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  • Lorenzoni, Luca  (16)
  • Colombo, Francesca  (10)
  • Social Issues/Migration/Health  (26)
  • 1
    Online Resource
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    Innovative providers’ payment models for promoting value-based health systems : Start small, prove value, and scale up (2023)
    Paris : OECD Publishing
    Details
    Language: English
    Pages: 1 Online-Ressource (52 p.) , 21 x 28cm.
    Series Statement: OECD Health Working Papers no.154
    Keywords: Finance and Investment ; Social Issues/Migration/Health
    Abstract: Innovative providers’ payment models represent an important policy lever that could be used to promote value-based health systems. By bundling services across the continuum of care or to target acute events or chronic conditions, innovative payment models set financial incentives for providers to increase efficiency in service delivery, improve health outcomes and enhance patient experience with care. This paper offers insights on value-based payment models, a type of innovative payment model implemented in several OECD countries and reviews the publicly available evidence on the impact of those payment models on value. Innovative payment models tend to be exceptional and small-scale compared to activity-based payment models and have been extensively piloted in the United States while implementation and evaluation in other countries is limited. The publicly available empirical evidence points to modest efficiency and quality gains from value-based payment models. Impact on healthcare spending, outcomes and patient experience varies across programmes. Given the significant variation in the key features of value-based payment models and the context-specific issues they address, those models do not offer a one-size-fits-all solution. This paper outlines several intervention points that policy makers need to consider when designing and implementing value-based payment models to maximise their positive outcome.
    DOI: 10.1787/627fe490-en
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  • 2
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    Improving the timeliness of health expenditure tracking in OECD and low- and middle-income countries (2023)
    Paris : OECD Publishing
    Details
    Language: English
    Pages: 1 Online-Ressource (76 p.) , 21 x 28cm.
    Series Statement: OECD Health Working Papers no.152
    Keywords: Gesundheitskosten ; OECD-Staaten ; Schwellenländer ; Entwicklungsländer ; Social Issues/Migration/Health
    Abstract: The COVID-19 pandemic has highlighted that access to timely health spending data is crucial for informed policy-making. This Health Working Paper summarises and compares the methodologies applied in around half of OECD countries to estimate public and private health spending for the most recent year (i.e., t-1) as well as the approaches taken by the OECD Secretariat to fill existing data gaps for the remaining OECD countries. For the first time, the paper also explores the feasibility of nowcasting health spending for the current year (i.e., t) and examines data sources that could be potentially useful in such an exercise. While this review should help OECD countries that do not yet have experience in estimating health spending for year t-1 to improve the timeliness in their data reporting, the paper also analyses the applicability of the methods in low- and middle-income countries.
    DOI: 10.1787/0b699976-en
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  • 3
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    Assessing the future fiscal sustainability of health spending in Ireland (2023)
    Paris : OECD Publishing
    Details
    Language: English
    Pages: 1 Online-Ressource (50 p.) , 21 x 28cm.
    Series Statement: OECD Health Working Papers no.161
    Keywords: Gesundheitskosten ; Öffentliche Ausgaben ; Finanzpolitik ; Irland ; Social Issues/Migration/Health
    Abstract: This working paper uses a new method to assess the fiscal sustainability of the Irish health system by considering the effects of population change and income growth on both government revenue and health spending over time. Spending on healthcare is comparatively high in Ireland, accounting for 8.4% of GNI in 2019. Health spending from public sources is projected to account for 24% of government revenues in 2040 (up from 20% in 2019). The fiscal balance is projected to slightly deteriorate in Ireland by 2040. Population change is projected to be a much greater driver of future health spending in Ireland over the next 20 years as compared to the OECD average. By coupling health spending projections with government revenue projections, our approach provides policymakers with a broader set of whole-of-government policies to consider when addressing financing shortfalls.
    DOI: 10.1787/1f5fadbc-en
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  • 4
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    Ageing and the long-run fiscal sustainability of health care across levels of government (2022)
    Paris : OECD Publishing
    Details
    Language: English
    Pages: 1 Online-Ressource (37 Seiten) , 21 x 28cm.
