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Comparing Health Care Systems Performance: Opportunities for Learning from Abroad

Comparing Health Care Systems Performance: Opportunities for Learning from Abroad. Alliance for Health Reform April 11, 2008 Robin Osborn Vice President and Director International Program in Health Policy The Commonwealth Fund.

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Comparing Health Care Systems Performance: Opportunities for Learning from Abroad

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  1. Comparing Health Care Systems Performance: Opportunities for Learning from Abroad Alliance for Health Reform April 11, 2008 Robin Osborn Vice President and Director International Program in Health Policy The Commonwealth Fund

  2. US Scorecard: Falls Short of Benchmarks on All Dimensions of a High Performance Health System • 37+ Indicators • U.S. compared to benchmarks Source: Commonwealth Fund National Scorecard on U.S. Health System Performance, 2006 2

  3. Average spending on healthper capita ($US PPP) Total expenditures on healthas percent of GDP International Comparison of Spending on Health, 1980–2004 Data: OECD Health Data 2007 (October 2007)

  4. Health Care Expenditure per Capitaby Source of Funding in 2005Adjusted for Differences in Cost of Living b a a2004 b2002 Source: OECD Health Data 2007

  5. Utilization of Health Care Services Average Length of Stay in Hospital in 2005 Average Number of Physician Visits per Capita in 2005 a a c a a a a b a2004 b2003 cSource: NZ Ministry of Health, 2004 Source: OECD Health Data 2007 (October 2007)

  6. Coronary Bypass Procedures per 100,000 population in 2005 a a a a a2004 Source: OECD Health Data 2007 (October 2007)

  7. Spending on Physician Services per Capita in 2005 Adjusted for Differences in Cost of Living a a2004 Source: OECD Health Data 2007 (October 2007)

  8. 8 Percentage of Total Health Care Spending on Health Insurance Administration in 2005 a a a a2004 Note: Total health care spending on health insurance administration includes insurer costs only. Source: OECD Health Data 2007 (October 2007)

  9. Mortality Amenable to Health Care, 2002-03 Mortality from causes considered amenable to health care is deaths before age 75 that are potentially preventable with timely and appropriate medical care. Deaths per 100,000 population* * Countries’ age-standardized death rates, ages 0–74; includes ischemic heart disease DATA: International: WHO mortality database from Nolte and McKee 2008

  10. Unable to Get Needed Care Because of Costs* Percent reporting yes * Percent reporting “yes” to at least one of the following in the past year: Did not fill a prescription or skipped doses; had a medical problem but did not visit a doctor; skipped test, treatment or follow-up. Source: 2007 Commonwealth Fund International Health Policy Survey

  11. Relationship with Regular Doctor Source: 2005 Commonwealth Fund International Health Policy Survey: Adults with Health Problems

  12. Access to Primary Care Able to Get Same Day Appointment with Doctor ER Use for Condition Doctor Could Have Treated if Available Percent Percent Source: 2007 Commonwealth Fund International Health Policy Survey

  13. Deficiencies in Care Coordination: Test or Records Not Available for Appointment/Duplicate Tests Ordered Percent Source: 2007 Commonwealth Fund International Health Policy Survey

  14. Medical Mistake, Medication, or Lab Error in Past 2 Years* Percent any error *Patient reports of medical mistake, medication error, or error in lab results (incorrect results or delay in getting abnormal results). Source: 2007 Commonwealth Fund International Health Policy Survey

  15. Primary Care Practices With Electronic Medical Records Percent Source: 2006 Commonwealth Fund International Health Policy Survey of Primary Care Physicians

  16. Primary Care Doctors’ Reports ofFinancial Incentives Targeted on Quality of Care * Receive or have the potential to receive. Source: 2006 Commonwealth Fund International Health Policy Survey of Primary Care Physicians.

  17. Overall Views of the Health Care Systemin Seven Countries, 2007 Source: 2007 Commonwealth Fund International Health Policy Survey

  18. Summary of Findings • Country patterns reflect underlying strategic policy choices • Universal coverage matters • National policies and leadership matter • Having a national “system” matters • Aligning financial incentives can enhance quality and value • Primary Care “redesign” is key to improving health system performance

  19. Acknowledgements With great appreciation to Meghan Bishop, Cathy Schoen, Karen Davis, and Stephen C. Schoenbaum for their contributions to this presentation

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