across countries. These limitations are acknowledged in both the text and footnotes.

Structure of the Report

The report is structured into ten chapters:

1. Indicator Overview: Provides a snapshot of health and health system performance across five dimensions.
2. Digital Health: Focuses on the readiness of health systems for digital transformation.
3. Health Status: Examines life expectancy, mortality trends, and mental health.
4. Risk Factors for Health: Looks at smoking, alcohol, diet, and environmental factors.
5. Access: Analyzes affordability, availability, and use of healthcare services.
6. Quality and Outcomes of Care: Reviews patient safety, clinical effectiveness, and care outcomes.
7. Health Expenditure: Discusses spending trends, financing schemes, and service types.
8. Health Workforce: Details the supply, remuneration, and migration of health professionals.
9. Pharmaceutical Sector: Explores pharmaceutical expenditure, consumption, and research.
10. Ageing and Long-term Care: Addresses the challenges and needs of aging populations and long-term care systems.

Conclusion

Health at a Glance 2023 underscores the ongoing challenges and opportunities in health systems. It highlights the need for more investment in health, a renewed focus on prevention and primary care, and the importance of digital transformation to improve efficiency and accessibility. The report serves as a valuable tool for policymakers to identify key areas for action and to benchmark their countries against others.