    Series Statement: OECD Working Papers on Fiscal Federalism no.38
    Keywords: Social Issues/Migration/Health ; Economics ; Taxation
    Abstract: OECD economies are undergoing a seemingly inevitable process of population ageing that has been changing income and consumption patterns. Notably, the demand for health services is expected to increase, while labour forces are projected to shrink. Both factors are projected to negatively impact the sustainability of health systems – the former through an increase in government expenditures on health and the latter through a decrease in government revenues. As health systems and their funding streams tend to be at least partially decentralised in most OECD countries, this fiscal pressure is expected to be asymmetric across levels of government. The objective of this paper is to provide order-of-magnitude estimates of the possible effects of population ageing on government finances across OECD countries, and to discuss reforms to fiscal federalism and intergovernmental relations with the purpose of funding expenditures at all levels of government.
    DOI: 10.1787/7c184406-en
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  • 5
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    Health spending projections to 2030 : new results based on a revised OECD methodology (2019)
    [Paris] : OECD
    Details
    Language: English
    Pages: 1 Online-Ressource (circa 46 Seiten) , Illustrationen
    Series Statement: OECD health working papers no. 110
    Keywords: Social Issues/Migration/Health ; Amtsdruckschrift ; Graue Literatur
    Abstract: To gain a better understanding of the financial sustainability of health systems, the OECD has produced a new set of health spending projections up to 2030 for all its member countries. Estimates are produced across a range of policy situations. Policy situations analysed include a “base” scenario – estimates of health spending growth in the absence of major policy changes – and a number of alternative scenarios that model the effect on health spending of policies that increase productivity or contribute to better lifestyles; or conversely, ineffective policies that contribute to additional cost pressures on health systems.
    Note: Zusammenfassung in französischer Sprache
    DOI: 10.1787/5667f23d-en
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  • 6
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    The impact of technological advancements on health spending : a literature review (2019)
    [Paris] : OECD
    Details
    Language: English
    Pages: 1 Online-Ressource (circa 33 Seiten) , Illustrationen
    Series Statement: OECD health working papers no. 113
    Keywords: Social Issues/Migration/Health ; Amtsdruckschrift ; Graue Literatur
    Abstract: The measurement of the impact of technology as a driver of health care expenditure is complex since technological effects are closely interlinked with other determinants such as income and the composition and health status of a population. Furthermore, the impact of the supply of advances in technology on health expenditure cannot be considered in isolation from demand and the policy context and the broader institutional context governing the adoption of new technologies. Hence, it is the interaction of supply and demand factors and the context that determine the ultimate level of technology use. There are also important quality changes that come with technological progress that also have monetary costs and benefits attached. Modelling quality improvements, both in terms of benefits within the health system and outside (e.g. its impact on life expectancy, ageing populations, productivity and GDP), is a challenging task, and no macroeconomic models to date have tried to capture them. This paper presents a comprehensive literature review of the impact of technological advances on health expenditure growth, the ‘cost’ side of the equation.
    Note: Zusammenfassung in französischer Sprache
    DOI: 10.1787/fa3bab05-en
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  • 7
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    Health systems characteristics : a survey of 21 Latin American and Caribbean countries (2019)
    [Paris] : OECD
    Details
    Language: English
    Pages: 1 Online-Ressource (circa 142 Seiten) , Illustrationen
    Series Statement: OECD health working papers no. 111
    Keywords: Gesundheitswesen ; Gesundheitsfinanzierung ; Lateinamerika ; Karibischer Raum ; Social Issues/Migration/Health ; Amtsdruckschrift ; Graue Literatur
    Abstract: In 2018, the Inter-American Development Bank and the OECD launched a survey to collect information on key health systems characteristics in Latin American and Caribbean (LAC) countries. This paper presents the information provided by 21 of these countries. 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).
    Note: Zusammenfassung in französischer Sprache
    DOI: 10.1787/0e8da4bd-en
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  • 8
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    Price setting and price regulation in health care : lessons for advancing Universal Health Coverage (2019)
    Geneva : World Health Organization
    Details
    ISBN: 9789264508866 , 9789241515924
    Language: English
    Pages: 1 Online-Ressource (circa 100 Seiten) , Illustrationen
    Keywords: Social Issues/Migration/Health
    Abstract: The objectives of this study are to describe experiences in price setting and how pricing has been used to attain better coverage, quality, financial protection, and health outcomes. It builds on newly commissioned case studies and lessons learned in calculating prices, negotiating with providers, and monitoring changes. Recognising that no single model is applicable to all settings, the study aimed to generate best practices and identify areas for future research, particularly in low- and middle-income settings. The report and the case studies were jointly developed by the OECD and the WHO Centre for Health Development in Kobe (Japan).
