Other Organization For Economic Cooperation And Development Countries Research Articles

Trends in National Pharmaceutical Expenditure in Korea during 2011 - 2020.

This study aimed to identify the trends in pharmaceutical expenditure (PE), share of PE in health expenditure (HE), and trends in expenditure by pharmacological groups (ATC level 1 classification) in Korea for a 10-year period (2011 - 2020) and compare the data with those of other Organisation for Economic Co-operation and Development (OECD) countries. Using the findings, we determined the current status of pharmaceutical expenditure (PE) management in Korea and derived the implications for establishing future macroscopic policies on PE. We analyzed the OECD Health Statistics and the Korean national health insurance claims database from January 2011 through December 2020. The outcome measures were HE, PE, and pharmaceutical sales data for ATC level 1 medicines from OECD Health Statistics data during 2011 - 2020. As OECD collects limited ATC level 1 data, we used the HIRA health insurance claims data for PEs of ATC level-1 classification, including D, L, P, and S. PE in Korea increased by 38.5% from 19.9 billion USD in 2011 to 27.6 billion USD in 2020, whereas the share of PE in HE decreased by 6.3%p from 26.4% in 2011 to 20.1% in 2020. In 2020, Korea ranked third in PE per capita (760.9 USD PPP) and had the highest share of PE (20.1%) among the 19 OECD countries studied. By ATC level 1 class, the highest PE was A (alimentary tract and metabolism) at 4.3 billion USD, and L (antineoplastic and immunomodulating agents) had the highest increase at 13.4%; in contrast, J (anti-infectives for systemic use) had the lowest increase in annual average PE at -0.2% in 2020 relative to 2011. Among the 17 OECD countries, Korea had the highest and the third-highest expenditures for ATC codes A and J, respectively. PE in Korea has continued to increase between 2011 and 2020, indicating the need for macroscopic management of PE. Our results on PE by ATC code may help health authorities in establishing future policies on PE.

Foreign Direct Investment in Real Estate and Related Business Services:Poland vs OECD Countries​

Poland has experienced a relatively large inflow of foreign direct investment (FDI) in the last two decades. FDI has been flowing mainly into services and manufacturing similarly to the trend observed in global capital movement. Within the services, the financial intermediation played the biggest role in terms of attracting FDI, but real estate and related business activities (legal, accounting, auditing, tax, marketing, etc.) also saw a high inflow of foreign capital. The paper analyzes the evolution of inward FDI stock in Poland over the period 1998–2012 with a particular emphasis on real estate and related business activities. It also discusses how Poland differs in terms of sectoral decomposition in the services of inward FDI stock from other Organization for Economic Cooperation and Development (OECD) countries representing both Central and Eastern Europe (CEE) and advanced economies. Finally, the paper answers the question how Poland is performing relative to other OECD members in terms of FDI attractiveness.

Bathtub drowning mortality among older adults in Japan

We examined the bathtub drowning mortality among older adults in Japan. Mortality data from Japan and 30 other Organization for Economic Co-operation and Development (OECD) countries were extracted from World Health Organization Cause of Death Query Online. During 2012–2014, unintentional drowning mortality rates in Japan were 9.5, 28.2 and 39.7 per 100,000 population for adults aged 65–74, 75–84 and ≥85 years, respectively—rates highest among the 31 OECD countries. In total, 6377 older adults aged ≥65 years died from unintentional drowning in 2014, of which 4857 (76%) deaths involved bathtubs. During 1995–2014, the bathtub drowning mortality rate for adults aged ≥65 years was stable in Japan. During 2011–2014, approximately 4800 older adults died from bathtub drowning annually. Death predominantly occurred ‘while in a bathtub’, rather than ‘following a fall into a bathtub’. In 2014, 95% and 87% of bathtub drowning deaths among older women and men aged ≥65 years, respectively, occurred at home. In conclusion, bathtub drowning deaths at home is an important public health problem among older adults Japanese and efforts are needed to reduce these preventable deaths.

