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  • 1
    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.
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  • 2
    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.
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  • 3
    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.
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  • 4
    Language: English
    Pages: 1 Online-Ressource (53 p.) , 21 x 28cm.
    Series Statement: OECD Social, Employment and Migration Working Papers no.277
    Keywords: Social Issues/Migration/Health ; Employment ; Spain
    Abstract: This paper sets out the OECD’s assessment of the information technology (IT) systems for social services used by the public administration in Spain. It shows that large disparities exist between and within regions in the use of IT tools. The lack of unified systems and the different ways to identify individuals and classify services makes the exchange of information extremely challenging. Improving the national data collection on social services highlights the importance of agreeing on a common terminology and deciding on a set of indicators as well as designing a flexible IT infrastructure to collect the information.
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  • 5
    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.
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  • 6
    Language: English
    Pages: 1 Online-Ressource (84 p.) , 21 x 28cm.
    Series Statement: OECD Social, Employment and Migration Working Papers no.276
    Keywords: Sozialer Dienst ; Spanien ; Social Issues/Migration/Health ; Employment ; Spain
    Abstract: This paper provides an overview of how social services are organised in European Union countries. With a special focus on Spain and countries with federal or semi-federal organisation, the paper starts by analysing social services from a legal perspective. It provides a comparative perspective on several concrete aspects of social services: sources of funding (national, regional, local, etc.), organization of service provision, expenditure, human resources, governance and coordination between institutions. The analysis finds that, despite differences across countries, there is no link between the existence of a comprehensive national social services laws and the comprehensiveness of the social service offer (the main differences concern family services and housing services in countries which consider housing as a right). There exist large differences in the contribution of central, regional, and local governments to social expenditure. Spending more on services does not necessarily imply spending less in cash transfers. Indeed, it appears that Nordic countries, that spend more on services as a share of their GDP, also spend more on cash transfers. Finally, the paper stresses the important role of the information technology and the horizontal and vertical coordination mechanisms to improve service quality and accessibility.
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  • 7
    Language: Spanish
    Pages: 1 Online-Ressource (57 p.) , 21 x 28cm.
    Parallel Title: Parallele Sprachausgabe Information technologies for social services in Spain: Reform of the national framework for the provision of social services in Spain
    Keywords: Employment ; Social Issues/Migration/Health ; Spain
    Abstract: Este documento presenta la evaluación de la OCDE de los sistemas de tecnología de la información (TI) para servicios sociales utilizados por la administración pública en España. Muestra que existen grandes disparidades entre las regiones y dentro de ellas en el uso de las herramientas informáticas. La falta de sistemas unificados, las diferentes formas de identificar a las personas y de clasificar los servicios dificultan el intercambio de información. Para mejorar la recogida de datos nacionales sobre servicios sociales será importante acordar una terminología común y decidir un conjunto de indicadores, así como diseñar una infraestructura informática flexible para recoger la información.
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  • 8
    Language: Spanish
    Pages: 1 Online-Ressource (95 p.) , 21 x 28cm.
    Parallel Title: Parallele Sprachausgabe Provision of social services in EU countries: Reform of the national framework for the provision of social services in Spain
    Keywords: Employment ; Social Issues/Migration/Health ; Spain
    Abstract: Este documento ofrece una visión general de la organización de los servicios sociales en los países de la Unión Europea. Con especial atención a España y a los países con organización federal o semifederal, el documento comienza analizando los servicios sociales desde una perspectiva jurídica. Ofrece una perspectiva comparada de varios aspectos concretos de los servicios sociales: fuentes de financiación (nacionales, regionales, locales, etc.), organización de la prestación de servicios, gastos, recursos humanos, gobernanza y coordinación entre instituciones. El análisis concluye que, a pesar de las diferencias entre países, no existe ningún vínculo entre la existencia de una legislación nacional integral de servicios sociales y la amplitud de la oferta de servicios sociales. Las principales diferencias entre los países se refieren a los servicios familiares y los servicios de vivienda ya que ciertos países consideran la vivienda como un derecho. Existen grandes diferencias en la contribución de las administraciones centrales, regionales y locales al gasto social. Gastar más en servicios no implica necesariamente gastar menos en transferencias monetarias. De hecho, parece que los países nórdicos, que gastan más en servicios en proporción a su PIB, también gastan más en transferencias monetarias. Por último, el documento subraya el importante papel de la tecnología de la información y de los mecanismos de coordinación horizontal y vertical para mejorar la calidad y la accesibilidad de los servicios.