    DOI: 10.1787/ed3c16ff-en
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  • 9
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    We must tackle the growing burden of obesity (2018)
    Paris : OECD Publishing
    In:  OECD Observer
    Details
    Language: English
    Pages: 1 Online-Ressource (3 p.)
    Titel der Quelle: OECD Observer
    Keywords: Social Issues/Migration/Health ; Economics
    DOI: 10.1787/bdbc5673-en
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  • 10
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    Healthcare systems: Tackling waste to boost resources (2018)
    Paris : OECD Publishing
    In:  OECD Observer
    Details
    Language: English
    Pages: 1 Online-Ressource (4 p.)
    Titel der Quelle: OECD Observer
    Keywords: Social Issues/Migration/Health ; Economics
    DOI: 10.1787/f5719ebb-en
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  • 11
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    Future trends in health care expenditure : a modelling framework for crosscountry forecasts (2017)
    Paris : OECD Publishing
    Details
    Language: English
    Pages: 1 Online-Ressource (circa 53 Seiten) , Illustrationen
    Series Statement: OECD health working papers no. 95
    Keywords: Gesundheitskosten ; Trend ; Prognose ; Vergleich ; OECD-Staaten ; Social Issues/Migration/Health ; Arbeitspapier ; Graue Literatur
    Abstract: Across the OECD, healthcare spending has typically outpaced economic growth in recent decades. While such spending has improved health outcomes, there are concerns about the financial sustainability of this upward trend, particularly as healthcare systems are predominantly funded from public resources in most OECD countries. To better explore this financial sustainability challenge, many countries and international institutions have developed forecasting models to project growth in future healthcare expenditure. Despite methodological differences between forecasting approaches, a common set of healthcare spending drivers can be identified. Demographic factors, rising incomes, technological progress, productivity in the healthcare sector compared to the general economy (Baumol’s cost disease) and associated healthcare policies have all been shown to be key determinants of healthcare spending.
    Note: Zusammenfassung in französischer Sprache
    DOI: 10.1787/247995bb-en
    URL: Volltext
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  • 12
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    Which policies increase value for money in health care? (2017)
    Paris : OECD Publishing
    Details
    Language: English
    Pages: 1 Online-Ressource (circa 72 Seiten) , Illustrationen
    Series Statement: OECD health working papers no. 104
    Keywords: 2000 - 2015 ; Gesundheitsversorgung ; Dienstleistungsqualität ; Gesundheitskosten ; OECD-Staaten ; Social Issues/Migration/Health ; Arbeitspapier ; Graue Literatur
    Abstract: The incentive structures produced by different institutional arrangements in health systems are important determinants of their performance, and can explain some of the differences in cross-country performance patterns. This paper proposes an approach and quantitative method to investigate how different policies and institutions helped achieving better value for money across 26 OECD countries for the period of 2000-2015. To this aim, it uses a panel of health system characteristics indicators - derived from questionnaires sent to countries by OECD in 2008, 2012 and 2016 - that describes primarily health financing and coverage arrangements, health care delivery systems, and governance and resource allocation.
    Note: Zusammenfassung in französischer Sprache
    DOI: 10.1787/a46c5b1f-en
    URL: Volltext  (lizenzpflichtig)
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  • 13
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    Understanding variations in hospital length of stay and cost : results of a pilot project (2017)
    Paris : OECD Publishing
    Details
    Language: English
    Pages: 1 Online-Ressource (circa 43 Seiten) , Illustrationen
    Series Statement: OECD health working papers no. 94
    Keywords: 2012 - 2014 ; Krankenhaus ; Dauer ; Krankenhauskosten ; Kanada ; Frankreich ; Irland ; Israel ; Social Issues/Migration/Health ; Arbeitspapier ; Graue Literatur
    Abstract: Hospitals are the most expensive component of OECD health care systems, accounting for around one third of total health care expenditure. Given growing pressures on government budgets, this is an area of expenditure that has already been, and will continue to be, thoroughly scrutinised for potential increases in efficiency. One way to assess hospital efficiency is to measure the amount of resources each hospital uses to treat specific conditions. A care delivery process may be seen as more efficient – after accounting for broader health system and market factors that may constrain the hospital from operating at an efficient level – if it consumes fewer resources while delivering adequate care for the same condition, the dimension of efficiency under review here. In this light, measuring hospital length of stay and costs for a given condition helps the understanding of how efficient (better performing) hospitals are relative to each other. Through international comparative work, this paper helps policy makers understand the scope and nature of length of stay/costs variation across hospitals in OECD countries. It also explores whether characteristic of hospitals or of countries' regulatory and operating environments can explain differences in efficiency. Data on length of stay and costs to treat patients admitted to hospitals for nine tracing conditions/treatments were collected and analysed for Canada (Alberta province), France, Ireland and Israel for 2012-2014. Our analysis shows that hospitals with a number of beds ranging between 200 and 600, and not-for-profit hospitals report shorter length of stay and lower costs for several conditions/treatments. It also shows that variations in efficiency are more likely to exist at the hospital level for cardiac surgery (acute myocardial infarction with percutaneous transluminal coronary angioplasty and coronary artery bypass graft), and at country level for hysterectomy, caesarean section and normal delivery. These results shed some light on the importance of hospital payment system in fostering efficiency in care delivery for standard/high volume treatments such as normal delivery, whereas hospital management and organisation seem to drive efficiency for more complex/technology driven treatments such as bypass surgery.