Foreign Direct Investment in Real Estate and Related Business Services: Poland vs OECD Countries

Poland has experienced a relatively large inflow of foreign direct investment (FDI) in the last two decades. FDI has been flowing mainly into services and manufacturing similarly to the trend observed in global capital movement. Within the services, the financial intermediation played the biggest role in terms of attracting FDI, but real estate and related business activities (legal, accounting, auditing, tax, marketing, etc.) also saw a high inflow of foreign capital. The paper analyzes the evolution of inward FDI stock in Poland over the period 1998–2012 with a particular emphasis on real estate and related business activities. It also discusses how Poland differs in terms of sectoral decomposition in the services of inward FDI stock from other Organization for Economic Cooperation and Development (OECD) countries representing both Central and Eastern Europe (CEE) and advanced economies. Finally, the paper answers the question how Poland is performing relative to other OECD members in terms of FDI attractiveness.

Life expectancy ranking of Canadians among the populations in selected OECD countries and its disparities among British Columbians.

BackgroundCanada is among the world’s leading nations with the longest life expectancy at birth (LE0), and British Columbia (BC) ranks top among Canadian provinces and territories for LE0 in both men and women. This paper examined recent data as well as projected trends in LE0 of Canadian men and women and explored the geographic and socioeconomic disparities in LE0 specific to BC.MethodsUsing retrospective data on LE0 and age-standardized mortality rates, Canada was compared to 11 other Organization for Economic Cooperation and Development (OECD) countries with the longest LE0. Projections were made using linear regression modelling to the year of 2023. The association between regional LE0 and regional socioeconomic status (SES) was examined for the province of BC using its Local Health Area (LHA) level data on SES and LE0.ResultsIn 2009, Canadian men (LE0: 78.7 years) and women (LE0: 83.3 years) ranked 7th and 8th, respectively among the 12 OECD nations under comparison. Significantly smaller annual gains in LE0 contributed to the losing of their top ranks in LE0 for Canadian men and women in recent years, which was projected to sustain. Higher mortality risks, particularly for lung cancer and external causes of mortality among women was found for Canada compared to leading countries on these measures. Geographic variations were evident in LE0 in BC, and there was a significant gap of 3.6 years in the average LE0 for BC’s LHAs in the lowest SES tertile (78.6 years, 95% CI: 78.0-79.3) compared to those in the highest SES tertile (82.2 years, 95% CI: 81.6-82.8).ConclusionsCanada continues to remain one of the OECD countries with longest living population. With the highest LE0 in the country, British Columbia has an opportunity to address socio-economic disparities in LE0.

Participation, Persistence, and Attainment Rates: The US Standing

Several recent reports in the United States have compared the American performance in higher education to that of other Organization for Economic Cooperation and Development (OECD) countries, and concern that the United States is slipping when it comes to attainment rates in tertiary education. However, the United States continues to have among the highest participation rates among OECD countries, below average rates of completion, among the highest attainment rates for bachelor's degrees, and average to below average attainment rates for subbachelor's degrees. One key conclusion from this analysis is that a key challenge for the United States is to figure out how to improve the degree completion rate of its community college students.

Canada's pregnancy-related mortality rates: doing well but room for improvement.

Canada's perinatal, infant and maternal mortality rates were examined and compared with other Organization for Economic Cooperation and Development (OECD) countries. The type and the quality of the available data and best practices in several OECD countries were evaluated. A literature search was performed in PubMed and the Cochrane Library. Vital statistics data were obtained from the OECD Health Database and Statistics Canada and subjected to secondary analysis. Overall, Canadian pregnancy mortality rates have fallen dramatically since the early 1960's. Perinatal and infant mortality rates remain low and stable, but the maternal mortality rate has increased slightly and both mortality rates have declined in their relative OECD rankings over the last 20 years. Data quality and coverage across Canada and internationally, especially for Indigenous peoples, is inconsistent and registration practices differ greatly, making comparisons difficult. Available data do show that Indigenous people's perinatal and infant mortality rates are nearly twice those of the general population. Best practices in other OECD countries include Australia's National Maternity Services plan to improve Aboriginal perinatal health, the Netherlands' midwifery services and National Perinatal Registry and Japan's national pregnancy registration and Maternal Handbook. To diminish Canadian disparities in perinatal health rates and improve health outcomes we recommend a) uniform registration practices across Canada, b) better data quality and coverage especially among Indigenous communities, c) adoption of a national pregnancy registration and a maternal handbook along with d) improved midwifery and primary practice services to rural and remote communities. At a time when Canada is focusing upon improving pregnancy health in developing nations, it also needs to address its own challenges in improving pregnancy outcomes.

