OECD’S HEALTH AT A GLANCE 2015 – WHAT

INSIGHTS FOR THE UK?

Mark Pearson, Deputy Director Directorate for Employment, Labour and Social Affairs

Health at a Glance 2015 – How does the

UK perform?

• A leader in innovative health policies, but not on OECD international benchmarks

• Based on OECD 2015 benchmarking, the UK is a middling-to-low performer on 3 out of 4 key domains – health status, risk factors, and quality

• UK is only excelling relative to OECD peers access

Health status: middling performance

compared to OECD peers

Health status indicators UK in the OECD

Life expectancy at birth –

Men

Life expectancy at birth -

women

Life expectancy at 65 - men

Life expectancy at 65 -

women

Mortality from

cardiovascular diseases

14th/34

24th/34

14th/34

23rd/34

9th/34

3

Risk factors: lagging behind OECD peers

Health risk indicators UK in the OECD

Smoking in adults

Alcohol consumption

Obesity in adults

Overweight and obesity in

children

20th/34

19th/34

27th/34

32nd/34

4

20th/23

Quality: a mixed and mediocre picture

Health status indicators UK in the OECD

Asthma and COPD hospital

admission

Diabetes hospital admission

Case-fatality for heart attach

(admission-based)

Case-fatality for stroke

(admission-based)

Cervical cancer survival

22nd/32

5th/29

20th/32

19th/31

21st/23

5

Breast and colorectal cancer

survival

Access: a strong performance

Health status indicators UK in the OECD

Share of out of pocket medical

expenditure in household

consumption

Unmet medical care needs

Unmet dental care needs

Waiting times – cataract

surgery (median)

Waiting times – knee

replacement (median)

3rd/34

9th/23

8th/24

4th/14

2nd/14

6

Resource levels are still relatively low

UK per capita spend on health is below the

OECD average

Health expenditure per capita USD PPP, 2013 (or nearest year)

Note: Expenditure excludes investments, unless otherwise stated.

1. Includes investments.

2. Data refers to 2012. Source: OECD Health Statistics 2015, http://dx.doi.org/10.1787/health-data-en; WHO Global Health Expenditure Database.

USD PPP

8 7

13

6 3

25

5 8

62

5 1

31

4 9

04

4 8

19

4 5

53

4 5

53

4 3

71

4 3

51

4 2

56

4 1

24

3 8

66

3 7

13

3 6

77

3 6

63

3 4

53

3 4

42

3 3

28

3 2

35

3 0

77

2 8

98

2 5

14

2 5

11

2 4

28

2 3

66

2 2

75

2 0

40

2 0

10

1 7

19

1 6

53

1 6

06

1 5

73

1 5

42

1 5

30

1 4

71

1 3

80

1 2

16

1 1

21

1 0

48

94

1

86

4

64

9

29

3

21

5

0

1000

2000

3000

4000

5000

6000

7000

8000

9000

Public Private

Average growth rate per capita in real terms has

been flat since 2009

Annual average growth rate in per capita health expenditure, real terms, 2005 to 2013 (or nearest year)

1. Mainland Norway GDP price index used as deflator. 2. CPI used as deflator. Source: OECD Health Statistics 2015, http://dx.doi.org/10.1787/health-data-en.

5.4

-0.4

5.3

1.3

3.5

0.5

3.4

0.4

3.2

5.4

3.6

3.5

6.7

3.2

3.4

11.3

4.1

-2.3

1.5

2.2

1.7

5.0

1.9

1.7

2.3

3.3

1.7

2.9

2.8

8.4

1.3

1.9

3.2

9.0

5.9

-7.2

-4.3

-4.0

-3.0

-1.7

-1.6

-0.8

-0.4

-0.3

-0.2

-0.1

0.3

0.3

0.5

0.6

0.6

0.6

0.8

0.9

1.0

1.0

1.2

1.2

1.3

1.5

1.7

1.7

2.0

2.0

2.3

2.5

3.6

3.9

5.4

6.4

-10

-5

0

5

10

152005-2009 2009-2013

Annual avera

ge g

row

th r

ate

(%

)

High bed occupancy rate (rising slightly from 2000

to 2010) which suggests efficient use of

resources…

Occupancy rate of curative (acute) care beds, 2000 and 2013 – latest data is 2010 for the United Kingdom

… and short (and falling) average lengths of

stay in hospitals

Average length of stay in hospitals, 2000 and 2013

UK is already doing well at increasing the volume

of generic pharmaceuticals in the market

Source: Health at a Glance 2015

Trend in share of generics (in volume) in pharmaceutical market, 2000 to 2013

UK

Germany

Italy

Switzerland

Lower than average numbers of doctors…

Practicing doctors per 1 000 population, 2000 and 2013

6.3

5.0

4.3

4.3

4.1

4.0

4.0

3.9

3.8

3.7

3.6

3.6

3.4

3.4

3.4

3.3

3.3

3.3

3.3

3.2

3.0

3.0

2.8

2.8

2.8

2.7

2.6

2.6

2.6

2.3

2.2

2.2

2.2

1.9

1.8

0

1

2

3

4

5

6

7

2013 2000Per 1 000 population

1. Data include not only doctors providing direct care to patients, but also those working in the health sector as managers, educators, researchers, etc. (adding another 5-10% of doctors). 2. Data refer to all doctors licensed to practice (resulting in a large over-estimation of the number of practising doctors in Portugal, of around 30%).

Source: OECD Health Statistics 2015, http://dx.doi.org/10.1787/health-data-en.

Access to care is good… but health risk factors

are undermining population health

Access in the UK is good – low out-of-

pocket spending

Out-of-pocket medical spending as a share of final household consumption, 2013

Access in the UK is good – low unmet need

Unmet care needs for medical examination, by income level, 2013

• UK has very little unmet need for medical examination, and very low variation in need by income

• Waiting times for planned interventions are now lower than in most other OECD countries

• Coverage of vaccinations, for example influenza for the over 65s, is also good and has been improving.

Health risk factors are undermining

population health: obesity…

Obesity among adults, 2013 (or nearest year)

Health risk factors are undermining

population health: smoking…

Change in daily smoking in adults, 2000 and 2013 (or nearest year)

Health risk factors are undermining

population health: alcohol

Alcohol consumption among adults, 2000 and 2013 (or nearest year)

UK is a quality policy innovator… but quality

of care outcomes are mediocre

In some areas quality outcomes are good…

• On some indicators UK is doing well – which reflects well on the primary care sector

• ‘Avoidable admissions’ for diabetes and congestive heart failure are low, as are amputations for diabetics

• Though antibiotic prescribing is slightly above the OECD average, prescribing of 2nd line antibiotics is very low

Major lower extremity amputation in adults with diabetes, 2013 (or nearest year)

Care seems to being delivered in a timely

way

Hip fracture surgery initiation after admission to hospital, 2013 (or nearest year)

Outcomes for acute care are mediocre

Thirty-day mortality after admission to hospital for AMI based on admission data, 2003 to 2013 (or nearest years)

Outcomes for acute care are mediocre

Thirty-day mortality after admission to hospital for ischemic stroke based on admission data, 2003 to 2013 (or nearest years)

Above average screening rates but below

average survival for cancer

Conclusions

• Access to care is very good, but population health

is undermined by high levels of smoking,

drinking and obesity.

• England is the pioneer in quality policies, but

basics are still not done right -- investing in

community care; adequate staffing so that

procedures and guidelines can be properly

followed; flow and quality of clinical information

• Per capita spending on health is close to the

OECD average, but below peers such as Ireland,

the Netherlands, Germany, France or Australia.

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