    Note: Zusammenfassung in französischer Sprache
    DOI: 10.1787/ae3a5ce9-en
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  • 14
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    Cyclical vs structural effects on health care expenditure trends in OECD countries (2017)
    Paris : OECD Publishing
    Details
    Language: English
    Pages: 1 Online-Ressource (circa 40 Seiten) , Illustrationen
    Series Statement: OECD health working papers no. 92
    Keywords: Gesundheitsfinanzierung ; Gesundheitskosten ; OECD-Staaten ; Social Issues/Migration/Health ; Arbeitspapier ; Graue Literatur
    Abstract: Health care expenditure per person, after accounting for changes in overall price levels, began to slow in many OECD countries in the early-to-mid 2000s, well before the economic and fiscal crisis. Using available estimates from the OECD’s System of Health Accounts (SHA) database, we explore common trends in health care expenditure since 1996 in a set of 22 OECD countries. We assess the extent to which the trends observed are the results of cyclical economic influences, and the respective contributions of changes in relative prices, health care volumes and coverage to the slowdown in health care expenditure growth. Our analysis suggests that cyclical factors may account for a little less than one half of the estimated slowdown in health care spending since the crisis, suggesting that structural changes have contributed to the trends. Before the crisis the slowdown in health care expenditure growth was accounted for by health care prices growing less than general prices and a reduction in care volumes, whereas the latter accounts for most of the steeper deceleration after the crisis. Although both privately and publically financed health care expenditure grew at a reduced pace during the study period, the sharp post-crisis deceleration happened mostly in the public component. When examined by function, the slowdown in publicly-financed expenditure has been largest in curative and rehabilitative care (particularly after the crisis) and in medical goods (especially pharmaceuticals), whereas the deceleration in the privately financed component is largely in medical goods (including pharmaceuticals). We 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. We examine a range of government policies enacted in a selection of OECD countries that likely contributed to the structural changes observed in our analysis.
    Note: Zusammenfassung in französischer Sprache
    DOI: 10.1787/be74e5c5-en
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  • 15
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    International comparison of South African private hospital price levels (2016)
    Paris : OECD Publishing
    Details
    Language: English
    Pages: 1 Online-Ressource (circa 70 Seiten) , Illustrationen
    Series Statement: OECD health working papers no. 85
    Keywords: Krankenhauskosten ; Krankenhaus ; Privatwirtschaft ; Vergleich ; OECD-Staaten ; Südafrika ; Social Issues/Migration/Health ; South Africa ; Arbeitspapier ; Graue Literatur
    Abstract: The health system in South Africa is unique in many ways. South Africa spends 41.8% of total health expenditures on private voluntary health insurance – more than any OECD country – but only 17% of the population – mostly high income citizens - can afford to purchase private insurance. Given the magnitude of private health expenditures, the activities in the private health care market have an important impact on the functioning of the health care system as a whole. Medical schemes (private health insurance) in South Africa mainly finance care that is predominantly delivered by private providers (i.e., private hospitals, specialists, general practitioners, pharmacies). Therefore, these schemes primarily finance an alternative to seeking care in the public sector and offer services that duplicate those available in the public sector.
    Note: Zusammenfassung in französischer Sprache
    DOI: 10.1787/5jrrxrzn24wl-en
    URL: Volltext
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  • 16
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    Public expenditure projections for health and long-term care for China until 2030 (2015)
    Paris : OECD
    Details
    Language: English
    Pages: Online-Ressource (43 S.) , graph. Darst.
