Discussion of oecd health data
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Discussion of “OECD Health Data”. major progress with SHA and indicators importance of Ministerial endorsement appreciating broader determinants of health and “what works” –versus – primacy of costs and “sustainable financing” caution re over reliance on SNA concepts. Michael Wolfson

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Discussion of “OECD Health Data”

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Discussion of oecd health data

Discussion of “OECD Health Data”

  • major progress with SHA and indicators

  • importance of Ministerial endorsement

  • appreciating broader determinants of health and “what works” –versus – primacy of costs and “sustainable financing”

  • caution re over reliance on SNA concepts

Michael Wolfson

Statistics Canada


Hospital and in patient curative rehabilitative expenditure

Hospital and In-patient Curative-rehabilitative Expenditure

previous uncertainty


Per capita health care costs over time by use current

Per Capita Health Care Costs over Time by Use (Current $)

($1.3 billion aggregate drop)

*

(CIHI)


Discussion of oecd health data

A model for looking at data availability in OECD Health Data

Non-medical Determinants (Part 8)

The Production of Health -Related Welfare

Health Status (Part 1)

Inputs to Health Services (Part 2)

Utilization of Services (Part 3)

Social Welfare and Individual Utility

Budgeting Decisions

Purchasing Decisions

Purchasing Decisions

Demographic (Part 9)

& Economic (Part 10)

References

The Flow of Health Expenditure

Overall social protection (Part 6)

Health Expenditure(Input volumes X prices)

Health Expenditure and Financing (Taxes, Insurance, Out-of-Pocket) (Part 4, 5)

Health Expenditure (Utilization volumes X prices)

Pharma Market (Part 7)


The evans and stoddart plumbing diagram

The Evans and Stoddart “Plumbing Diagram”


Discussion of oecd health data

top quintile


Discussion of oecd health data

One year mortality rate vs. % revascularized within 14 days, AMI patients in health regions with populations over 100,000, 4 provinces, 1995/96

30

25

20

15

% revascularized within 14 days

better

10

5

0

0

5

10

15

20

25

30

Adjusted 1 year mortality rate (%)

(Johansen et. al., Stats Can, 2001)


Discussion of oecd health data

(with virtually no differences in one year survival; but what about differences in health-related QoL?)


Changes in life expectancy le and health adjusted life expectancy hale by cause

Changes in Life Expectancy (LE) and Health-Adjusted Life Expectancy (HALE) by Cause

LE

HALE

Source: Manuel et al, ICES and Health Canada, NPHS


Ons atkinson and productivity

ONS, Atkinson, and Productivity

  • mandate (from ONS National Statistician):

  • “To advance methodologies for the measurement of government output and productivity…” (OK)

  • “in the context of the National Accounts”

  • BUT: why not pose issue first in general, and then ask whether SNA is an appropriate framework for this, and if not, what would be?

  • Caution: OECD should be careful about entering this domain


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