A report on health care has found that a significant share of health spending in OECD countries is at best ineffective and at worst wasteful.

‘Tackling Wasteful Spending on Health’ says that at a time when public budgets are under pressure worldwide, around one fifth of health expenditure likely makes no or minimal contribution to good health outcomes. In other words, governments could spend significantly less on health care and still improve patients’ health.

Efforts to improve the efficiency of health spending at the margin were no longer good enough, it said.

According to the report:

• One in 10 patients in OECD countries is unnecessarily harmed at the point of care.

• More than 10 per cent of hospital expenditure is spent on correcting preventable medical mistakes or infections that people catch in hospitals.

• One in three babies is delivered by caesarean section, whereas medical indications suggest that C-section rates should be 15 per cent at most.

• The market penetration of generic pharmaceuticals – drugs with effects equivalent to those of branded products but typically sold at lower prices – ranges between 10-80 per cent across OECD countries.

• A third of OECD citizens consider the health sector to be corrupt or even extremely corrupt.

“Actions to tackle waste are needed in the delivery of care, in the management of health services, and in the governance or health care systems,” the report said.

Strategies to reduce waste can be summed up as: i) stop doing things that do not bring value: for example, unnecessary surgeries and clinical procedures; and ii) swap when equivalent but less pricy alternatives of equal value exist: for example, by encouraging the use of generic drugs, developing advanced roles for nurses, or ensuring that patients who do not require hospital care are treated in less resource-consuming settings.

“Change requires challenging embedded habits and vested interests and investing in credible alternatives to existing costly solutions,” it acknowledged.

“With as much as nine per cent of GDP spent on health care systems across the OECD, three-quarters of which is by governments, all stakeholders must now contribute to the solution.”

The report is available online at www.oecd.org/health/tackling-wasteful-spending-on-health-9789264266414-en.htm

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