    Series Statement: OECD health working papers 84
    Keywords: 2015 - 2030 ; Öffentliche Ausgaben ; Gesundheitsversorgung ; Häusliche Pflege ; China ; Social Issues/Migration/Health ; China, People’s Republic ; Arbeitspapier ; Graue Literatur
    Abstract: In recent years, China has seen an unprecedented expansion of health insurance for its population in its quest to achieve universal health coverage. By 2011, 95% of the Chinese population was insured up from less than 50% in 2005 through public or employer-based insurance schemes. As part of this move, the structure of health care financing has shifted significantly, such that public sources in 2013 funded well over half of all health spending, compared with just over a third in the early 2000s. In that context, it is important to determine the main drivers of future growth in health spending in the medium term, to assess the possible impact on public budgets. Using a component-based health expenditure model developed at the OECD, future projections of public spending on health care and long-term care are made for OECD and key emerging economies, including China. The uniform cross-country framework allows for consistent international comparisons under different cost-pressure and cost-containment scenarios.
    Note: Zsfassung in franz. Sprache , Systemvoraussetzungen: PDF Reader.
    DOI: 10.1787/5jrs3c274vq3-en
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  • 17
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    Comparing hospital and health prices and volumes internationally : results of a EUROSTAT/OECD project (2014)
    Paris : OECD
    Details
    Language: English
    Pages: Online-Ressource (62 S.) , graph. Darst.
    Series Statement: OECD health working papers 75
    Keywords: Gesundheitskosten ; Gesundheitsstatistik ; Vergleich ; OECD-Staaten ; Social Issues/Migration/Health ; Arbeitspapier ; Graue Literatur
    Abstract: Health services account for a large and increasing share of production and expenditure in OECD and Eurostat countries but there are also noticeable differences between countries in expenditure per capita. Whether such differences are due to more services being consumed or whether they reflect differences in the price of services is a question of significant policy relevance. Yet, cross-country comparisons of health services have typically not disentangled these effects. This paper presents the results of a joint effort between 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 that can then be applied to matching national accounts expenditure data so as to derive consistent price and volume comparisons of health products. The data is novel in that it reflects “quasi prices” (negotiated or administrative prices or tariffs) of the output of hospital services, instead of prices of inputs such as wages of medical personnel. The new methodology moves away from the traditional input perspective, thereby relaxing the assumption that hospital productivity is the same across countries...
    Note: Zsfassung in franz. Sprache , Systemvoraussetzungen: Acrobat Reader.
    DOI: 10.1787/5jxznwrj32mp-en
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  • 18
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    A comparative analysis of health forecasting methods (2012)
    Paris : OECD
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    Language: English
    Pages: Online-Ressource , graph. Darst.
    Series Statement: OECD health working papers 59
    Keywords: Gesundheitskosten ; Prognoseverfahren ; OECD-Staaten ; Social Issues/Migration/Health ; Arbeitspapier ; Graue Literatur
    Abstract: 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...
    Note: Zsfassung in franz. Sprache , Systemvoraussetzungen: Acrobat Reader.
    DOI: 10.1787/5k912j389bf0-en
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  • 19
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    Help Wanted? : Providing and Paying for Long-Term Care (2011)
    Paris : OECD Publishing
    Details
    ISBN: 9789264097759
    Language: English
    Pages: Online-Ressource (328 p.) , ill.
    Series Statement: OECD Health Policy Studies
    Parallel Title: Druckausg.
    Parallel Title: Parallelausg. Besoin d'aide ? ; La prestation de services et le financement de la dépendance
    Parallel Title: Erscheint auch als Help wanted?