Regulation and the international competitiveness of US-based companies

Purpose– The purpose of this paper is to provide and assess evidence bearing on whether government regulation in the USA is harming the international competitiveness of the US economy. A related purpose is to clarify the concept of international competitiveness from a public policy perspective.Design/methodology/approach– The paper draws on various sources comparing the regulatory environment of the USA and other Organisation for Economic Co-operation and Development (OECD) countries over the past 15-20 years, as well as the international competitiveness of those countries, particularly the productivity growth of home country firms. The various measures of regulatory quality and international competitiveness for the USA are compared to those for a sample of other OECD countries to provide empirical evidence on two broad issues: has government regulation become more onerous in the USA relative to other OECD countries? and has the USA economy become less competitive compared to other OECD countries?Findings– The evidence indicates that the US regulatory environment has become more onerous compared to other OECD countries and that the relative productivity performance of the US economy has declined in recent years. Evidence also suggests that the USA has become relatively less attractive as a location for production and research and development. While the paper does not directly link national measures of performance to measures of the regulatory environment, it provides a literature review of the empirical relationship between government regulation and private sector productivity performance. The review suggests that an apparent recent weakening of the international competitiveness of the US economy can be linked to a more onerous regulatory environment.Research limitations/implications– As noted above, the paper does not directly link in a statistical manner, data regarding the changing regulatory environment across countries to changes in measures of international competitiveness. This is the focus of future research.Originality/value– By assessing a range of measures of the regulatory environment and national economic performance, the paper provides a fairly comprehensive and nuanced assessment of frequently made claims about regulation in the USA relative to other countries, as well as the relative attractiveness of the USA as a location for private sector activity.

The changing demographics of Australia over the last 30 years

The changing demographics of <scp>A</scp>ustralia over the last 30 years

Comparative study on medical fees: caesarean section, cataract, and appendectomy surgeries among OECD countries

The question has been raised whether the medical fee schedule is very low in Korea. However, studies that empirically address this matter on a national scale are rare. This study attempted to determine the level of Korea's medical fees for caesarean section (C-section), cataract, and appendectomy surgeries by comparing and analyzing them with other Organization for Economic Cooperation and Development (OECD) countries' medical cost data obtained from other studies. There are two ways to compare the level of medical fees: one is a direct comparison, which obtains each country's medical fee schedule and compares them with each other. Another is indirect comparison, a method which compares data such as physician income. For direct comparison, fees were calculated using data provided by the OECD and Health Insurance Review and Assessment. For indirect comparison by physician income, data obtained from Korea Employment Information Services were used to represent Korean physician income. When compared with other OECD countries, the results suggest that, overall, the Korean fee schedule could be low, based on the fees for C-section, cataract, and appendectomy surgeries. The study results also confirm that Korean physicians' average earnings ranked relatively low among OECD countries. These results are meaningful in that they empirically support the contention that Korean medical fees could be low. In addition, under what is known as national health insurance, in which the medical fee schedule is determined by a single payer, an empirical analysis on medical fee levels, as in this study, has substantial political implications because it may be utilized for medical fee schedule negotiation in the near future. An attempt to directly research fees and the range of services of OECD countries is still needed in order to provide more established data.