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  • 9
    Language: English
    Pages: 1 Online-Ressource (circa 49 Seiten) , Illustrationen
    Series Statement: OECD social, employment and migration working papers no. 249
    Keywords: Employment ; Social Issues/Migration/Health ; Belgium ; Korea, Republic of ; Norway ; Amtsdruckschrift ; Graue Literatur
    Abstract: This paper documents joblessness in OECD countries, provides a detailed diagnosis of structural employment barriers in Belgium, Korea and Norway by applying the OECD Faces of Joblessness methodology to the situation just before the COVID-19 crisis and discusses the policy implications. It shows that individuals experiencing major employment difficulties often face a combination of barriers related to work availability, readiness and incentives. It suggests a number of avenues for enhancing the effectiveness of public support: i) make greater use of statistical profiling tools to adapt programmes to the needs of the jobless and target resources to those at the highest risk of long-term joblessness; ii) better coordinate support provided by employment, health and education services; iii) place a greater emphasis on preventive policies (equal opportunities, life-long learning).
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  • 10
    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
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  • 11
    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
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  • 12
    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
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  • 13
    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).
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  • 14
    Language: English
    Pages: 1 Online-Ressource (circa 78 Seiten) , Illustrationen
    Series Statement: OECD social, employment and migration working papers no. 205
    Keywords: Arbeitslosigkeit ; Litauen ; Employment ; Social Issues/Migration/Health ; Lithuania ; Amtsdruckschrift ; Graue Literatur
    Abstract: In the aftermath of the financial and economic crisis, large shares of working-age individuals in Lithuania either do not work or only to a limited extent. By 2013, several years after the start of the labour-market recovery, 21% were still without employment during the entire year, and a further 11% had weak labour-market attachment, working only a fraction of the year, or on restricted working hours. This paper applies a novel method for measuring and visualising employment barriers of individuals with no or weak labour-market attachment, using household micro-data. It first develops indicators to quantify employment obstacles under three broad headings: (i) work-related capabilities, (ii) incentives, and (iii) employment opportunities. It then uses these indicators in conjunction with a statistical clustering approach to identify unobserved (“latent”) groups of individuals facing similar combinations of barriers. The resulting typology of labour-market difficulties provides insights on the most pressing policy priorities in supporting different groups into employment. A detailed policy discussion illustrates how these empirical results can inform people-centred assessments of existing labour-market integration measures and of key challenges across different policy areas and institutions. The most common employment obstacles in Lithuania were health limitations, limited work experience, and scarce job opportunities. Although financial disincentives and care responsibilities were less widespread overall, they remained important barriers for some groups. A notable finding is that just over one third of jobless or low-intensity workers face three or more simultaneous barriers, highlighting the limits of narrow policy approaches that focus on subsets of these employment obstacles in isolation.
