2023年健康报告（英）-234页_15mb

2023 OECD Health at a Glance Summary

Core Content

Health at a Glance 2023 is a comprehensive report published by the OECD that compares key health and health system indicators across 38 OECD member countries, along with accession candidates and key partner countries. It provides an overview of population health status, risk factors, access to care, quality of care, and health system capacity and resources, while also highlighting the role of digital health in transforming health systems.

Main Themes and Key Findings

1. Financial Pressures on Health Systems

• Health expenditure as a share of GDP:
  • In 2019, OECD countries spent an average of 8.8% of GDP on health.
  • This increased to 9.7% in 2021 due to pandemic-related spending, but fell to 9.2% in 2022 due to reduced pandemic needs and inflation.
• Per capita health spending:
  • On average, about USD 5,000 per person in 2022, ranging from USD 12,555 in the US to USD 1,181 in Mexico.
• Financial protection gaps:
  • Out-of-pocket payments account for nearly a fifth of total health spending on average, and over 40% in Mexico.
  • Lower-income individuals are three times more likely to delay or avoid care due to cost.

2. Health Status and Pandemic Impact

• Life expectancy:
  • Fell by 0.7 years on average between 2019 and 2021.
  • In 2022, life expectancy remained below pre-pandemic levels in 28 countries.
• Main causes of death:
  • Circulatory diseases caused over 25% of deaths, cancer caused 20%, and COVID-19 caused 7% of deaths in 2021.
  • About a third of all deaths could have been prevented with better prevention and healthcare.
• Chronic conditions:
  • On average, over one-third of people aged 16+ reported living with a chronic illness or health issue.
  • Socio-economic disparities are significant: 43% of the lowest income quintile reported chronic issues, compared to 27% in the highest.
• Mental health:
  • The share of the population reporting symptoms of depression in 2022 was at least 20% higher than pre-pandemic levels.
  • Mental health remains elevated even as societies begin to recover.

3. Risk Factors for Health

• Smoking:
  • Daily smoking rates are falling in most OECD countries, but vaping is increasing.
  • On average, 16% of people aged 15+ still smoke daily, with higher rates in France and Türkiye.
• Alcohol use:
  • Heavy episodic drinking is common, with over 30% in Germany, Luxembourg, the UK, and Denmark.
• Obesity:
  • 54% of adults are overweight or obese, with 18% obese on average.
• Physical activity:
  • Only 15% of adults consume five or more portions of fruits and vegetables daily.
  • Only 40% perform at least 150 minutes of moderate-to-vigorous physical activity weekly.
• Ambient air pollution:
  • Causes an average of 29 deaths per 100,000 people annually.
  • Premature deaths from air pollution decreased by 31% between 2000 and 2019.

4. Access to Healthcare

• Universal health coverage:
  • While most OECD countries have universal coverage, disparities in access remain.
• Waiting times:
  • Waiting times for hip and knee replacements remain higher than pre-pandemic levels in most countries.
• Teleconsultations:
  • Increased significantly post-pandemic, accounting for 19% of all doctor consultations in 2021.

5. Quality of Care

• Patient safety:
  • Safe prescribing in primary care has improved, with reduced use of antibiotics, opioids, and long-term anticoagulant prescriptions.
  • 57% of hospital staff still perceive unsafe work conditions and staffing levels.
• Avoidable hospital admissions:
  • Fell in most OECD countries over the past decade, with significant reductions in Lithuania, Mexico, Poland, and the Slovak Republic.
• Acute care outcomes:
  • 30-day mortality rates after heart attack or stroke have improved in most countries, but slightly increased between 2019 and 2021 due to pandemic-related delays in treatment.
• Patient-reported outcomes:
  • Quality of life improved significantly after hip surgery, reaching scores equivalent to 80% or higher, up from 35–50% pre-surgery.

6. Digital Health

• Digital readiness:
  • 90% of OECD countries have an electronic health portal, but only 42% allow public access and interaction with all health data.
• Interoperability:
  • Only 38% of countries have clinical standards or vendor certification for electronic health records.
• Digital transformation challenges:
  • Strong data governance, digital security, and responsible use of digital tools are essential for successful health system digital transformation.

Key Chapters

• Chapter 1: Overview of health and health system performance, including country dashboards and major trends.
• Chapter 2: Focus on digital health readiness and transformation.
• Chapter 3: Health status indicators such as life expectancy, mortality, and self-rated health.
• Chapter 4: Risk factors for health including smoking, alcohol, diet, and environmental factors.
• Chapter 5: Access to care, including affordability, availability, and use of services.
• Chapter 6: Quality of care and outcomes, including patient safety and chronic disease management.
• Chapter 7: Health expenditure and financing, including public and private spending.
• Chapter 8: Health workforce, including supply, remuneration, and migration trends.
• Chapter 9: Pharmaceutical sector, including consumption, generics, and R&D.
• Chapter 10: Ageing and long-term care, including demand, access, and costs.

Data and Methodology

• Data is sourced from official national statistics and other international organizations.
• OECD uses mid-year population estimates for calculations.
• Some countries have different population bases for economic indicators due to overseas territories.
• The report includes country-specific ISO codes for reference.

Conclusion

The report highlights that while health systems are showing signs of recovery from the pandemic, they are still under financial pressure. There are persistent inequalities in access and outcomes, and many countries are not yet fully prepared for digital transformation. The emphasis is on the need for policy reforms to improve affordability, quality, and efficiency in healthcare, especially through strengthening primary care and prevention efforts.