Latest Documents

The report analyses the performance of Lithuania’s health system which has been long characterised by its institutional stability and the steady pursuit of a policy agenda aimed at adapting it to the evolving burden of disease. Today, even if total spending on health is low and out-of-pocket payments represent nearly a third of it, the system ensures fairly equitable access to care. The main challenge to the system is that health outcomes still place Lithuania among the lowest ranked in the OECD. Efforts need to be geared more systematically towards strengthening public health and improving the quality of the services delivered at primary and hospital care levels.

This report assesses how Kazakhstan measures up in the development and application of its national health accounts, delivering a set of recommendations to improve the country’s health care financing information. As Kazakhstan has made significant economic progress over recent decades, health has risen on the policy agenda with a number of sector reforms introduced to modernise the system and improve the health of the population. Informing this agenda and monitoring progress towards health system goals requires accurate, timely and comprehensive information on health care financing and spending. A clear understanding of the resource allocations and drivers in the health sector is a prerequisite to support health system performance in Kazakhstan.

Kazakhstan has made significant economic progress over recent decades. Health has risen on the policy agenda with a number of sector reforms introduced to modernise the system and improve the health of the population. This review uses globally recognised frameworks and indicators to evaluate Kazakhstan’s overall health system as well as its primary care and hospital sectors. Data provided by Kazakhstan is used to benchmark the various dimensions of performance with that of OECD countries. While the review points to notable successes, Kazakhstan continues to face challenges to improve the accessibility, equity, and efficiency of health services. To strengthen health system performance, the report points to key actions that Kazakhstan should consider prioritising in the coming years.

There are important differences in the markets for medicines in countries in Asia and the Pacific in this study. These are mainly due to the political, financial and regulatory environments as well as characteristics of the pharmaceutical manufacturing industry. However, all countries face the test of transition brought about by demographic changes, shifting epidemiological trends and increasing inequities, among others. As with other regions of the world, a characteristic of lower- and upper-middle-income countries is that pharmaceuticals account for a high proportion of health expenditures. Medicines account for a larger share of the health budgets in resource-constrained countries.

Peru has seen great progress towards the goal of providing universal health coverage to its population but still faces structural barriers to provide accessible and quality care . At the same time, Peru is going through a demographic and epidemiological transition, with an increasing disease burden from non-communicable diseases, with significant increases in cancer, CVD and diabetes, especially in urban areas. Measuring how the Peruvian health system is responding to these challenges requires a solid set of health sector statistics and indicators, underpinned by a robust health information system. The breadth and depth of data must be relevant and applicable to decision making at all levels of the health system, both to respond to national policy needs as well as comparing Peru in a regional and global context. This report assesses the status and availability of Peru’s routinely reported health sector data and statistics as well as the underlying data infrastructure. The report provides a set of recommendations to improve the health information system and to strengthen data coverage and comparability as Peru’s health care system develops.

This is the OECD’s first Health System Review of Peru. It seeks to support Peru’s policy goal to attain universal health coverage by 2021, and build a high-performing health system with continuously improving accessibility, quality, efficiency and sustainability. Peru’s health care system is confronting a complex set of challenges. The population faces persistent rates of infectious diseases, alongside an increasingly heavy burden of non-communicable disease. Governance must simultaneously grapple with how to assure basic access – universal health coverage has still not been achieved, for instance – while prioritising efficiency and value for money, and improving care quality. This Health System Review of Peru makes a number of recommendations to strengthen performance of the health system, with a particular focus on the government-subidised health system – the Sistema Integral de Salud. Using examples of best practice drawn from OECD and Latin American health systems, the Review addresses how Peru can promote access to high quality care and achieve universal health coverage; take a more strategic approach to funding, budgeting, and purchasing; and become a data-driven health system that puts people at the centre.

This report puts forward policy recommendations for strengthening the performance and sustainability of the health care system in Costa Rica. There is much to praise in Costa Rica’s health care system: institutional stability; a closely integrated but well-differentiated provider arm, with strong primary care; a degree of inter-sectoral co-ordination that serves as a model of good practice; detailed and effective dialogue between users and health service managers; and, innovation around professional roles and the use of ICT that other health systems could learn from. All this leads to health outcomes on a par with several OECD economies. Nevertheless, serious strains are evident: spending is rising steeply, fuelled by salaries, fees and facility payments based on last year’s outlay. These spending increases are not always associated with improvement in services: waiting lists are excessively long and growing. The system is perhaps too stable: institutional rigidity and vested interests have stalled vital reforms, meaning that Costa Rica still lacks systematic application of DRGs and health technology assessment, despite attempts to bring them in.