Quality, access and affordability are at the heart of reforms to successfully enhance universal health coverage.

The OECD monitors and evaluates these key aspects of universal health coverage, and assesses the future sustainability of universal health systems. OECD country experiences can also offer valuable lessons for other countries seeking to attain universal health coverage.

Monitoring the quality of health services

Quality is too often a forgotten element of universal health coverage. Yet poor quality and unsafe care harms lives and wastes scarce resources. Monitoring quality is therefore essential. OECD countries have developed the most comprehensive body of knowledge worldwide on measuring the quality of health services.

• Universal health coverage and measuring quality
• Healthcare Quality and Outcomes project
• Quality of Care Reviews
• Health at a Glance: Europe 2022, Asia/Pacific 2022, OECD 2021, and LAC 2023 

Access: evaluating which services should be covered

New medical technologies widen the range of treatment options available, but can be expensive. Rather than compromise population coverage or increase cost-sharing, a better approach is to be more specific in defining the treatments covered. Current OECD work assesses how countries determine the range of services included in benefit baskets.

• The range of benefits covered in OECD countries
  (OECD Health Working Paper No. 90)

Access: ensuring skilled health workers are in place

Health workers play a key role in enabling access to health services. Yet there are wide staffing variations both across and within countries. The OECD is working with ILO and WHO to deliver the Working for Health programme to support countries implement the recommendations from the Commission on Health Employment and Economic Growth.

The OECD has reviewed how countries could improve health workforce planning and innovative provider payment reforms.

• Health workforce planning
• Geographic imbalances in doctor supply and policy responses
• Nurses in advanced roles
• Better ways to pay for healthcare 

Affordability: tracking health expenditures

Using health services should not lead to financial hardship. Appropriate health financing policies can mitigate this risk so that cost-sharing is never excessive. The System of Health Accounts provides a transparent framework for tracking health expenditures.

• Universal health coverage and monitoring spending
• System of Health Accounts
• Health Expenditure Data