Price and Utilization: Why We Must Target Both to Curb Health Care Costs

The United States spends nearly $8000 per person on health care annually. Even for a wealthy country, this amount is substantially more than would be expected and 2.5 times the average spent by other Organization for Economic Cooperation and Development (OECD) countries. The growth rate of health care spending in the United States has also far outpaced that in all other high-income OECD countries since 1970, even accounting for population growth. This increase in health spending threatens to squeeze out critical investments in education and infrastructure. To successfully develop and implement policies that effectively address both the level and growth of U.S. health care costs, it is critical to first understand cost drivers. Many health policy and economics scholars have contributed to an ongoing debate on whether to blame high prices or high utilization of services for escalating health care spending in the United States. This paper argues that price and volume both contribute to high and increasing health care costs, along with high administrative costs, supply issues, and the fee-for-service payment system. Initial strategies to contain costs might include implementation and expansion of bundled payment systems and competitive bidding.

Comment on “Meeting the Social Policy Challenges Facing Korea”

Comment on “Meeting the Social Policy Challenges Facing Korea”

Healthcare Financing: How Does Turkey Compare?

The authors provide an overview of Turkey's healthcare financing. After comparing financing data on Turkey and other Organization for Economic Cooperation and Development (OECD) member countries, they examine Turkey's performance on a wide range of healthcare input and outcome indicators using descriptive data drawn from the World Health Organization, World Bank, OECD, and Turkish Statistical Institute. The data analysis shows that Turkey ranks low by a number of key healthcare indicators across the OECD countries. Empirical analysis suggests that although many factors are associated with improvements in healthcare outcomes, a significant part of changes in life expectancy at birth are associated with higher spending on healthcare.

How much do we spend on prescription medicines? Out-of-pocket costs for patients in Australia and other OECD countries

To determine changes in out-of-pocket expenditure on prescription medicines for Australian patients, and how patient expenditure compares with other Organisation for Economic Co-operation and Development (OECD) countries. We examined out-of-pocket expenditure on prescription medicines by patients in Australia between 1970 and 2007, and between Australia and 15 other OECD countries (Canada, Czech Republic, Denmark, Finland, France, Germany, Japan, Republic of Korea (South Korea), Luxembourg, Poland, Slovak Republic, Spain, Sweden, Switzerland and the United States) in 2005. Spending on publicly subsidised medicines by Australian patients increased from $16 per person in 1971 to $62 in 2007. Patient expenditure on all prescription medicines had risen to $134 per person in 2007. Out-of-pocket expenditure for Australian patients ranked 4th of 14 OCED countries with universal pharmaceutical subsidies. Australian patients pay 28% of national pharmaceutical expenditure; more than patients in South Korea (27%), Slovak Republic (26%), Sweden (22%), France, Luxembourg, Japan and Switzerland (17%), Germany (15%), Czech Republic (11%) and Spain (6%), but less than patients in Finland (36%), Denmark (33%) and Poland (34%). Compared to other OECD countries, Australian out-of-pocket costs are now in the mid to upper range. Further increases have the potential to significantly affect access to care.

Facts, Fallacies, and Politics of Comparative Effectiveness Research: Part I. Basic Considerations