    RVK:
    QX 900
    Keywords: Ältere Menschen ; Häusliche Pflege ; Pflegeversicherung ; Finanzierung ; OECD-Staaten ; Employment ; Finance and Investment ; Social Issues/Migration/Health ; Finanzierung ; Krankenpflege ; Langzeitbetreuung ; Private Krankenversicherung
    Abstract: This book examines the challenges countries are facing with regard to providing and paying for long-term care. With populations ageing and the need for long-term care growing rapidly, this book looks at such issues as: future demographic trends, policies to support family carers, long-term care workers, financing arrangements, long-term care insurance, and getting better value for money in long-term care. “WHO recognizes that long-term care represents a major challenge for all countries in the world, with important implications for economic development and for the health and well-being of older people. This well-documented book provides a comparative analysis of the common challenges and diverse solutions OECD countries are adopting to respond to the growing demand for long-term care services, and particularly its implications for financing and labour markets. It provides much needed evidence to guide policy makers and individuals.” -Dr John Beard, Director, Department of Ageing and Life Course, World Health Organization “This carefully researched book offers invaluable data and insights into the organization and financing of long-term care in OECD countries. The book is an indispensable resource for anyone interested in international long-term care”. -Dr. Joshua M. Wiener, Distinguished Fellow and Program Director of RTI’s Aging, Disability, and Long-Term Care Program, United States
    DOI: 10.1787/9789264097759-en
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  • 20
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    Besoin d'aide ? : La prestation de services et le financement de la dépendance (2011)
    Paris : OECD Publishing
    Details
    ISBN: 9789264097766
    Language: French
    Pages: Online-Ressource (392 p.) , ill.
    Series Statement: Etudes de l'OCDE sur les politiques de santé
    Series Statement: Études de l'OCDE sur les politiques de santé
    Parallel Title: Druckausg.
    Parallel Title: Parallelausg. Help Wanted?; Providing and Paying for Long-Term Care
    Keywords: Employment ; Finance and Investment ; Social Issues/Migration/Health
    Abstract: Au moment où l’espérance de vie approche des 80 ans pour les hommes et dépasse nettement cet âge pour les femmes, la population est de plus en plus nombreuse à vouloir vivre pleinement aussi longtemps que possible. Comment l’évolution démographique et les tendances du marché du travail vont-elles peser sur l’offre familiale, amicale et des travailleurs susceptibles d’assumer une prise en charge ? Les finances publiques seront-elles menacées par le coût de la prise en charge future de la dépendance ? Quel équilibre doit-on rechercher entre implication privée et soutien public de cette prise en charge des soins liés à la dépendance ? Ce livre traite de ces enjeux et autres questions importantes.
    DOI: 10.1787/9789264097766-fr
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  • 21
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    Private Health Insurance in OECD Countries : The Benefits and Costs for Individuals and Health Systems (2004)
    Paris : OECD Publishing
    Details
    Language: English
    Pages: 62 p. , 21 x 29.7cm
    Series Statement: OECD Health Working Papers no.15
    Keywords: Social Issues/Migration/Health
    Abstract: Governments often look to private health insurance (PHI) as a possible means of addressing some health system challenges. For example, they may consider enhancing its role as an alternative source of health financing and a way to increase system capacity, or promoting it as a tool to further additional health policy goals, such as enhanced individual responsibility. In some countries policy makers regard PHI as a key element of their health coverage systems While private health insurance represents, on average, only a small share of total health funding across the OECD area, it plays a significant role in health financing in some OECD countries and it covers at least 30% of the population in a third of the OECD members. It also plays a variety of roles, ranging from primary coverage for particular population groups to a supporting role for public systems. This paper assesses evidence on the effects of PHI in different national contexts and draws conclusions about its ...
    DOI: 10.1787/527211067757
    URL: Volltext
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  • 22
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    Private Health Insurance in the Netherlands : A Case Study (2004)
    Paris : OECD Publishing
    Details
    Language: English
    Pages: 44 p. , 21 x 29.7cm
    Series Statement: OECD Health Working Papers no.18
    Keywords: Social Issues/Migration/Health ; Netherlands
    Abstract: Private health insurance (PHI) is the sole source of primary health coverage for a third of the Netherlands’ population earning above a set income threshold. Social insurance (together with limited public (tax-based financing) is the main source of health coverage for the majority of the population. Most socially insured also purchase supplementary private health coverage. All citizens are eligible for a system of coverage for long-term care and care for the chronically ill. Thus, in the Netherlands, the source of health financing is determined according to the category of health risk, type of illness, as well as income level. Decisions have been made allocating the cost of more expensive long-term care and coverage of high-risk individuals and persons earning below a set level, to social or public insurance, or to PHI subsidised by a broader pool. From an equity perspective, the Dutch public/private financing mix appears to do well, although challenges remain. There appear to be ...
