OECD data shows long-term care drive health expenditure, health outcome variations persist

The OECD recently published its yearly report consolidating and analysing health statistics known as Health at a Glance 2017. The report provides an overview of overall health status in OECD countries, and how medical progress has contributed to longer and healthier lives for citizens. The report notes that mortality from Ischemic Heart Disease (including heart attacks) and cerebrovascular disease (including stroke) has fallen by 50% or more since 1990, which the OECD attributes both to a reduction in risk factors (in particular smoking) and improved medical treatments. Also mortality for several cancers have decreased, thanks to early detection and improved treatments. 5-year survival for children with leukemia has also improved, primarily due to improved chemotherapies and stem cell technology.

The report also highlights stark differences in healthcare outcomes for a number of common diseases and conditions. For foot or leg amputations for diabetes patients there is a 14-fold difference between OECD countries. For example, Italy, Finland and the United Kingdom report rates lower than 3 per 100 000 general population whereas Austria reports rates above 14. Other EU countries that have amputation rates above the OECD average include Germany, Estonia and Portugal.

Looking at stroke-care, the OECD data reveals that the 30-day mortality after stroke is around 8 per 100 patients for the best performers in Europe – Finland, Switzerland and Norway, while countries including Czech Republic, Slovenia and Estonia have rates way above the OECD average of 11,6 per 100 patients, with Latvia having a rate as high as 25 per 100 patients. The OECD statistics also show the power of being able to link data between hospitals, thereby capturing also patients who were originally admitted to one hospital but died in another hospital.

Variations in outcomes also exist for cancer care. According to the OECD data, the 5-year survival rate for women with breast cancer is close to or above 88% in Sweden, Finland, Norway and Portugal, but only around 73-76 % in Lithuania, Slovakia, Poland and Estonia.

The report also contains statistics of health expenditure across OECD countries, and shows that during the last few years (2009-2015), the growth of pharmaceutical expenditure has been negative (the expenditure has contracted by 0,5% annually) whereas in particular long-term care and outpatient care have been driving increased healthcare expenditure (by 3,2 % and 2,3 % respectively). All in all, health expenditure is still growing much slower compared to the years before the economic crisis, with a growth rate of 1,4% as the OECD average.

Commenting on the report, EFPIA’s Executive Director for Strategy and Healthcare Systems Thomas Allvin said: “Variations in health outcomes have many causes, one being the level of investment in new technologies such as screening programmes, diagnostics and innovative medicines. But there are also variations where the organization and coordination of care is a substantial factor. For example, the high rate of foot and leg amputations in some countries reflect a failure of managing diabetes care through primary and community care services, to a huge cost for patients and societies.”

For healthcare services to be able to better analyse and act upon variations in quality of care, EFPIA calls for more standardized collection of health outcomes data across providers and countries. This would not only enable better health outcomes for patients, but also reduction of waste and making healthcare systems more sustainable. For this reason, EFPIA welcomes the new OECD project to collect comparable Patient Reported Outcomes from OECD countries for a number of conditions and disease areas. The so-called PaRIS project – Patient Reported Indicator Survey – was mandated by the OECD Health Ministers in January of this year, and will complement the already existing statistics on healthcare inputs and processes with more granular and comparable information on actual health outcomes for patients.