While the United States leads the world in many measures of health care innovation, it has been suggested that it lags behind many developed nations in a variety of health outcomes. It has also been stated that the United States continues to outspend all other Organisation for Economic Co-operation and Development (OECD) countries by a wide margin. Spending on health goods and services per person in the United States, in 2007, increased to $7,290 – almost 2½ times the average of all OECD countries. Rising health care costs in the United States have been estimated to increase to 19.1% of gross domestic product (GDP) or $4.4 trillion by 2018. The increases are illustrated in both public and private sectors. Higher health care costs in the United States are implied from the variations in the medical care from area to area around the country, with almost 50% of medical care being not evidence-based, and finally as much as 30% of spending reflecting medical care of uncertain or questionable value. Thus, comparative effectiveness research (CER) has been touted by supporters with high expectations to resolve most ill effects of health care in the United States and provide high quality, less expensive, universal health care. CER is defined as the generation and synthesis of evidence that compares the benefits and harms of alternate methods to prevent, diagnose, treat, and monitor a clinical condition or to improve the delivery of care. The efforts of CER in the United States date back to the late 1970’s even though it was officially born with the Medicare Modernization Act (MMA) and has been rejuvenated with the American Recovery and Reinvestment Act (ARRA) of 2009 with an allocation of $1.1 billion. CER has been the basis for health care decision-making in many other countries. According to the International Network of Agencies for Health Technology Assessments (INAHTA), many industrialized countries have bodies that are charged with health technology assessments (HTAs) or comparative effectiveness studies. Of all the available agencies, the National Institute for Health and Clinical Excellence (NICE) of the United Kingdom is the most advanced, stable, and has provided significant evidence, though based on rigid and proscriptive economic and clinical formulas. While CER is making a rapid surge in the United States, supporters and opponents are expressing their views. Part I of this comprehensive review will describe facts, fallacies, and politics of CER with discussions to understand basic concepts of CER. Key words: Comparative effectiveness research, evidence-based medicine, Institute of Medicine, National Institute for Health and Clinical Excellence, interventional pain management, interventional techniques, geographic variations, inappropriate care.

Timing of liver transplantation following transjugular intrahepatic portosystemic shunt in patients with Budd-Chiari syndrome

Large cost variations of liver transplantation are reported. The aim of this study was to assess cost differences of liver transplantation and clinical follow-up between the United States and other Organization for Economic Cooperation and Development (OECD) countries. Eight electronic databases were searched, and 2,000 citations published after 1990 with more than 10 transplantations, and with original cost data, were identified. A total of 30 articles included 5,975 liver transplantations. Meta-analysis was used to derive a combined mean using a random-effects model to test for heterogeneity between studies. Estimated mean cost of a U.S. liver transplantation was US$163,438 (US$145,277-181,598) compared to US$103,548 (US$85,514-121,582) for other OECD countries. Patient characteristics, disease characteristics, quality of the health care provider, and methodology could not explain this cost difference. Health system characteristics differed between the U.S. and other OECD countries. Cost differences in liver transplantation between these two groups may be largely explained by health system characteristics.

On solutions to the shortage of doctors in Australia and New Zealand

The World Health Organization estimates a current global shortage of 4.3 million health workers. Australia and New Zealand compare unfavourably with other Organisation for Economic Co-operation and Development (OECD) countries in respect to doctor numbers. The overall shortage of doctors in Australia and New Zealand is exaggerated by the disciplinary, cultural and demographic maldistribution of the doctors relative to need and utility. Australia and New Zealand are the most reliant of the OECD countries on foreign doctors. An increase in spending on health promotion and disease prevention is essential. However, it is unlikely that the demand for doctors will be significantly reduced by compressions of morbidity in the later years of life or that there will be a substantive increase in either the percentage of the community employed in health services or in the output from the current workforce. Doctor shortages are better addressed by alignment of elements of the education and health systems with each other and with patient care needs, and by innovative health provider training and employment.

Cost of Liver Transplantation

Large cost variations of liver transplantation are reported. The aim of this study was to assess cost differences of liver transplantation and clinical follow-up between the United States and other Organization for Economic Cooperation and Development (OECD) countries. Eight electronic databases were searched, and 2,000 citations published after 1990 with more than 10 transplantations, and with original cost data, were identified. A total of 30 articles included 5,975 liver transplantations. Meta-analysis was used to derive a combined mean using a random-effects model to test for heterogeneity between studies. Estimated mean cost of a U.S. liver transplantation was US$163,438 (US$145,277-181,598) compared to US$103,548 (US$85,514-121,582) for other OECD countries. Patient characteristics, disease characteristics, quality of the health care provider, and methodology could not explain this cost difference. Health system characteristics differed between the U.S. and other OECD countries. Cost differences in liver transplantation between these two groups may be largely explained by health system characteristics.