    Note: Zusammenfassung in französischer Sprache
    URL: Volltext  (lizenzpflichtig)
    URL: Volltext  (lizenzpflichtig)
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  • 15
    Language: English
    Pages: 1 Online-Ressource (circa 82 Seiten) , Illustrationen
    Series Statement: OECD social, employment and migration working papers no. 208
    Keywords: Arbeitslosigkeit ; Italien ; Employment ; Social Issues/Migration/Health ; Italy ; Amtsdruckschrift ; Graue Literatur
    Abstract: In the aftermath of the financial and economic crisis, large shares of working-age individuals in Italy either did not work or only to a limited extent. As the employment rate bottomed out in 2013, 32% were without employment during the entire year, and a further 7% had weak labour-market attachment, working only a fraction of the year, or on restricted working hours. This paper applies a novel method for measuring and visualising employment barriers of individuals with no or weak labour-market attachment, using household micro-data. It first develops indicators to quantify employment obstacles under three broad headings: (i) work-related capabilities, (ii) incentives, and (iii) employment opportunities. It then uses these indicators in conjunction with a statistical clustering approach to identify unobserved (“latent”) groups of individuals facing similar combinations of barriers. The resulting typology of labour-market difficulties provides insights on the most pressing policy priorities in supporting different groups into employment. A detailed policy discussion illustrates the use of these empirical results to inform people-centred assessments of existing labour-market integration measures and of key challenges across different policy areas and institutions. The most common employment obstacles in Italy were limited work experience, low education and skill levels, and scarce job opportunities. Although financial disincentives, health limitations and care responsibilities were less widespread overall, they remained important barriers for some groups. A striking finding is that more than half of jobless or low-intensity workers face three or more simultaneous barriers, highlighting the limits of narrow policy approaches that focus on subsets of these employment obstacles in isolation.
    Note: Zusammenfassung in französischer Sprache
    URL: Volltext  (lizenzpflichtig)
    URL: Volltext  (lizenzpflichtig)
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  • 16
    Language: English
    Pages: 1 Online-Ressource (circa 80 Seiten) , Illustrationen
    Series Statement: OECD social, employment and migration working papers no. 210
    Keywords: Arbeitslosigkeit ; Portugal ; Employment ; Social Issues/Migration/Health ; Portugal ; Amtsdruckschrift ; Graue Literatur
    Abstract: .In the aftermath of the financial and economic crisis, large shares of working-age individuals in Portugal either did not work or only to a limited extent. As the employment rate bottomed out in 2013, 29% were without employment during the entire year, and a further 10% had weak labour-market attachment, working only a fraction of the year, or on restricted working hours. This paper applies a novel method for measuring and visualising employment barriers of individuals with no or weak labour-market attachment, using household micro-data. It first develops indicators to quantify employment obstacles under three broad headings: (i) work-related capabilities, (ii) incentives, and (iii) employment opportunities. It then uses these indicators in conjunction with a statistical clustering approach to identify unobserved (“latent”) groups of individuals facing similar combinations of barriers. The resulting typology of labour-market difficulties provides insights on the most pressing policy priorities in supporting different groups into employment. A detailed policy discussion illustrates how these empirical results can inform people-centred assessments of existing labour-market integration measures and of key challenges across different policy areas and institutions. The most common employment obstacles in Portugal were low education/skills, a lack of recent work experience, scarce job opportunities and health problems. Financial disincentives and care responsibilities were less widespread overall, although important barriers for some groups. A striking finding is that 45% of jobless or low-intensity workers face three or more simultaneous barriers, highlighting the limits of narrow policy approaches that focus on subsets of these employment obstacles in isolation.
    Note: Zusammenfassung in französischer Sprache
    URL: Volltext  (lizenzpflichtig)
    URL: Volltext  (lizenzpflichtig)
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  • 17
    Language: English
    Pages: 1 Online-Ressource (circa 75 Seiten) , Illustrationen
    Series Statement: OECD social, employment and migration working papers no. 206
    Keywords: Arbeitslosigkeit ; Estland ; Employment ; Social Issues/Migration/Health ; Estonia ; Amtsdruckschrift ; Graue Literatur
    Abstract: In the aftermath of the financial and economic crisis, large shares of working-age individuals in Estonia either did not work or only to a limited extent. By 2013, several years after the start of the labour-market recovery, 18% were still without employment during the entire year, and a further 13% had weak labour-market attachment, working only a fraction of the year, or on restricted working hours. This paper applies a novel method for measuring and visualising employment barriers of individuals with no or weak labour-market attachment, using household micro-data. It first develops indicators to quantify employment obstacles under three broad headings: (i) work-related capabilities, (ii) incentives, and (iii) employment opportunities. It then uses these indicators in conjunction with a statistical clustering approach to identify unobserved (“latent”) groups of individuals facing similar combinations of barriers. The resulting typology of labour-market difficulties provides insights on the most pressing policy priorities in supporting different groups into employment. A detailed policy discussion illustrates how the empirical results can inform people-centred assessments of existing labour-market integration measures and of key challenges across different policy areas and institutions. The most common employment obstacles in Estonia were low skill levels, health limitations and limited work experience. Financial disincentives, care responsibilities and scarce job opportunities were less widespread overall, although important barriers for some groups. A notable finding is that almost one third of jobless or low-intensity workers face three or more simultaneous barriers, highlighting the limits of narrow policy approaches that focus on subsets of these employment obstacles in isolation.
