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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

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Discussion of “OECD Health Data”

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  1. 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

  2. Hospital and In-patient Curative-rehabilitative Expenditure previous uncertainty

  3. Per Capita Health Care Costs over Time by Use (Current $) ($1.3 billion aggregate drop) * (CIHI)

  4. 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)

  5. The Evans and Stoddart “Plumbing Diagram”

  6. top quintile

  7. 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)

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

  9. Changes in Life Expectancy (LE) and Health-Adjusted Life Expectancy (HALE) by Cause LE HALE Source: Manuel et al, ICES and Health Canada, NPHS

  10. 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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