Reports

This second edition of Health at a Glance: Latin America and the Caribbean, prepared jointly by OECD and the World Bank, presents a set of key indicators of health status, determinants of health, healthcare resources and utilisation, healthcare expenditure and financing, quality of care, health workforce, and ageing across 33 Latin America and the Caribbean countries. Each of the indicators is presented in a user-friendly format, consisting of charts illustrating variations across countries, and over time, brief descriptive analyses highlighting the major findings conveyed by the data, and a methodological box on the definition of the indicators and any limitations in data comparability. This edition of Health at a Glance: Latin America and the Caribbean also provides thematic analyses on two key topics for building more resilient health in the LAC region: the impact of the COVID-19 pandemic on LAC healthcare systems, and climate change and health.

Innovative providers’ payment models represent an important policy lever that could be used to promote value-based health systems. By bundling services across the continuum of care or to target acute events or chronic conditions, innovative payment models set financial incentives for providers to increase efficiency in service delivery, improve health outcomes and enhance patient experience with care. This paper offers insights on value-based payment models, a type of innovative payment model implemented in several OECD countries and reviews the publicly available evidence on the impact of those payment models on value. Innovative payment models tend to be exceptional and small-scale compared to activity-based payment models and have been extensively piloted in the United States while implementation and evaluation in other countries is limited. The publicly available empirical evidence points to modest efficiency and quality gains from value-based payment models. Impact on healthcare spending, outcomes and patient experience varies across programmes. Given the significant variation in the key features of value-based payment models and the context-specific issues they address, those models do not offer a one-size-fits-all solution. This paper outlines several intervention points that policy makers need to consider when designing and implementing value-based payment models to maximise their positive outcome.

This report quantifies the environmental, health and economic consequences of policy action on air pollution in Arctic Council countries, with a focus on sectoral differences. The report takes a modelling approach and compares a baseline scenario that reflects current legislation, with a policy scenario in which the best available techniques to reduce emissions are deployed in all emitting sectors. The report highlights that benefits from air quality improvements can be obtained when considering emission reductions throughout the economy, and not just in the sectors that are targeted more often, such as industry and transport. The results presented in the report also highlight the need for country-specific policy strategies that take into account the current levels of policy stringency, the sectoral contributions to air pollution, and the need for sectoral investment in new technologies, which also vary by country.

Good mental health is a vital part of people’s well-being, and the COVID-19 pandemic brought renewed attention to its importance. However, discussions so far have not focused sufficiently on how governments should best monitor it at the broader population level, and on how to consider both mental ill-health and positive mental states. This report supports national statistical offices and other data producers in collecting high-quality measures of population mental health outcomes in a more frequent, consistent and internationally harmonised manner. It documents existing measurement practice across OECD countries, discusses the advantages and limitations of available measurement tools, and recommends priority measures to adopt in household, social and health surveys. Measuring Population Mental Health is the first of two reports as part of an assessment of mental health and well-being in the context of the OECD's work on measuring well-being.

The provision of key health technologies and products such as vaccines and antibiotics is insufficient in purely competitive and volume-based markets, requiring new revenue streams for sustainability. Recent developments in health innovation suggest that innovative collaborative mechanisms can be effective in addressing this issue. In the domains of vaccines and antibiotics, these approaches should incorporate shared research investment, long-term access planning, the provision of manufacturing infrastructure, supply chains, and financial returns. Collaborative approaches such as subscription models could be piloted at the regional level, while other models could be developed to delink innovation, manufacturing, and access from sales volume and revenue. Finally, blended finance instruments from the development field could encourage greater collaboration among established and emerging stakeholders in health innovation. These stakeholders should work together to create, test, access, and implement more collaborative approaches to health innovation to share upfront investments, mitigate risks of failure, and accelerate market access.

The COVID 19 pandemic has disproportionately hit some vulnerable population groups. Those living in deprived areas, migrant population, and ethnic minorities are at higher risk of catching and dying from the virus than other groups, and they also face significant indirect health impacts of the COVID-19 pandemic - both mental health impacts and disruption of routine care. The working paper gathers evidence on the direct and indirect health impacts of the COVID-19 on the poor population and the ethnic minorities. It reviews factors underlying these inequalities, and maps policy interventions adopted by OECD countries to help address the disproportionate impacts of the COVID-19 pandemic on vulnerable population groups.

The COVID-19 pandemic has highlighted that access to timely health spending data is crucial for informed policy-making. This Health Working Paper summarises and compares the methodologies applied in around half of OECD countries to estimate public and private health spending for the most recent year (i.e., t-1) as well as the approaches taken by the OECD Secretariat to fill existing data gaps for the remaining OECD countries. For the first time, the paper also explores the feasibility of nowcasting health spending for the current year (i.e., t) and examines data sources that could be potentially useful in such an exercise. While this review should help OECD countries that do not yet have experience in estimating health spending for year t-1 to improve the timeliness in their data reporting, the paper also analyses the applicability of the methods in low- and middle-income countries.

The COVID-19 pandemic had massive consequences for societies and health systems across the OECD and beyond. Health systems were not resilient enough. Resilient health systems plan and are ready for shocks, such as pandemics, economic crises or the effects of climate change. They are able to minimise the negative consequences of crises, recover as quickly as possible, and adapt to become better performing and more prepared. Smart, targeted investments in health system resilience are needed to improve health and ensure the next shock is less disruptive and costly. This report reviews the lessons of the COVID-19 pandemic and applies them to build policy recommendations to ensure the global community is ready for the next crisis. The reviews and recommendations cover health system issues – including workforce, digitalisation, continuity of care and mental health – and other topics, including long-term care, supply chains and international co-operation.