    DOI: 10.1787/834375482128
    URL: Volltext
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  • 23
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    Online Resource
    Private Health Insurance in Ireland : A Case Study (2004)
    Paris : OECD Publishing
    Details
    Language: English
    Pages: 56 p. , 21 x 29.7cm
    Series Statement: OECD Health Working Papers no.10
    Keywords: Social Issues/Migration/Health ; Ireland
    Abstract: This paper analyses the Irish private health insurance (PHI) market. It describes how PHI interacts with the public system, and assesses its contribution to equity, efficiency and responsiveness of the health system. The analysis identifies some of the factors affecting insurance market performance and its impact on the health system, including market characteristics, the regulatory and fiscal environment, health system organisation, and any actors’ incentives and behaviours. PHI plays a prominent role in Ireland. The health system is designed to offer comprehensive publicly funded health services to low-income groups, and universal public hospital coverage. Policies have encouraged the development of PHI to provide all individuals with a private alternative to the public system, as well as a means of funding cost-sharing and services not covered by the public system. With the implementation of the requirements of the Third EU Non-Life Directive, the PHI market, historically ...
    DOI: 10.1787/226617182041
    URL: Volltext
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  • 24
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    The Slovak Health Insurance System and The Potential Role for Private Health Insurance : Policy Challenges (2004)
    Paris : OECD Publishing
    Details
    Language: English
    Pages: 34 p. , 21 x 29.7cm
    Series Statement: OECD Health Working Papers no.11
    Keywords: Social Issues/Migration/Health ; Slovak Republic
    Abstract: This paper analyses the Slovak health insurance system and the policy challenges it faces. It describes the structure of health coverage and health sector reforms being implemented by the Slovak government. It provides a preliminary assessment of the possible impact of such reforms, with a focus on the health insurance system and the possible introduction of private health insurance (PHI). It assesses how private health insurance would impact upon the health system, particularly equity, efficiency incentives facing providers and insurers, and responsiveness. The Slovak health system is based upon a mandatory Bismarck-style social health insurance system. Contributions are shared between employers and employees and the state contributes for the inactive population. Five non-profit and non-competing insurers operate nationwide, one of which covers two-thirds of the population. Individuals can freely enrol with any of the insurance companies and a risk equalisation system ...
    DOI: 10.1787/561285317408
    URL: Volltext
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  • 25
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    Online Resource
    Private Health Insurance in Australia : A Case Study (2003)
    Paris : OECD Publishing
    Details
    Language: English
    Pages: 50 p. , 21 x 29.7cm
    Series Statement: OECD Health Working Papers no.8
    Keywords: Social Issues/Migration/Health ; Australia
    Abstract: Despite universal public insurance coverage, private health insurance (PHI) covers almost half of the Australian population – a high coverage rate in comparison with most other OECD countries. Reflecting the belief that a well-functioning health care system should be based on a mixed system of insurance and provision, Australia’s policy makers have encouraged the development of private financing and delivery arrangements operating in parallel to the public system. PHI is seen as a vehicle for enhancing individuals’ choice of provider and care options, and for reducing cost and demand pressures on public hospitals. Policy makers have intervened substantially in the private health insurance market. Regulation has promoted risk-pooling and incentive policies have stimulated the purchase of private cover. This paper analyses the Australian private health insurance market. It describes how PHI interacts with the public system, and assesses its contribution to equity, efficiency and ...
    DOI: 10.1787/478608584171
    URL: Volltext
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  • 26
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    Towards More Choice in Social Protection? : Individual Choice of Insurer in Basic Mandatory Health Insurance in Switzerland (2001)
    Paris : OECD Publishing
    Details
    Language: English
    Pages: 60 p. , 21 x 29.7cm
    Series Statement: OECD Labour Market and Social Policy Occasional Papers no.53
    Keywords: Social Issues/Migration/Health ; Switzerland
    Abstract: There is a considerable interest in some OECD countries in understanding how greater choice in health markets can be combined with the equity and efficiency goals of health systems. This paper reviews the system of free choice of insurer in basic mandatory health insurance that was introduced in Switzerland with the 1994 Health Insurance Law (LAMal). The thrust of the reform was to increase solidarity in basic health insurance while enhancing choice among individuals and competition on quality-price ratios among insurers. The reform encompassed regulatory mechanisms to facilitate the switching mechanism and choice-led competition, such as measures to ensure cross-subsidisation across individuals of different risk and income, information disclosure requirements for insurers, and the mandatory participation to a risk equalisation mechanism for all insurers offering basic health insurance. The analysis presented in this paper suggests that some features of the individual choice ...
    DOI: 10.1787/664178220717
    URL: Volltext
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