Publications & Documents

This is the first in a series of three reports that explore how science was mobilised in response to the COVID-19 pandemic. The focus is on policy for science – access to data and information, the role of infrastructures and the interface between academia and industry. The report includes recommendations and options for policy action to improve the resilience of national science systems and their capacity to co-operate internationally in response to crises. The context in each country is different, as illustrated by the many case studies included in the report, and so the priority attached to these recommendations and the specific details of how they might be implemented will vary. They are provided as an overall framework for science policymakers and other actors, including research funders and research providers, to consider.

Lithuania is one of the fastest-ageing countries in Europe. Its working-age population is not only ageing, but also expected to decline significantly, giving rise to considerable economic, labour market, social and public governance challenges. The inclusion of older persons has improved in many areas in the past two decades. Yet, many Lithuanians aged 55 and over continue to lag in fully engaging in society relative to younger people and their peers in neighbouring countries. This report takes a holistic approach to analyse Active Ageing policies in Lithuania in three dimensions: labour market inclusion, social policies, and participation in public and political life. It provides tailored policy recommendations to improve the well-being of older people in Lithuania in terms of better employment and lifelong learning outcomes, stronger integration in society, and participation in democratic institutions and processes.

This report presents an in-depth cross-country analysis of how long-term care workers fare along the different dimensions of job quality. In the initial stages of the COVID-19 pandemic, the applause for care workers was a clear expression of the strong recognition of their hard work and exposure to risks in their job. However, as the applause faded after the peak of the crisis, questions have re-emerged about how to improve the working conditions of long-term care workers in a sustainable way. Over the coming decades, the demand for these workers will increase substantially. Several countries are already facing shortages as the large baby-boom generation joins the older population. To go Beyond Applause, a comprehensive policy strategy is needed to tackle poor working conditions and insufficient social recognition of long-term care work, attract workers in the sector and avoid labour shortages reaching unacceptable levels. Such a strategy should cover several dimensions, with different priorities across countries depending on their specific context, including: direct interventions to raise wages and increase staff requirements; increasing public financing and fostering the leading role by governments; supporting collective bargaining and social dialogue; strengthening training; increasing use of new technologies; and, strengthening health prevention policies.

The Menzis Shared Savings Program was initiated in 2014 by the Dutch insurer Menzis and the national primary care organisation Arts en Zorg, and is among the first value-based payment models for primary care in Europe. It runs as a complement to the current – volume-driven – primary care payment system. This paper reviews the evidence of the impact of this programme against its stated objectives. The Menzis Shared Savings Program led to a lower volume of care, particularly in terms of referrals to specialist care, laboratory care and general practitioners care. Main facilitating factors were the advanced data infrastructure in place, communication and transparency about the programme’s parameters, and the programme’s focus on mitigating financial risk and uncertainty for providers. Shared savings models – even when added as a mere complement to existing volume-driven payment methods – could enhance value in health systems.

The Health System Performance Assessment (HSPA) framework for Estonia acts as a tool for stakeholders and policy makers to guide health reforms in an evidence-based and targeted manner. This report outlines the Estonian HSPA framework and documents its development through a highly inclusive and consultative process. It also reports on indicators that were selected to populate the first Estonian HSPA report, their selection criteria and core methodologies, and describes the HSPA governance structure, implementation plan, and HSPA capacity building. The report provides a guideline to embed the HSPA in Estonian governance processes in a sustainable manner. Implementing the HSPA will improve systematised public reporting on the health system performance in Estonia, thus increasing transparency and accountability of stakeholders and public awareness and involvement in the health system policy making.

The 2018 OECD report Pharmaceutical Innovation and Access to Medicines noted that fostering competition in both on- and off-patent markets can improve the efficiency of pharmaceutical spending. Various policies are used to promote competition among off-patent medicines, but generally do not induce competition in on-patent markets. While tendering is widely used for hospital and other institutional purchasing, it is less common for ambulatory care medicines, or where medicines are reimbursed rather than supplied directly. As part of its broader work agenda on 'Increasing the transparency of pharmaceutical markets to inform policies', this paper explores how payers could harness competition to improve the efficiency of spending on medicines still subject to patent protection or regulatory exclusivity. The OECD undertook an extensive analysis consisting of two parts: 1) a quantitative analysis using product-level time series sales data to explore whether therapeutic competition occurs, and, if so, how it has affected prices and volumes over time, based on a sample of countries and therapeutic classes and 2) a review of current practices and policies on pricing, coverage and procurement of on-patent medicines to identify whether these have been influencing competition between alternative therapeutic products. This report presents the key findings from this analytical work.

The health system performance assessment (HSPA) framework for the Czech Republic is an initiative designed to help the Czech health system improve policy planning, monitoring, and decision taking. This report describes the HSPA framework for the Czech Republic, its development process, governance structure and implementation roadmap. It also details the Czech HSPA framework domains, populated by indicators selected through a comprehensive review process. As such, the framework enables the assessment of strengths and weaknesses of the Czech health system. Its implementation will increase the accountability of national authorities and principal healthcare stakeholders, improve public involvement, smooth flow of information across the health sector, and allow reform planning and monitoring.