    Note: Zusammenfassung in französischer Sprache
    URL: Volltext  (lizenzpflichtig)
    URL: Volltext  (lizenzpflichtig)
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  • 18
    Language: English
    Pages: 1 Online-Ressource (circa 80 Seiten) , Illustrationen
    Series Statement: OECD social, employment and migration working papers no. 209
    Keywords: Arbeitslosigkeit ; Irland ; Employment ; Social Issues/Migration/Health ; Ireland ; Amtsdruckschrift ; Graue Literatur
    Abstract: In the aftermath of the financial and economic crisis, large shares of working-age individuals in Ireland either did not work or only to a limited extent. As the labour-market recovery gathered pace during 2013, 32% were without employment during the entire year, and a further 14% had weak labour-market attachment, working only a fraction of the year, or on restricted working hours. This paper applies a novel method for measuring and visualising employment barriers of individuals with no or weak labour-market attachment, using household micro-data. It first develops indicators to quantify employment obstacles under three broad headings: (i) work-related capabilities, (ii) incentives, and (iii) employment opportunities. It then uses these indicators in conjunction with a statistical clustering approach to identify unobserved (“latent”) groups of individuals facing similar combinations of barriers. The resulting typology of labour-market difficulties provides insights on the most pressing policy priorities in supporting different groups into employment. A detailed policy discussion illustrates how the empirical results can inform people-centred assessments of existing labour-market integration measures and of key challenges across different policy areas and institutions. The most common employment obstacles in Ireland were limited work experience, low skill levels, and scarce job opportunities. Although financial disincentives, health problems and care responsibilities were less widespread overall, they remained important barriers for some groups. A notable finding is that just under 40% of jobless or low-intensity workers face three or more simultaneous barriers, highlighting the limits of narrow policy approaches that focus on subsets of these employment obstacles in isolation.
    Note: Zusammenfassung in französischer Sprache
    URL: Volltext  (lizenzpflichtig)
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  • 19
    Language: English
    Pages: 1 Online-Ressource (circa 79 Seiten) , Illustrationen
    Series Statement: OECD social, employment and migration working papers no. 207
    Keywords: Arbeitslosigkeit ; Spanien ; Employment ; Social Issues/Migration/Health ; Spain ; Amtsdruckschrift ; Graue Literatur
    Abstract: In the aftermath of the financial and economic crisis, large shares of working-age individuals in Spain either did not work or only to a limited extent. As the employment rate bottomed out in 2013, 30% were without employment during the entire year, and a further 15% had weak labour-market attachment, working only a fraction of the year, or on restricted working hours. This paper applies a novel method for measuring and visualising employment barriers of individuals with no or weak labour-market attachment, using household micro-data. It first develops indicators to quantify employment obstacles under three broad headings: (i) work-related capabilities, (ii) incentives, and (iii) employment opportunities. It then uses these indicators in conjunction with a statistical clustering approach to identify unobserved (“latent”) groups of individuals facing similar combinations of barriers. The resulting typology of labour-market difficulties provides insights on the most pressing policy priorities in supporting different groups into employment. A detailed policy discussion illustrates how these empirical results can inform people-centred assessments of existing labour-market integration measures and of key challenges across different policy areas and institutions. The most common employment obstacles in Spain were a lack of work experience, low education and skill levels, and scarce job opportunities. Although financial disincentives, health limitations and care responsibilities were less widespread overall, they remained important barriers for some groups. A striking finding is that 45% of jobless or low-intensity workers face three or more simultaneous barriers, highlighting the limits of narrow policy approaches that focus on subsets of these employment obstacles in isolation.
