In the ongoing debate about the quality and cost of U.S. healthcare, it’s easy to forget that these are actually international problems. While the disparity between cost and quality may be most glaring in the U.S., other countries also face significant issues. At the same time, healthcare practices in other nations can be models for change in one’s own country. The Office of Economic Cooperation and Development (OECD) has undertaken a substantial project to analyze member countries’ healthcare practices:
OECD Healthcare Quality Reviews seek to highlight and support the development of better policies to improve quality in health care, to help ensure that the substantial resources devoted to health are being used effectively in supporting people to live healthier lives.
Their first report, from February of this year, covers healthcare in South Korea. It comes to some interesting conclusions. First of all, it points out that South Korea faces a significant cost inflation problem:
Since 2002, health spending in Korea has grown at nearly 8% each year, more than double the OECD annual average of 3.6%. That’s in large part due to an over-reliance on hospitals. Korea has 55 hospitals per million people with 8.3 beds per 1000 people, many more than most OECD countries relative to the size of its population.
Despite a rapid increase in investment, hospitals and new technologies, the OECD’s Health Care Quality Review finds that the Korean health system is not delivering proportionately higher quality care and suggests that better care in the community could both improve health outcomes and reduce the number of hospital visits.
Cost inflation out of whack with quality is a familiar issue to anyone who follows healthcare in the U.S. The report goes on to make a number of interesting recommendations:
To help the Korean government and health sector focus on keeping people healthy and out of hospital, the report recommends:
- Building a stronger primary care system by increasing financial support for preventive healthcare and patient counselling in community-based clinics, and reducing doctors’ reliance on minor surgical procedures and diagnostic tests to support their incomes.
- Financially rewarding hospitals according to the appropriatness of their services rather than the number of services they deliver, by adopting Diagnostic-Related-Group based financing across the entire Korean hospitals sector.
- Making the most of its world-class health information infrastructure to identify and reward those health services that deliver high quality of care and target services to patients who need them most.
- Expanding current quality of care strategies beyond select institutions to the entire health system including accreditation for all hospitals, upgrading the skills of health professionals and encouraging the use of clinical practice guidelines.
The full report on South Korea is at this link. A report on Israel will be released later this year. PBS Newshour conducted an in-depth interview with Matthias Rumpf of the OECD on these issues back in November of 2011, and you can read the OECD 2011 Health At A Glance report here.