    Note: Zusammenfassung in französischer Sprache
    URL: Volltext  (lizenzpflichtig)
    URL: Volltext  (lizenzpflichtig)
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  • 20
    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
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  • 21
    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
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  • 22
    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
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  • 23
    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
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  • 24
    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
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  • 25
    Language: English
    Pages: 1 Online-Ressource (circa 59 Seiten) , Illustrationen
    Series Statement: OECD social, employment and migration working papers no. 192
    Keywords: Arbeitsmarkt ; Beschäftigungsfähigkeit ; Arbeitslosigkeit ; Aktivierende Arbeitsmarktpolitik ; Estland ; Spanien ; Employment ; Social Issues/Migration/Health ; Amtsdruckschrift ; Arbeitspapier ; Graue Literatur
    Abstract: This paper proposes a novel method for identifying and visualising key employment obstacles that may prevent individuals from participating fully in the labour market. The approach is intended to complement existing sources of information that governments use when designing and implementing activation and employment-support policies. In particular, it aims to provide individual and household perspectives on employment problems, which may be missed when relying on common labour-force statistics or on administrative data, but which are relevant for targeting and tailoring support programmes and related policy interventions. A first step describes a series of employment-barrier indicators at the micro level, comprising three domains: work-related capabilities, financial incentives and employment opportunities. For each domain, a selected set of concrete employment barriers are quantified using the EU-SILC multi-purpose household survey. In a second step, a statistical clustering method (latent class analysis), is used to establish profiles and patterns of employment barriers among individuals with no or weak labour-market attachment. A detailed illustration for two countries (Estonia and Spain) shows that “short-hand” groupings that are often highlighted in the policy debate, such as “youth” or “older workers”, are in fact composed of multiple distinct sub-groups that face very different combinations of employment barriers and likely require different policy approaches. Results also indicate that individuals typically face two or more simultaneous employment obstacles suggesting that addressing one barrier at a time may not have the intended effect on employment levels. From a policy perspective, the results support calls for carefully sequencing activation and employment support measures, and for coordinating them across policy domains and institutions.
    Note: Zusammenfassung in französischer Sprache
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  • 26
    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.
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  • 27
    Language: English
    Pages: Online-Ressource (109 p.)
    Series Statement: OECD Social, Employment and Migration Working Papers no.164
    Keywords: Employment ; Social Issues/Migration/Health ; Economics
    Abstract: This paper presents an overview of the situation of youth in OECD countries since the onset of the financial crisis focusing primarily on describing the characteristics and living conditions of youth not in employment, education or training (the ‘NEETs’). It also provides data on the availability, coverage and effectiveness of income-support policies for young people, and summarises available evidence on the impact of interventions that aim at improving the social, education and employment situation of the most disadvantaged youth. Due to the paper’s explicit focus on the hardest-to-place, most disadvantaged youth, the range of policies covered is broader than in earlier studies on the same topic, including various social benefits and in-kind services targeted at this group. The paper shows that NEET rates have not yet recovered from the crisis. There are large differences in youth unemployment and inactivity across countries, and these differences were further exacerbated by the recession. Reducing NEET rates is a great challenge for governments, as youth who remain jobless for long periods typically come from more disadvantaged backgrounds, have low levels of educational attainment, and are in many cases inactive. There is substantial evidence, however, that even the most disadvantaged youth can benefit from a variety of targeted interventions, including for instance special education programmes and mentoring.
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  • 28
    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.
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  • 29
    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.
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